Purpose in Life Is Associated With a Reduced Risk of Incident Disability Among Community-Dwelling Older Persons

Background: Purpose in life is thought to be associated with positive health outcomes in old age, but its association with disability is unknown. Objective: Test the hypothesis that greater purpose in life is associated with a reduced risk of incident disability, including impairment in basic and instrumental activities of daily living and mobility disability, among community-based older persons free of dementia. Design: Participants were from the Rush Memory and Aging Project, a large longitudinal clinical-pathologic study of aging. Setting: Retirement communities, senior housing facilities, and homes across the greater Chicago metropolitan area. Measurements: All participants underwent baseline assessment of purpose in life and detailed annual clinical evaluations to document incident disability. Results: The mean score on the purpose in life measure at baseline was 3.6 (standard deviation = 0.5, range: 2-5). In a series of proportional hazards models adjusted for age, sex, and education, greater purpose in life was associated with a reduced risk of disability in basic activities of daily living (hazard ratio [HR] = 0.60, 95% confidence interval [C1] = 0.45-0.81), instrumental activities of daily living (HR = 0.56, 95% CI = 0.40-0.78), and mobility disability (HR = 0.61, 95% CI = 0.44-0.84). These associations did not vary along demographic lines and persisted after the addition of terms to control for global cognition, depressive symptoms, social networks, neuroticism, income, physical frailty, vascular risk factors, and vascular diseases. Conclusions: Among community-based older persons without dementia, greater purpose in life is associated with maintenance of functional status, including a reduced risk of developing impairment in basic and instrumental activities of daily living and mobility disability. (Am J Geriatr Psychiatry 2010; 18: 1093-1102)