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Pfund et al. (2022) examine the protective effects of sense of purpose among a cohort of 595 older adults aged 65–78 years enrolled in the St. Louis Personality and Aging Network study. Their main finding that greater sense of purpose was negatively related to subjective cognitive decline (SCD) and appeared to attenuate the effects of loneliness on perceived cognitive decline adds to a growing “Positive Psychiatry” (Jeste et al., 2015) literature establishing the alimentary effects of opportunities for generative social contributions in the late-life course (Wilkins et al., 2022). So too do the results substantiate the known deleterious effects of loneliness, disconnection, and age segregation for elders and suggest that loss of purposemay be a key part of the causal matrix leading to decrements in cognitive functioning (Dahlberg, 2022). There are admittedly methodological challenges in measuring idiosyncratic aspects of the human experience such as “sense of purpose” and “wisdom” or reducing them to narrow operational definitions and standardized scales that fail to capture their complex and somewhat ineffable qualities. This process of reification can give a false sense of solidity. Is it possible that the most important aspects of human existence are in fact incommensurable? Mixed methods studies integrating qualitative data (interviews/ethnography/photovoice, etc.) may offer even greater sensitivity in appreciating the complex human mechanisms at play beneath statistical correlations linking purpose, loneliness, depression, and cognitive decline. Qualitative data invites narrative, through which human beings may speak explicitly and implicitly to the relationships among these variables and offer even greater illumination than the interaction effects identified in this study via statistical analysis. Further, such stories might reveal important cultural variations in concepts of purpose. In Japan, for example, the popular concept of “ikigai”—“that which makes life worth living”—blends purpose with joy and meaning. Additional to these conceptual limitations, the newly invented predisease category “SCD” on which the authors rely is itself controversial and lacking validity and clear utility. The history of the related term, mild cognitive impairment, another supposed “precursor” to dementia invented two decades ago, illustrates the dangers of propagating such concepts for use in research and then applying them prematurely in clinical practice to help professionals but not necessarily patients and families. It is obvious that progressive cognitive decline exists on a continuum, but less obvious why we must arbitrarily label segments of the curve. It is also clear there is extremely high variability in the progression of people given those labels, with studies consistently showing a substantial number of people with precursor diagnoses do not progress to Alzheimer’s. The unproven presupposition that early treatment is always better leads to labeling people with milder symptoms earlier in the process. Consequently, this leads to overdiagnosis, “medicalization,” and stigma, with all their inherent dangers for the elderly, rather than progressing along a presumed march to progress. All that is to say that, as with “sense of purpose,” there is empirical risk in relying on prematurely reified concepts like “SCD,” and further work will be needed to replicate and clarify this study’s findings. Moreover, while the researchers stratified participants by race, it would have been even more useful to examine the cohort based on socioeconomic status (or even proxy markers like education) to investigate how class position might itself confer resilience against lack of purpose and brain aging. Those limitations aside, studies like this help put a degree of statistical weight behind commonsense assumptions about the human condition and thus reinforce our understanding of what may be protective against dementia. In this particular moment, such increased focus on psychosocial pathways of brain health is much needed, as, over the past two decades, the biotechnological search for an anti-Alzheimer’s drug has yielded a 100% fail rate. The high-profile story of Biogen’s aducanumab, a monoclonal antibody against amyloid that was disastrously approved by the FDA in 2021 despite lack of clear clinical efficacy, serious and at times lethal side effects (brain swelling/bleeds, atrophy, headaches, and falls), and substantial cost (originally priced at $56,000 before being reduced to $28,000) has helped reveal the folly of overinflated expectations for markets and biotechnology to produce cures via a single-mechanism drugs (Whitehouse et al., 2022). While we may not International Psychogeriatrics (2022), 34:12, 1019–1022 © International Psychogeriatric Association 2022