Religion, spirituality, and healthy cognitive aging.

Research suggests that religious involvement favors health and longevity. Studies are beginning to show that religious involvement may also benefit cognitive functioning in late life. This article reviews and discusses research on religion, spirituality, and healthy cognitive aging.

Van Ness and Kasl were among the first to consider the effects of religious attendance and religious identity on cognitive functioning. (1) They used data from the New Haven Established Populations for the Epidemiologic Studies of the Elderly survey, a sample of 2,812 men and women aged 65 and over. Pfeiffer's Short Portable Mental Status Questionnaire was used to assess cognitive functioning over 6 years. The study incorporated several relevant control variables, including sociodemographic characteristics, drinking and smoking, depression, chronic conditions, physical activity, disability, baseline cognitive functioning, and secular forms of social engagement. Results showed that religious attendance, not religious identity, was associated with a reduction in the odds of cognitive dysfunction over time. Compared with those who attended religious services less than once per week, those who attended services at least once per week exhibited a 36% reduction in cognitive dysfunction over 3 years.

Kaufman and colleagues considered the association between religious involvement and cognitive decline over 3 years. (2) They collected data from 68 individuals between the ages of 49 and 94, with mixed social and religious backgrounds, who met the criteria for Alzheimer disease. The researchers used the Duke University Religion Index and the Fetzer Institute's Brief Multidimensional Measure of Religiousness and Spirituality to measure religious involvement. The Mini-Mental State Examination was used to assess cognitive decline. Results showed that higher levels of religiosity and religious practice were associated with slower rates of cognitive decline in Alzheimer patients. The researchers concluded that spirituality and religious practices may delay the progression of Alzheimer disease.

Hill and colleagues investigated whether religious attendance was associated with slower rates of cognitive decline among older Mexican Americans. (3) They used data from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly survey, a sample of 3,050 Mexican-origin men and women aged 65 and over, residing in the Southwestern United States. The Mini-Mental State Examination was used to assess cognitive decline over 8 years. The study controlled for several important background characteristics, including sociodemographic characteristics, English proficiency, drinking and smoking, depression, chronic conditions, sensory impairments, disability, baseline cognitive functioning, and secular forms of social engagement. Results demonstrated that religious attendance was associated with slower rates of cognitive decline among older Mexican Americans. Specifically, respondents who attended religious services monthly, weekly, and more than weekly exhibited slower rates of cognitive decline than those who did not attend services.

Although researchers have only begun to consider the connection between religion and healthy cognitive aging, there are several viable theoretical explanations for this relationship. Religious involvement is associated with a greater sense of coherence, meaning, and hope. If these factors help the elderly to cope with stress, anxiety, and depression, various aspects of religious involvement may buffer against hippocampal atrophy, cognitive decline, and the progression of Alzheimer disease.

Religious attendance in particular may involve a number of activities that are likely to stimulate cognitive faculties, including sermons, prayer, scriptural study, singing, philosophical discussions, and general socializing. If social ties and activities stimulate cognitive faculties, they may delay the deterioration of cognitive performance in old age, presumably through the maintenance of dense neocortical synapses in the brain.

If social engagement promotes healthy cognitive aging, it is important for physicians to emphasize the significance of social activities when treating elderly patients. The elderly can become socially isolated under any number of conditions, including the loss of a spouse, poor health, and transportation restrictions. If physicians promote social activities, elderly patients, their family members, and caregivers may be motivated to coordinate efforts to overcome these circumstances. Given the studies reviewed in this article, which suggest that religious attendance may benefit cognitive functioning over and above other forms of social engagement, it may be important for physicians to consider barriers to religious activities in particular when treating elderly patients.

References

1. Van Ness PH, Kasl SV. Religion and cognitive dysfunction in an elderly cohort. J Gerontol B Psychol Sci Soc Sci 2003;58B:S21-S29.

2. Kaufman Y, Binns A, Freedman M. The effects of spirituality and religiosity on the rates of cognitive decline and quality of life in Alzheimer disease. Miami, FL: 57th Annual Meeting of the American Academy of Neurology, April 13, 2005.

3. Hill T, Burdette A, Angel J, et al. Religious attendance and cognitive functioning among older Mexican Americans. J Gerontol B Psychol Sci Soc Sci 2006;61:P3-P9.

Our lives are to be used and thus to be lived as fully as possible, and
truly it seems that we are never so alive as when we concern ourselves
with other people.
--Harry Chapin

Terrence D. Hill, PhD

From the Department of Sociology, the University of Miami, Coral Gables, FL.

Reprint requests to Terrence D. Hill, PhD, Department of Sociology, The University of Miami, PO Box 248162. Coral Gables, FL 33124. Email: [e-mail]