What does your psychological approach to life say about your brain health?

As we age, our brains naturally change. While some mild changes in cognition are considered a normal part of the aging process, severe decline is abnormal and can be associated with deterioration in brain health, mental health, and risk of developing dementia.

To maximise the years of life in good health, it is essential to identify both risk and protective factors of cognitive decline. But, until now, the influence of psychological characteristics (including personality traits, thinking styles and outlook on life) have been relatively overlooked.

The current research, published in Nature Mental Health explored the health profiles and psychological characteristics of 750 middle-aged adults who were part of the Barcelona Brain Health Initiative (BBHI) and 282 older adults, part of the Medit-Ageing study.

In both cohorts independently, the researchers found evidence for three distinct psychological profiles. The first group had low protective characteristics, these people scored low for traits such as extraversion, openness to experience and purpose in life. The second group had high risk characteristics, scoring high for traits such as brooding, worry and neuroticism, traits which have been linked to cognitive decline and dementia. The final group displayed well-balanced characteristics, they scored relatively high for the protective traits such as purpose in life and low for the risk characteristics, such as worry (see Figure 1 below).

These three psychological profiles were related to differences in cognitive performance, mental health, and brain health trajectories.

Compared to the other profiles, a profile of low protective characteristics was associated with greater dementia risk scores in both middle and older-age and worse cognitive performance in older age. This group also showed greater cortical thinning in both non-Alzheimer’s and Alzheimer’s-sensitive brain regions.

Those who displayed high risk characteristics, such as a proneness for negative thoughts like brooding, worry and anxiety exhibited the greatest symptoms of depression, anxiety and loneliness, and worst sleep quality compared with the other profiles. However, compared to the ‘well balanced’ profile, there were no differences in objective measures of age-related health like cognition or cortical thickness.

Having a ‘well-balanced’ psychological profile with moderately high protective and moderately low risk factors was related to better cognitive and mental health outcomes in both cohorts.

Approximately two-thirds of those in the BBHI cohort of middle-aged adults were followed up after 2.3 years. Longitudinal analyses showed that psychological profile membership was associated with change in cortical thickness. Those with low protective characteristics exhibited accelerated brain atrophy compared to the other profiles (see Figure 2).

Emphasising the potential impact of these findings, Senior author, Dr Natalie Marchant UCL Division of Psychiatry, said: "Our study provides valuable insights into how different psychological profiles are related to health in ageing. By adopting a person-centered approach, we have identified three profiles with quite different and distinct associations in terms of cognition, mental health and brain health.

“This highlights the potential for more personalised interventions to prevent cognitive decline and dementia, tailored to the unique psychological profiles of individuals."

Related

• Read the research paper in Nature Mental Health
• Dr Natalie Marchant's academic profile