title: Purpose in life and cerebral infarcts in community-dwelling older people.
abstract: OBJECTIVE
  Purpose in life, the sense that life has meaning and direction, is associated with reduced risks of adverse health outcomes. However, it remains unknown whether purpose in life protects against the risk of cerebral infarcts among community-dwelling older people. We tested the hypothesis that greater purpose in life is associated with lower risk of cerebral infarcts.
  
  
  METHODS
  Participants came from the Rush Memory and Aging Project. Each participant completed a standard measure of purpose in life. Uniform neuropathologic examination identified macroscopic infarcts and microinfarcts, blinded to clinical information. Association of purpose in life with cerebral infarcts was examined in ordinal logistic regression models using a semiquantitative outcome.
  
  
  RESULTS
  Four hundred fifty-three participants were included in the analyses. The mean score on the measure of purpose was 3.5 (SD, 0.5; range, 2.1-5.0). Macroscopic infarcts were found in 154 (34.0%) people, and microinfarcts were found in 128 (28.3%) people. Greater purpose in life was associated with a lower odds of having more macroscopic infarcts (odds ratio, 0.535; 95% confidence interval, 0.346-0.826; P=0.005), but we did not find association with microinfarcts (odds ratio, 0.780; 95% confidence interval, 0.495-1.229; P=0.283). These results persisted after adjusting for vascular risk factors of body mass index, history of smoking, diabetes mellitus, and blood pressure, as well as measures of negative affect, physical activity, and clinical stroke. The association with macroscopic infarcts was driven by lacunar infarcts, and was independent of cerebral atherosclerosis and arteriolosclerosis.
  
  
  CONCLUSIONS
  Purpose in life may affect risk for cerebral infarcts, specifically macroscopic lacunar infarcts.
authors: From the Rush Alzheimer's Disease Center (L.Y., P.A.B., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (L.Y., R.S.W., J.A.S., D.A.B.), Department of Behavioral Sciences (P.A.B., R.S.W.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn (S.R.L.); and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.). lei_yu@rush.edu.
authors: Lei
authors: L
authors: Yu
authors: From the Rush Alzheimer's Disease Center (L.Y., P.A.B., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (L.Y., R.S.W., J.A.S., D.A.B.), Department of Behavioral Sciences (P.A.B., R.S.W.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn (S.R.L.); and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors: Patricia A
authors: PA
authors: Boyle
authors: From the Rush Alzheimer's Disease Center (L.Y., P.A.B., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (L.Y., R.S.W., J.A.S., D.A.B.), Department of Behavioral Sciences (P.A.B., R.S.W.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn (S.R.L.); and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors: Robert S
authors: RS
authors: Wilson
authors: From the Rush Alzheimer's Disease Center (L.Y., P.A.B., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (L.Y., R.S.W., J.A.S., D.A.B.), Department of Behavioral Sciences (P.A.B., R.S.W.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn (S.R.L.); and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors: Steven R
authors: SR
authors: Levine
authors: From the Rush Alzheimer's Disease Center (L.Y., P.A.B., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (L.Y., R.S.W., J.A.S., D.A.B.), Department of Behavioral Sciences (P.A.B., R.S.W.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn (S.R.L.); and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors: Julie A
authors: JA
authors: Schneider
authors: From the Rush Alzheimer's Disease Center (L.Y., P.A.B., R.S.W., J.A.S., D.A.B.), Department of Neurological Sciences (L.Y., R.S.W., J.A.S., D.A.B.), Department of Behavioral Sciences (P.A.B., R.S.W.), and Department of Pathology (J.A.S.), Rush University Medical Center, Chicago, IL; Department of Neurology and Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn (S.R.L.); and Department of Neurology, Kings County Hospital Center, Brooklyn, NY (S.R.L.).
authors: David A
authors: DA
authors: Bennett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology / Q000523:psychology*; D002544:Cerebral Infarction / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D018570:Risk Assessment
keywords: aging; cerebral infarcts; lacunar; purpose in life