Oct. 1, 2024 — Charles Dickens, the famous 19th-century British novelist, believed that "the best way to lengthen out our days is to walk steadily and with a purpose.”
Modern science backs him up.
Growing research over the last 2 decades suggests that having a purpose in life may lower the risk of heart problems and prolong life. (Granted, Dickens only lived to 58, but to be fair, life expectancy was less than 40 back then.)
More research also links purpose to brain health: It may ward off all types of dementia, from vascular dementia to Alzheimer’s disease.
“Across every study and every sample that we have looked at, we find that feeling more purposeful is related to a lower risk of developing dementia,” said Angelina Sutin, PhD, a cognitive psychologist at Florida State University.
Defining purpose isn’t easy. For Ralph Waldo Emerson, it meant “to be useful, to be honorable, to be compassionate.” For Sutin, it’s a feeling that one’s life is future-oriented and “moving towards a larger goal.”
“There's this long-term intentionality to it,” said Emily Mroz, PhD, a social behavioral researcher at Emory University. “Purpose in life is not something you are doing today or this week, or even this year.”
Your purpose doesn’t have to be grand, either. While curing cancer is certainly a noble goal, Sutin said, a life’s purpose can be as simple as “gardening because you want to create a beautiful space for your neighborhood.”
While scientists distinguish “meaning” from purpose — with meaning being a larger, more encompassing idea; a perception that one’s life has significance and coherence — Sutin acknowledges that “a regular person on the street doesn't necessarily make these distinctions.” That can complicate research.
Yet no matter how scientists frame their survey questions, links between meaning, purpose, and dementia risk remain strong.
What the Research Shows
When Sutin and her colleagues analyzed data from over 150,000 British people, they discovered that those who felt their life to be meaningful had a 35% decreased risk of dementia — a benefit comparable to that of regular exercise. A 2022 meta-analysis of studies from 32 countries suggests that meaning and purpose keep our brains sharp: Those who reported these feelings in abundance performed best on tests of memory and verbal fluency — for example, listing as many animals as possible in 60 seconds. (Such tests can pick up warning signs of dementia.) Having purpose may delay the onset of Alzheimer’s by as much as 6 years, other research shows.
In a 2024 study, researchers at the University of Wisconsin-Madison used diffusion MRI — an advanced imaging technique that lets scientists look at very small structures of the brain — to examine the brains of more than 100 adults ages 48 to 95. They found that people lacking a sense of purpose have differences in their neurons (brain cells) suggesting their brains are less healthy than those of people with greater feelings of purpose.
They may experience “loss of myelin, which is a sort of an insulator around neurons,” said lead study author Ajay Nair, PhD, a neuroscientist at the University of Wisconsin–Madison. Such changes are particularly apparent in the hippocampus, a sea horse-shaped part of the brain responsible for learning and memory. These alterations “are happening at a very, very small level,” Nair said, so the person affected may not be aware that something is off.
Which Came First: Purpose or a Healthy Brain?
One big question these observational studies can’t answer is causality. Does a sense of purpose protect the brain from dementia? Or does dementia diminish feelings of purpose and meaning?
“I think both have merit,” Mroz said. She believes purpose and dementia create a feedback loop: If you are low on purpose, your cognitive function may deteriorate; and if your cognitive function deteriorates, finding purpose may become harder.
Several arguments support the idea that purpose influences dementia risk, Sutin said.
“Some studies on dementia risk have looked at purpose measured 10, 20 years before dementia [sets in],” she said. “And the associations are the same.” Cognitive decline is not likely to affect purpose that long before symptoms begin, Sutin said.
What’s more, several mechanisms might explain the beneficial effects of purpose on dementia risk.
Some of these are behavioral. For instance, since people with purpose have plans and goals, they may try to stay in shape so they have the energy to fulfill them. “You want to stay fit and healthy, so you might be exercising more,” Nair said. Research shows that feelings of purpose motivate people to be physically active, eat healthy, stay socially connected, stop smoking, and go for regular medical checkups — all behaviors linked to lower dementia risk.
More direct mechanisms may be at play, too.
“Purpose helps keep the brain active,” Sutin said, “and we know that keeping the brain active and engaged is protective of Alzheimer's or cognitive impairment.”
In a study published this year, she and her colleagues gave smartphones to more than 300 volunteers. The phones buzzed several times a day, asking users how purposeful they felt and prompting them to do simple cognitive tests. Results showed that in moments when people felt more purposeful, their brains processed information faster.
Having a strong sense of purpose can also help you deal with stress, which is associated with a higher risk for dementia and Alzheimer’s. People with purpose tend to report less stress in their daily lives — an effect that’s been observed across various populations, from older adults in Brazil to deep-sea mariners in Poland and African Americans in Chicago. Of note: They report the same number of daily stressors — arguments at work, discrimination — but say they feel less stressed by these events than do people who are low on purpose.
Purpose may imbue a certain resilience, helping you recover faster from negative emotions: Some research suggests that purposeful people’s physical response to stressors calms down more quickly than it does for less purpose-oriented folks. On a biological level, having a sense of purpose has been linked to lower levels of chronic inflammation, even years down the road — an important finding, given that inflammation is another predictor of dementia.
Finding Your Purpose
Purpose has been linked to many other health benefits: lower risk of stroke and Parkinson’s disease, slower aging, and lower risk of falling among older adults. Yet about two-thirds of middle-aged and older Americans lack purpose in their lives.
So how do you go about finding purpose?
Some experts suggest an exercise called life crafting: You reflect on your values and passions, as well as your ideal future, and assess how well these align with your life. Then you create a detailed plan — literally write it down — to achieve specific, meaningful life goals that embody these values. They may include babysitting your grandkids, raising funds for a charity, or improving the community where you live. Other strategies involve mindfulness and cognitive-behavioral therapy.
One thing to remember, Sutin said, is that a sense of purpose in life is very individual: “What is purposeful for one person might not be purposeful for another.” The key is finding a purpose that feels right for you.
The best time to start is now: A sense of purpose in life tends to decline with age and drops sharply after a dementia diagnosis. But even if Alzheimer’s-related brain changes have already begun, developing a sense of purpose may buffer against the damaging effects.
When researchers from Rush University Medical Center conducted long-term observations of patients with Alzheimer’s — and later performed postmortem autopsies on their brains — they found that those with a greater sense of purpose had more agile minds than patients lacking purpose. This held true even if they had similar pathological changes in their brains.
Helping Patients With Dementia Find Purpose
For Mroz, such data underlines the importance of helping people with dementia find purpose. External factors related to the diagnosis — like beliefs that they are less capable or everyday tasks becoming harder — often interfere with the ability to experience purpose and meaning.
But in her research, Mroz has found that patients with mild to moderate dementia “are really motivated to pursue a sense of purpose,” she said. “A lot of them ended up being other-focused as opposed to self-focused.”
At Emory University, where Mroz works, there is an Integrated Memory Care Clinic that offers holistic care and psychological support to people with dementia, helping them redefine what they can or can’t do.
Mroz would like to see more such efforts around the country, where people with dementia could find support in their search for meaning and purpose. We need to change “the stigma around what dementia is and what people can do in their lives,” she said.
Finding purpose may also be particularly beneficial for middle-aged adults at risk for dementia.
“If I have a family history of dementia, then I need to be particularly careful and vigilant and think about it thoughtfully,” Nair said. “If you do this in your 40s and 50s, then the likelihood of having a healthier life is much better.”
