Self-Reflection Linked to Improved Late-Life Cognition and Brain Health

Summary: A person’s ability to self-reflect is associated with cognition and glucose metabolism later in life, a new study finds. Those who engage in more self-reflection had improved cognition, better overall brain health, and increased glucose metabolism later in life.

Source: UCL

Self-reflection is positively associated with cognition late in life as well as glucose metabolism, a marker of brain health, finds a new study led by UCL researchers.

The authors of the new study, published in Neurology, say that older adults who engage in self-reflection may have a reduced risk of dementia.

Lead author, Ph.D. student Harriet Demnitz-King (UCL Psychiatry), says that “there is a growing body of evidence finding that positive psychological factors, such as purpose in life and conscientiousness, may reduce the risk of dementia.

Finding further ways to reduce the risk of dementia is an urgent priority, so we hope that as self-reflection capabilities can be improved upon, it could be a useful tool in helping people to stay cognitively healthy as they age.”

“Anyone can engage in self-reflection and potentially increase how much they self-reflect, as it is not dependent on physical health or socioeconomic factors.”

The study used cross-sectional data (rather than reporting results of the trial interventions) from two clinical trials, Age-Well and SCD-Well, that included a total of 259 participants with mean ages of 69 and 73. They answered questions about reflective pondering, measuring how often they think about and try to understand their thoughts and feelings.

The researchers found that people who engaged more in self-reflection had better cognition and improved glucose metabolism as shown by brain imaging. The researchers did not find any association with amyloid deposition, the build-up of harmful brain proteins linked to Alzheimer’s disease.

Previous research has shown that self-reflection capabilities can be improved with a recently tested psychological intervention, and the researchers say that such a program might be useful for people at risk of dementia.

Harriet Demnitz-King explained that “other studies have found that a self-reflective thinking style leads to a more adaptive stress response, with evidence even showing improvements in inflammatory responses to stress and better cardiovascular health, so this may be how self-reflection could improve our resilience against cognitive decline.”

They caution that while their findings suggest that engagement in self-reflection helps to preserve cognition, they cannot rule out that it might instead be that people with better cognition are also better able to self-reflect, and suggest that more, longitudinal research is needed to determine the direction of causation.

Senior author Dr. Natalie Marchant (UCL Psychiatry) says that “with no disease-modifying treatments yet available, it is important that we find ways to prevent dementia; by finding out which factors make dementia or cognitive decline more or less likely, we may be able to develop ways to target these factors and reduce dementia risk.”

“Self-reflection has also been associated with other benefits, such as recovery from depression and better cardiovascular health, so even if we cannot confirm exactly how it might impact cognitive decline, there is other evidence showing its overall benefits.”

This shows a head and a question mark
The researchers found that people who engaged more in self-reflection had better cognition and improved glucose metabolism as shown by brain imaging. Image is in the public domain

Previous studies by Dr. Marchant have found that repetitive negative thinking may increase the risk of Alzheimer’s disease, while mindfulness may help to improve cognition in older adults.

Dr. Richard Oakley, Associate Director of Research at Alzheimer’s Society, commented that “in this study researchers showed for the first time that self-reflection—reflecting on your own thoughts, feelings and behaviors—was linked to better brain function in areas of the brain known to be affected by dementia.”

“While more research is needed to fully understand the implications of this finding, if self-reflection does seem to have a positive effect on brain function, there’s a chance one day we could reduce the risk of dementia with psychological treatments that help people build healthy thought patterns.”

“The number of people living with dementia in the UK is set to rise to 1.6 million by 2040—the Government committing to double dementia research funding will ensure researchers can explore every way to reduce the risk.”

About this aging and self-reflection research news

Author: Chris Lane
Source: UCL
Contact: Chris Lane – UCL
Image: The image is in the public domain

Original Research: Closed access.
Association Between Self-Reflection, Cognition, and Brain Health in Cognitively Unimpaired Older Adults” by Harriet Demnitz-King et al. Neurology


Association Between Self-Reflection, Cognition, and Brain Health in Cognitively Unimpaired Older Adults

Background and Objectives: Self-reflection (the active evaluation of ones thoughts, feelings and behaviours) can confer protection against adverse health outcomes. Its impact on markers sensitive to Alzheimer’s disease (AD), however, is unknown. The primary objective of this cross-sectional study was to examine the association between self-reflection and AD-sensitive markers.

Methods: This study utilised baseline data from cognitively unimpaired older adults enrolled in the Age-Well clinical trial and older adults with subjective cognitive decline from the SCD-Well clinical trial. In both cohorts, self-reflection was measured via the reflective pondering subscale of the Rumination Response Scale, global cognition assessed via the Preclinical Alzheimer’s Cognitive Composite 5, and a modified late-life Lifestyle-for-Brain-Health (LIBRA) index computed to assess health and lifestyle factors.

In Age-Well, glucose metabolism and amyloid deposition were quantified in AD-sensitive grey matter regions via FDG- and AV45-PET scans, respectively. Associations between self-reflection and AD-sensitive markers (global cognition, glucose metabolism, and amyloid deposition) were assessed via unadjusted and adjusted regressions. Further, we explored whether associations were independent of health and lifestyle factors. To control for multiple comparisons in Age-Well, false discovery rate corrected p-values (pFDR) are reported.

Results: A total of 134 (mean age 69.3 ± 3.8 years, 61.9% female) Age-Well and 125 (mean age 72.6 ± 6.9 years, 65.6% female) SCD-Well participants were included. Across unadjusted and adjusted analyses self-reflection was positively associated with global cognition in both cohorts (Age-Well: adjusted-β = 0.22, 95% confidence interval [CI] 0.05-0.40, pFDR = 0.041; SCD-Well: adjusted-β = 0.18, 95% CI 0.03-0.33, p = 0.023) and with glucose metabolism in Age-Well after adjustment for all covariates (adjusted-β = 0.29, 95% CI 0.03-0.55, pFDR = 0.041). Associations remained following additional adjustment for LIBRA but did not survive FDR correction. Self-reflection was not associated with amyloid deposition (adjusted-β = 0.13, 95% CI -0.07-0.34, pFDR = 0.189).

Discussion: Self-reflection was associated with better global cognition in two independent cohorts and with higher glucose metabolism after adjustment for covariates. There was weak evidence that relationships were independent from health and lifestyle behaviours. Longitudinal and experimental studies are warranted to elucidate whether self-reflection helps preserve cognition and glucose metabolism, or whether reduced capacity to self-reflect is a harbinger of cognitive decline and glucose hypometabolism.

Trial Registration: Age-Well: NCT02977819; SCD-Well: NCT03005652

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