Cognitive aging and dementia prevention: the time for psychology?

Abstract

Modifiable risk and protective factors (e.g. engaging in active lifestyles and avoiding alcohol or smoking amongst others) are seen as key agents for dementia prevention [1], and they also exert an important effect on cognitive trajectories of non-demented older adults [2]. Within this context, recent research has begun to identify psychological processes that confer relative risk and protection. For example, repetitive negative thinking (RNT), a cognitive process defined by self-relevant, persistent thoughts that elaborate on negative themes, has been associated with greater burden of typical Alzheimer’s disease (AD) pathological brain markers and accelerated cognitive decline over time [3]. In contrast, self-reflection [4], as well as purpose in life and other components of psychological well-being, may help to maintain cognition and boost cognitive resilience against neuropathological burden [5]. The possibility of incorporating psychological elements as key players in affecting one of the most important public health issues of the century opens a window of great therapeutic opportunity, particularly because fundamental psychological processes are at the core of cognitive-behavioural interventions that may help reduce dementia risk [6]. However, for this emergent area to develop and wield maximum benefit, major unanswered questions need to be addressed. Here, we highlight three main areas for future research.