Meaning and Purpose in Life in Aging: A Scoping Review

Alonso, Vanessa; Defanti, Fernanda M. G.; Neri, Anita L.; Cachioni, Meire

doi:10.1590/0102.3772e39306.en

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School and Developmental Psychology • Psic.: Teor. e Pesq. 39 • 2023 • https://doi.org/10.1590/0102.3772e39306.en copy

Meaning and Purpose in Life in Aging: A Scoping Review

Sentido e Propósito de Vida na Velhice: Uma Revisão de Escopo

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The feeling that life has meaning or purpose is essential for human beings. Absence of meaning can lead to an existential vacuum. Purpose in life, akin to meaning in life, derives from the humanistic psychology theory of Frankl, and they are considered synonymous. Other scholars, however, regard the two constructs as distinct. The objective of the review was to map both concepts in the gerontological literature, examining how they manifest in aging. The review of the databases was carried out between January 2019 and March 2020. Thirty articles were included. In the context of aging, results were conflicting. The literature review yielded evidence to affirm that meaning and purpose in life are distinct concepts, despite sharing the same existential-philosophical roots.

KEYWORDS:
aging; psychology; review; purpose in life; meaning in life

Database	Search strategy
PUBMED	(((((((Aging[MeSH Terms]) OR Aging[Title/Abstract]) OR Senescence[Title/Abstract]) OR “Biological Aging”[Title/Abstract]) OR “Aging, Biological”[Title/Abstract])) AND ((“purpose in life”) OR “meaning in life”)) AND (((((Aged) OR Elderly)) OR ((((((((((Aged, 80 and over[MeSH Terms])) OR (“Aged, 80[Title/Abstract] AND over”[Title/Abstract])) OR “Oldest Old”[Title/Abstract]) OR Nonagenarians[Title/Abstract]) OR Nonagenarian[Title/Abstract]) OR Octogenarians[Title/Abstract]) OR Octogenarian[Title/Abstract]) OR Centenarians[Title/Abstract]) OR Centenarian[Title/Abstract])) OR ((“old people”) OR “old adults”))
PUBMED PMC	(((((((Aging[MeSH Terms]) OR Aging[Title/Abstract]) OR Senescence[Title/Abstract]) OR “Biological Aging”[Title/Abstract]) OR “Aging, Biological”[Title/Abstract])) AND ((“purpose in life”) OR “meaning in life”)) AND (((((Aged) OR Elderly)) OR ((((((((((Aged, 80 and over[MeSH Terms])) OR (“Aged, 80[Title/Abstract] AND over”[Title/Abstract])) OR “Oldest Old”[Title/Abstract]) OR Nonagenarians[Title/Abstract]) OR Nonagenarian[Title/Abstract]) OR Octogenarians[Title/Abstract]) OR Octogenarian[Title/Abstract]) OR Centenarians[Title/Abstract]) OR Centenarian[Title/Abstract])) OR ((“old people”) OR “old adults”))
BVS / BIREME MEDLINE LILACS CUMED IBECS INDEXPSI	((“Propósito na vida” OR “purpose in life” OR “propósitos en la vida”) OR (“sentido na vida” OR “meaning in life” OR “sentido de la vida”)) AND (aging OR envejecimiento OR envelhecimento) AND ((aged OR anciano OR idoso) OR (“Aged, 80 and over” OR “Anciano de 80 o más Años” OR “Idoso de 80 Anos ou mais”) OR (“old people” OR “old adults” OR ancianos OR “personas mayores” OR seniores)) AND (instance:”regional”)
CINAHL - The Cumulative Index to Nursing and Allied Health Literature	(MH “Aging”) OR “Aging” OR Aging OR Senescence OR “Biological Aging” OR “Aging, Biological” AND (MH “Life Purpose”) OR “purpose in life” OR “meaning in life” AND (Aged OR Elderly) OR (“Aged, 80 and over” OR “Oldest Old” OR Nonagenarians OR Nonagenarian OR Octogenarians OR Octogenarian OR Centenarians OR Centenarian ) OR ( “old people” OR “old adults” )
SCOPUS	(TITLE-ABS-KEY (aging OR senescence OR “Biological Aging” OR “Aging, Biological” ) ) AND ( ( ALL ( “purpose in life” ) OR ALL ( “meaning in life” ) ) ) AND ( ( ALL ( aged OR elderly ) ) OR ( ALL ( “Aged, 80 and over” OR “Oldest Old” OR nonagenarians OR nonagenarian OR octogenarians OR octogenarian OR centenarians OR centenarian ) ) OR (ALL ( “old people” OR “old adults” ) ) )
WEB OF SCIENCE	TÓPICO: (Aging OR Senescence OR “Biological Aging” OR “Aging, Biological”) Índices=SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, ESCI Tempo estipulado=Todos os anos AND TÓPICO: (“purpose in life”) OR TÓPICO: (“meaning in life”) Índices=SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, ESCI Tempo estipulado=Todos os anos AND TÓPICO: (Aged OR Elderly) Índices=SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, ESCI Tempo estipulado=Todos os anos OR TÓPICO: (“Aged, 80 and over” OR “Oldest Old” OR Nonagenarians OR Nonagenarian OR Octogenarians OR Octogenarian OR Centenarians OR Centenarian) Índices=SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, ESCI Tempo estipulado=Todos os anos OR TÓPICO: (“old people” OR “old adults”)
EMBASE	(aged OR elderly OR 'aged, 80 and over' OR 'oldest old' OR nonagenarians OR nonagenarian OR octogenarians OR octogenarian OR centenarians OR centenarian OR 'old people' OR 'old adults') AND ('aging'/exp OR 'aging'/syn) AND ('purpose in life'/exp OR 'purpose in life'/syn OR 'meaning in life'/exp OR 'meaning in life'/syn)
AGELINE	DE “Aging” OR Aging OR Senescence OR “Biological Aging” OR “Aging, Biological” AND DE “Purpose in Life” OR “Purpose in Life” OR “Meaning in Life” AND (Aged OR Elderly ) OR ( “Aged, 80 and over” OR “Oldest Old” OR Nonagenarians OR Nonagenarian OR Octogenarians OR Octogenarian OR Centenarians OR Centenarian ) OR ( “old people” OR “old adults” )
COCHRANE LIBRARY	MeSH descriptor: [Aged] in all MeSH products OR MeSH descriptor: [Aged] in all MeSH products AND (“purpose in life”) OR (“meaning in life”) AND (Aged OR Elderly) OR (“Aged, 80 and over” OR “Oldest Old” OR Nonagenarians OR Nonagenarian OR Octogenarians OR Octogenarian OR Centenarians OR Centenarian) OR (“old people” OR “old adults”)
PSYCINFO	((Any Field: (Aging) OR Any Field: (Senescence) OR Any Field: (“Biological Aging”) OR Any Field: (“Aging, Biological”)) OR (IndexTermsFilt: (“AGING”))) AND ((Any Field: (“purpose in life”)) OR (Any Field: (“meaning in life”))) AND ((Any Field: (“old people”) OR Any Field: (“old adults”)) OR (Any Field: (“Aged, 80 and over”) OR Any Field: (“Oldest Old”) OR Any Field: (Nonagenarians) OR Any Field: (Nonagenarian) OR Any Field: (Octogenarians) OR Any Field: (Octogenarian) OR Any Field: (Centenarians) OR Any Field: (Centenarian)) OR (Any Field: (Aged) OR Any Field: (Elderly)))
PSYCARTICLES	((Any Field: (Aging) OR Any Field: (Senescence) OR Any Field: (“Biological Aging”) OR Any Field: (“Aging, Biological”)) OR (IndexTermsFilt: (“AGING”))) AND ((Any Field: (“purpose in life”)) OR (Any Field: (“meaning in life”))) AND ((Any Field: (“old people”) OR Any Field: (“old adults”)) OR (Any Field: (“Aged, 80 and over”) OR Any Field: (“Oldest Old”) OR Any Field: (Nonagenarians) OR Any Field: (Nonagenarian) OR Any Field: (Octogenarians) OR Any Field: (Octogenarian) OR Any Field: (Centenarians) OR Any Field: (Centenarian)) OR (Any Field: (Aged) OR Any Field: (Elderly)))

Author/year	Country	Sample	Design	Conceptual discussion	Main results
Boyle, Barnes, Buchman, et al. (2009Boyle, P.A., Barnes, L. L., Buchman, A. S., & Bennett, D. A. (2009). Purpose in life is associated with mortality among community-dwelling older persons.Psychosomatic medicine,71(5), 574-579. https://doi.org/10.1097/PSY.0b013e3181a5a7c0 https://doi.org/10.1097/PSY.0b013e3181a5... )	USA	1,238 community-dwelling older adults	Longitudinal	Purpose in life in existentialism line.	High level of purpose in life was associated with reduced risk of mortality.
Burbank (1992Burbank P. M. (1992). An exploratory study: assessing the meaning in life among older adult clients.Journal of gerontological nursing,18(9), 19-28. https://doi.org/10.3928/0098-9134-19920901-06 https://doi.org/10.3928/0098-9134-199209... )	USA	81 community-dwelling older adults	Cross-sectional	Meaning in life in existentialism line	The majority of the sample (89%) reported having something so important that it gave their lives meaning. The categories that most gave life meaning were, in descending order: relationships, religion, service, activities and others such as living/growth, home, health and learning.
Czekierda, Banik, Park, et al. (2017Czekierda, K., Bannik, A., Park, C.L., & Luszczynska, A. (2017). Meaning in life and physical health: systematic review and meta-analysis. Health Psychology Review; 11(4):387-418. https://doi.org/10.1080/17437199.2017.1327325 https://doi.org/10.1080/17437199.2017.13... )	USA (Poland)	66 studies	Systematic review and meta-analysis	Meaning and purpose as synonymous Meaning in life in existentialism line	Weak to moderate association between meaning in life and physical health. Concept of meaning, health status and age were not moderators of these associations. Health operationalization moderated the relationship between meaning in life and health.
Duppen, Machielse, Verté, et al. (2019)	Belgium (Netherlands)	121 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	Socially frail older adults experience meaning in life in different dimensions: purpose, moral worth, competence, self-worth, coherence, connectedness and excitement.
Guttmann (2001Guttmann, D. (2001). A logotherapeutic approach to the quest for meaningful old age. Social Thougt, 20(3-4), 117-137. https://doi.org/10.1080/15426432.2001.9960298 https://doi.org/10.1080/15426432.2001.99... )	Israel	---	Review	Meaning in life in existentialism line	Meaning can be obtained through work, hobbies or volunteer activities, through attitudes taken toward fellow human beings and God.
Hedberg, Gustafson & Brulin (2010Hedberg, P., Gustafson, Y., & Brulin, C. (2010). Purpose in life among men and women aged 85 years and older. Int J Aging Hum Dev; 70(3):213-229. https://doi.org/10.2190/AG.70.3.c https://doi.org/10.2190/AG.70.3.c... )	Sweden	189 community-dwelling older adults	Cross-sectional	Purpose and meaning as synonyms. Purpose in life in existentialism line.	The study indicates that the very old people studied were feeling indecisive about their purpose in life and that feelings are linked with poorer psychological health.
Hedberg, Brulin, Aléx, et al. (2019Hedberg, P., Brulin, C, & Aléx, L. (2019). Experiences of purpose in life when becoming and being a very old woman. Journal of Women & Aging, 21(2), 125-137. https://doi.org/10.1080/08952840902837145 https://doi.org/10.1080/0895284090283714... )	Sweden	30 community-dwelling very old women	Cross-sectional	Meaning and purpose as synonymous Meaning in life in existentialism line	Very old women experience purpose in life in daily life activities and in contact with the spiritual world. Some of the participants saw their lives in terms of simply existing, and did not experience purpose in life.
Hoeyberghs, Verté, Verté ,et al. (2019Hoeyberghs, L.J., Verté, E., Verté, D., Schols, J.M.G.A., & De Witte, N. (2019). The importance of sources of meaning in life of community dwelling psychologically frail older people. Working with older people; 23(2):65-76. https://doi.org/10.1108/WWOP-01-2019-0001 https://doi.org/10.1108/WWOP-01-2019-000... )	Belgium	16,872 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	Financial security, meeting basic needs and personal relations play an important role as sources of meaning in life.
Hupkens, Machielse, Goumans, et al (2018Hupkens, S., Machielse, A., Goumans, M., & Derkx, P. (2018). Meaning in life of older persons: an integrative literature review. Nursing Ethics ; 25(8):973-991. https://doi.org/10.1177/0969733016680122 https://doi.org/10.1177/0969733016680122... )	Netherlands	44 studies	Integrative review	Meaning in life conceptualized in several ways	Older persons find meaning in life through different processes. Meaning in life is associated with the circumstances old persons live in.
Irving, Davis, & Collier (2017Irving, J., Davis, S., & Collier, A. (2017). Aging with purpose: systematic search and review of literature pertaining to older adults and purpose. Int J Aging Hum Dev; 85(4):403-437.https://doi.org/10.1177/0091415017702908 https://doi.org/10.1177/0091415017702908... )	Australia	31 studies	Systematic review	Purpose and meaning as synonyms. Goal-oriented purpose	Research outcomes suggest that greater reported purpose is related to a range of better health and well-being outcomes for older adults.
Jewell (2010Jewell, A. (2010). The Importance of Purpose in Life in an Older British Methodist Sample: Pastoral Implications. Journal of Religion, Spirituality & Aging. 22:3, 138-161. https://doi.org/10.1080/15528030903321170 https://doi.org/10.1080/1552803090332117... )	England	535 community-dwelling elders	Cross-sectional	Purpose and meaning as synonyms. Purpose in life in existentialism line	Purpose in life is positively related to a collaborative religious coping style, an approach-lefted death attitude, intrinsic religiosity, and spiritual transcendence.
Jonsén, Norberg, & Lundman (2014Jonsén, E., Norberg, A., & Lundman, B. (2014). Sense of meaning in life among the oldest old people living in a rural area in northern Sweden. International Journal of Older People Nursing; 10(3):221-229. https://doi.org/10.1111/opn.12077 https://doi.org/10.1111/opn.12077... )	Sweden	10 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	The sense of meaning in life in the oldest old was linked to regarding oneself as having a mission to carry out and to finding beauty, joy and happiness in life. The sense of meaning involved transferring to coming generations what earlier generations had left and having a deeply rooted faith in being taken care of from birth to the afterlife.
Ju (2017Ju, H. (2017). The relationship between physical activity, meaning in life, and subjective vitality in community-dwelling older adults. Arch Gerontol Geriatr; 73:120-124. https://doi.org/10.1016/j.archger.2017.08.001 https://doi.org/10.1016/j.archger.2017.0... )	South Korea	239 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	Physical activity was positively associated with meaning in life and subjective vitality. The relationship between physical activity and vitality was partially mediated by meaning in life.
Koren & Lowenstein (2008Koren, C. & Lowenstein, A. (2008). Late-life widowhood and meaning in life. Ageing Int ; 32:140. https://doi.org/10.1007/s12126-008-9008-1 https://doi.org/10.1007/s12126-008-9008-... )	Israel	180 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	Widowhood in older ages can cause loss of sense of meaning. Married couples have a higher level of meaning in life than widowers do.
Krause (2004Krause, N. (2004). Stressors arising in highly valued roles, meaning in life, and the physical health status of older adults.The journals of gerontology. Series B, Psychological sciences and social sciences,59(5), S287-S297. https://doi.org/10.1093/geronb/59.5.s287 https://doi.org/10.1093/geronb/59.5.s287... )	USA	1,518 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	The findings suggest that life events arising in roles that are valued highly are associated with less favorable health ratings.
Krause (2005Krause, N. (2005). God-mediated control and psychological well-being in late life. Research on Aging; 27(2):136-164. https://doi.org/10.1177/0164027504270475 https://doi.org/10.1177/0164027504270475... )	USA	1,313 community-dwelling elders	Longitudinal	Meaning in life in existentialism line	Emotional support reduces the effects of trauma on meaning, whereas negative inter-personal contacts tend to intensify the pernicious effects of trauma on meaning in life.
Krause (2007aKrause, N. (2007a). Longitudinal study of social support and meaning in life.Psychology and Aging, 22(3), 456-469.https://doi.org/10.1037/0882-7974.22.3.456 https://doi.org/10.1037/0882-7974.22.3.4... )	USA	959 community-dwelling elders	Longitudinal	Meaning in life in existentialism line	Negative interaction lowers an older person’s sense of meaning in life. Increased early support was associated with a greater sense of meaning in life and was more strongly associated with changes in meaning over time than other measures of social support.
Krause (2007bKrause, N. (2007b). Thought suppression and meaning in life: a longitudinal investigation.International journal of aging & human development,64(1), 67-82. https://doi.org/10.2190/2044-390U-7106-5610 https://doi.org/10.2190/2044-390U-7106-5... )	USA	988 community-dwelling seniors	Longitudinal	Meaning in life in existentialism line	The results suggested that a sense of meaning in life declines at an accelerating rate with progressively higher levels of difficulty with thought suppression.
Krause (2009Krause, N. (2009). Meaning in life and mortality.The journals of gerontology. Series B, Psychological sciences and social sciences,64(4), 517-527. https://doi.org/10.1093/geronb/gbp047 https://doi.org/10.1093/geronb/gbp047... )	USA	1,361 community-dwelling elders	Longitudinal	Meaning in life in existentialism line	Old people with a strong sense of meaning were less likely to die during the follow-up period of the study than those who did not have a strong sense of meaning. Having a strong sense of meaning was strongly associated with mortality.
Krause (2010Krause, N. (2010). God-Mediated Control and Change in Self-Rated Health.The International journal for the psychology of religion,20(4), 267-287. https://doi.org/10.1080/10508619.2010.507695 https://doi.org/10.1080/10508619.2010.50... )	USA	1,011 community-dwelling elders	Longitudinal	Meaning in life in existentialism line	People with a strong sense of God-mediated control are more likely to find a sense of meaning in life and be more optimistic than individuals who do not have a strong sense of God-mediated control. People who are optimistic and who have a strong sense of meaning in life will rate their health more favorably over time than individuals who are not optimistic, as well as individuals who have not found a sense of meaning in life.
MacKinlay (2002MacKinlay, E. (2002). The spiritual dimension of caring: applying a model for spiritual tasks of ageing. Journal of Religious Gerontology; 12(3-4):151-166. https://doi.org/10.1300/J078v12n03_12 https://doi.org/10.1300/J078v12n03_12... )	Australia	24 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	---
Melo, Eulálio, Gouveia, et al. (2013Melo, R.L.P, Eulálio, M.C., Gouveia, V.V., & Silva, H.D.M. (2013). O efeito do estresse na qualidade de vida de idosos: o papel moderador do sentido de vida. Psicologia: Reflexão e Crítica; 26(2):222-230. https://dx.doi.org/10.1590/S0102-79722013000200002 https://dx.doi.org/10.1590/S0102-7972201... )	Brazil	210 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	The influence of stress on quality of life was significant for the group with low meaning in life, where this was not the case for the group with high meaning.
Moore, Metcalf & Schow (2000Moore, S.L, Metcalf, B., & Schow, E. (2000). Aging and meaning in life: examining the concept. Geriatr Nurs; 21:27-9. https://doi.org/10.1067/mgn.2000.105790 https://doi.org/10.1067/mgn.2000.105790... )	Canada	---	Literature review	Meaning in life in existentialism line	----
Neville, Adams, Montayre, et al (2018Neville, S., Adams, J., Montayre, J., Larmer, P., Garrett, N., Stephens, C., & Alpass, F. (2018). Loneliness in Men 60 Years and Over: The Association With Purpose in Life.American Journal of Men’s Health, 730-739.https://doi.org/10.1177/1557988318758807 https://doi.org/10.1177/1557988318758807... )	New Zealand	614 community-dwelling elders	Cross-sectional	Meaning and purpose as synonyms. Purpose in life in existentialism line	Having poor mental health and lower purpose in life were indicators of loneliness. Old people with low levels of purpose had higher rates of loneliness than those with higher or neutral purpose.
Nygren, Jonsén, Gustafson, et al. (2005Nygren, B., Aléx, L, Jonsén, E., Gustafson, Y., Norberg, A., & Lundman, B. (2005). Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old.Aging & Mental Health ;9:4, 354-362. https://doi.org/10.1080/1360500114415 https://doi.org/10.1080/1360500114415... )	Sweden	125 community-dwelling elders	Cross-sectional	Meaning and purpose as synonyms. Purpose in life in existentialism line	The correlation between scores on the different scales suggests that the scales measure some dimension of inner strength and that the oldest old have this strength at least in the same extent as younger adults
Pinquart (2002Pinquart, M. (2002). Creating and maintaining purpose in life in old age: a meta-analysis. Ageing International; 27(2):90-114. https://doi.org/10.1007/s12126-002-1004-2 https://doi.org/10.1007/s12126-002-1004-... )	Germany	70 studies	Meta-analysis	Meaning and purpose as synonyms. Purpose in life in existentialism line	Purpose in life showed a strong association with social integration, and with relational quality in particular. In addition, high purpose in life was related to better health, higher everyday competence, higher socioeconomic status, being employed, and being married.
Ryff, Heller, Schaefer, et al. (2016Ryff, C.D., Heller, A.S., Schaefer, S.M., van Reekum, C., & Davidson, R.J. (2016). Purposeful engagement, healthy aging, and the brain. Current Behavioral Neuroscience Reports; 3:318-327. https://doi.org/10.1007/s40473-016-0096-z https://doi.org/10.1007/s40473-016-0096-... )	USA	---	Review	Goal-oriented purpose	The results showed declining scores for purpose in life and personal growth with aging, but also underscore the notable variability among older persons in these patterns.
Takkinen & Ruopilla (2001aTakkinen, S. & Ruoppilla, I. (2001a). Meaning in life as an important component of functioning in old age. The International Journal of Aging and Human Development; 53(3):211-231. https://doi.org/10.2190/H6H6-YAT0-181Y-5BR3 https://doi.org/10.2190/H6H6-YAT0-181Y-5... )	Finland	55 community-dwelling elders	Longitudinal	Meaning in life in existentialism line	The space of functioning provided a novel and illustrative approach to functioning as a multifaceted behavioral competence with meaning in life as an integral part of it.
Takkinen & Ruopilla (2001Takkinen, S., & Ruoppila, I. (2001b). Meaning in life in three samples of elderly persons with high cognitive functioning.International journal of aging & human development,53(1), 51-73. https://doi.org/10.2190/WBUG-NRKM-XJ7A-5QWP https://doi.org/10.2190/WBUG-NRKM-XJ7A-5... b)	Finland	559 community-dwelling elders	Cross-sectional	Meaning in life in existentialism line	The interactions between the various measures of meaning in life showed that having a sense of coherence and zest for life were factors related to the sense of meaningfulness in life. Meaning of death was not related to other measures.
van der Vaart & van Oudenaarden (2018van der Vaart, W., & van Oudenaarden, R. (2018). The practice of dealing with existential questions in long-term elderly care. International Journal of Qualitative Studies on Health and Well-being; 3(1): 1508197. https://doi.org/10.1080/17482631.2018.1508197 https://doi.org/10.1080/17482631.2018.15... )	Netherlands	02 organizations	Cross-sectional	Meaning in life in existentialism line	The outcomes indicate that the long-term care organizations had little active policy on dealing with existential questions; also, personnel had few specific tools except listening closely.

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