This review focuses on the role of psychological factors in cognitive aging and dementia, an area that has received less attention compared to other modifiable factors (e.g. sleep, physical activity, and so on) or reduction of disease risk. A range of mental health and psychological aspects, including clinical symptoms, stable personality traits, and more specific constructs or processes (e.g. repetitive negative thinking, purpose in life), are associated with cognitive aging and dementia risk. Psychological factors can either serve as protective or risk elements, influencing brain health through general mechanisms, including stress regulation and impact on several biological systems, as well as modulate brain resistance and cognitive resilience to Alzheimer's disease and age-related brain changes. Protective psychological traits are linked to healthier lifestyle habits, while risk factors are associated with negative behaviors, and may impact cognitive function across the lifespan, suggesting benefits for psychological education from early life. The review emphasizes the need for greater focus on optimizing psychological well being, particularly in at-risk populations, and suggests that interventions should be tailored to individuals' values and life purposes. Additionally, further research is needed to explore the neurobiological mechanisms through which psychologically focused interventions may influence cognitive decline and dementia.
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