Cultivating Regular Physical Activity: Associations among Purpose in Life, Physical Activity, and Cognitive Function in Alzheimer's Disease and Related Dementias

About This Grant

Abstract Physical activity (PA) is a significant area of research in aging, dementia, and cognitive impairment (CI), but regular PA may be challenging to begin and sustain for older adults with cognitive impairment (OACI). One way to engage OACI in PA is to set goals to enhance motivation. While this has succeeded in rehabilitative settings and residential care facilities, there remains a gap in knowledge on PA goalsetting among community- dwelling OACI to maintain function and independence. A recent area of interest in PA and goalsetting is purpose in life (PiL), which is defined as the subjective experience of living with meaning and direction. Older adults with greater PiL tend to be more physically active, likely because they connect their PiL and long-term goals with the importance of PA. However, utilizing PiL as motivation for regular PA likely requires higher-order cognitive abilities that older adults with more advanced CI may not have. Furthermore, while the most currently validated PiL measurement developed by Ryff and colleagues has been successfully administered among OACI, there is concern that this PiL measurement may not entirely suit the circumstances of OACI. Since preliminary analyses further found that this measurement did not fit data from the Health and Retirement Study (HRS) well among OACI, there is a need to refine the measurement of PiL for OACI to ensure applicability. The goal of this study is to understand who can connect PiL to PA among OACI and how. Aim 1 refines the measurement of PiL among OACI using the HRS. Items from Ryff's HRS PiL framework will be assessed using a confirmatory factor analysis (CFA) for applicability to OACI based on current literature, and a modified model will be proposed using a subset of HRS PiL items. Aim 2 employs the HRS to evaluate the association between PiL and PA among older adults with varying degrees of CI. This aim is based on the hypothesis that the degree of CI moderates the association between PiL and PA, such that the association between PiL and PA is similar and strong among older adults without CI and older adults with mild cognitive impairment (MCI) but weaker among older adults with dementia. Lastly, Aim 3 qualitatively investigates how older adults with MCI and mild dementia evaluate PiL and incorporate PiL into PA goalsetting. The authors propose that connecting one's PiL to one's PA goals leads to enhanced motivation for and engagement in regular PA. This aim uses the ongoing Promoting In-Home Activities at a Memory & Aging Clinic (P30AG022849-19 sub-fund, PI: Muramatsu), a PA intervention with PA goalsetting for inactive older adults with MCI or mild dementia. Aim 3 will identify participants' PiL, support the development of personalized and meaningful PA goals, and observe how participants engage in the PA intervention when involving their PiL. Findings from this study will be triangulated and used to develop themes for clinical tools to motivate OACI to engage in regular PA.