By Valentin Ourry

(posted 16th March 2021)

Ageing well is not just having good cognitive and brain health, it is also having good physical and mental health – a good quality of life.

The World Health Organization defines quality of life as “individuals’ perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns”. This  encompasses many aspects – or domains – including physical health, psychological health, social relationships, as well as our relationship with the environment [1].

As we age, quality of life can decrease [2]. Interestingly, previous studies have shown that better quality of life is related to greater brain volume in older adults [3], [4]. However, these studies did not look at the multi-faceted domains of quality of life with multimodal brain measurements. Yet this is crucial to better understand the mechanisms of the relationship between quality of life and brain health, and more specifically: i) to identify the specific aspect of quality of life that is more related to brain health, and ii) to provide a comprehensive overview of the nature of the relationship.

In our study [5], we included the 135 participants of the Age-Well cohort from the Medit-Ageing project. Participants completed a multi-domain quality of life questionnaire devised by the World Health Organization. Using a range of neuroimaging techniques, we were able to obtain their detailed brain characteristics: grey matter volume (density of neurons), white matter microstructural integrity (density of axons), perfusion (quality of blood circulation) and amyloid deposition (one of the biomarkers of Alzheimer’s disease). We then assessed whether there were any links between each quality of life domain and each brain characteristic. Interestingly, we found that better quality of life, particularly physical health, was related to brain structures (greater grey matter volume and white matter microstructural integrity) in regions relevant to ageing. No link was found with brain perfusion or amyloid deposition. The results highlight the relevance of monitoring and promoting quality of life in the older population, and particularly self-perceived physical health.

Better understanding the relationship between quality of life and brain health in ageing is an important part of the Medit-Ageing project. This is because we believe that mental training may help us to age well and maintain a good quality of life – one of the main goals of the Medit-Ageing project.

References:

[1]       The WHOQOL Group, “Development of the WHOQOL: Rationale and Current Status,” International Journal of Mental Health, vol. 23, no. 3, pp. 24–56, Sep. 1994, doi: 10.1080/00207411.1994.11449286.

[2]       G. Netuveli, R. D. Wiggins, Z. Hildon, S. M. Montgomery, and D. Blane, “Quality of life at older ages: evidence from the English longitudinal study of aging (wave 1),” Journal of Epidemiology & Community Health, vol. 60, no. 4, pp. 357–363, Apr. 2006, doi: 10.1136/jech.2005.040071.

[3]       V. Elderkin-Thompson, M. Ballmaier, G. Hellemann, D. Pham, H. Lavretsky, and A. Kumar, “Daily Functioning and Prefrontal Brain Morphology in Healthy and Depressed Community-Dwelling Elderly,” The American Journal of Geriatric Psychiatry, vol. 16, no. 8, pp. 633–642, Aug. 2008, doi: 10.1097/JGP.0b013e3181794629.

[4]       S. Hahm, M. Lotze, M. Domin, and S. Schmidt, “The association of health-related quality of life and cerebral gray matter volume in the context of aging: A voxel-based morphometry study with a general population sample,” NeuroImage, vol. 191, pp. 470–480, May 2019, doi: 10.1016/j.neuroimage.2019.02.035.

[5]       V. Ourry et al., “Association of quality of life with structural, functional and molecular brain imaging in community-dwelling older adults,” NeuroImage, vol. 231, p. 117819, May 2021, doi: 10.1016/j.neuroimage.2021.117819.