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Datta D, Yang S, Joyce MKP, Woo E, McCarroll SA, Gonzalez-Burgos G, Perone I, Uchendu S, Ling E, Goldman M, Berretta S, Murray J, Morozov Y, Arellano J, Duque A, Rakic P, O’Dell R, van Dyck CH, Lewis DA, Wang M, Krienen FM, Arnsten AFT. Key Roles of CACNA1C/Cav1.2 and CALB1/Calbindin in Prefrontal Neurons Altered in Cognitive Disorders. JAMA Psychiatry 2024; 81:870-881. [PMID: 38776078 PMCID: PMC11112502 DOI: 10.1001/jamapsychiatry.2024.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/14/2024] [Indexed: 05/25/2024]
Abstract
Importance The risk of mental disorders is consistently associated with variants in CACNA1C (L-type calcium channel Cav1.2) but it is not known why these channels are critical to cognition, and whether they affect the layer III pyramidal cells in the dorsolateral prefrontal cortex that are especially vulnerable in cognitive disorders. Objective To examine the molecular mechanisms expressed in layer III pyramidal cells in primate dorsolateral prefrontal cortices. Design, Setting, and Participants The design included transcriptomic analyses from human and macaque dorsolateral prefrontal cortex, and connectivity, protein expression, physiology, and cognitive behavior in macaques. The research was performed in academic laboratories at Yale, Harvard, Princeton, and the University of Pittsburgh. As dorsolateral prefrontal cortex only exists in primates, the work evaluated humans and macaques. Main Outcomes and Measures Outcome measures included transcriptomic signatures of human and macaque pyramidal cells, protein expression and interactions in layer III macaque pyramidal cells using light and electron microscopy, changes in neuronal firing during spatial working memory, and working memory performance following pharmacological treatments. Results Layer III pyramidal cells in dorsolateral prefrontal cortex coexpress a constellation of calcium-related proteins, delineated by CALB1 (calbindin), and high levels of CACNA1C (Cav1.2), GRIN2B (NMDA receptor GluN2B), and KCNN3 (SK3 potassium channel), concentrated in dendritic spines near the calcium-storing smooth endoplasmic reticulum. L-type calcium channels influenced neuronal firing needed for working memory, where either blockade or increased drive by β1-adrenoceptors, reduced neuronal firing by a mean (SD) 37.3% (5.5%) or 40% (6.3%), respectively, the latter via SK potassium channel opening. An L-type calcium channel blocker or β1-adrenoceptor antagonist protected working memory from stress. Conclusions and Relevance The layer III pyramidal cells in the dorsolateral prefrontal cortex especially vulnerable in cognitive disorders differentially express calbindin and a constellation of calcium-related proteins including L-type calcium channels Cav1.2 (CACNA1C), GluN2B-NMDA receptors (GRIN2B), and SK3 potassium channels (KCNN3), which influence memory-related neuronal firing. The finding that either inadequate or excessive L-type calcium channel activation reduced neuronal firing explains why either loss- or gain-of-function variants in CACNA1C were associated with increased risk of cognitive disorders. The selective expression of calbindin in these pyramidal cells highlights the importance of regulatory mechanisms in neurons with high calcium signaling, consistent with Alzheimer tau pathology emerging when calbindin is lost with age and/or inflammation.
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Affiliation(s)
- Dibyadeep Datta
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Shengtao Yang
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Mary Kate P. Joyce
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Elizabeth Woo
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Steven A. McCarroll
- Department of Genetics, Harvard Medical School, Boston, Massachusetts
- Stanley Center for Psychiatric Research, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | | | - Isabella Perone
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Stacy Uchendu
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Emi Ling
- Stanley Center for Psychiatric Research, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Melissa Goldman
- Stanley Center for Psychiatric Research, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Sabina Berretta
- Basic Neuroscience Division, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - John Murray
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Yury Morozov
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Jon Arellano
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Alvaro Duque
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Pasko Rakic
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Ryan O’Dell
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Christopher H. van Dyck
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - David A. Lewis
- Departments of Psychiatry and Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Min Wang
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Fenna M. Krienen
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey
| | - Amy F. T. Arnsten
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
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He CYY, Zhou Z, Kan MMP, Chan DHY, Wong ACT, Mok KHY, Lam FMH, Chan SCC, Cheung CKC, Yeung MKC, Wong AYL. Modifiable risk factors for mild cognitive impairment among cognitively normal community-dwelling older adults: A systematic review and meta-analysis. Ageing Res Rev 2024; 99:102350. [PMID: 38942197 DOI: 10.1016/j.arr.2024.102350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 05/16/2024] [Accepted: 05/26/2024] [Indexed: 06/30/2024]
Abstract
Although numerous studies have investigated modifiable risk factors for mild cognitive impairment (MCI) among community-dwelling seniors, no meta-analysis has summarized these findings. Five databases were searched from January 1, 2000, to December 30, 2023. The protocol was registered with PROSPERO. Data were extracted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant meta-analyses of modifiable risk factors were performed. The evidence of each factor was assessed by the GRADE for cohort studies. Of 16,651 citations, 87 studies involving 225,584 community-dwelling seniors were included. Fourteen meta-analyses involving 20 studies with 44,199 participants were performed. The analyses revealed low-to-moderate-quality evidence supporting that diabetes, 2 or more comorbidities, anxiety, apathy, depressive symptoms, and physical frailty were risk factors for incident MCI in older adults. Conversely, hypertension, agitation, and irritability might not be risk factors. Additionally, moderate-quality evidence supports the protective effect of engaging in cognitive-demanding activities on the onset of MCI. Collectively, this study constitutes the first extensive compilation of evidence regarding the various risk factors for the development of MCI in older adults. Our findings hold significant potential to guide the formulation of prevention and management strategies to either prevent or potentially reverse the onset of MCI.
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Affiliation(s)
- Christo Y Y He
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Zhixing Zhou
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Mandy M P Kan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Dorothy H Y Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Athena C T Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Kenny H Y Mok
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Freddy M H Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Sam C C Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Chelsia K C Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China.
| | - Michael K C Yeung
- Department of Psychology, The Education University of Hong Kong, 999077, Hong Kong Special Administrative Region of China.
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 999077, Hong Kong Special Administrative Region of China; Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China.
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Cheung ESL, Zhang Z. Moderating Role of Neighborhood Environment in the Associations Between Hearing Loss and Cognitive Challenges Among Older Adults: Evidence From US National Study. Res Aging 2024; 46:400-413. [PMID: 38361482 DOI: 10.1177/01640275241234372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
This study examined the associations between hearing loss and cognitive challenges among community-dwelling older adults and whether neighborhood characteristics (physical disorder and low social cohesion) moderated the associations. Cross-sectional national data from Round 11 of the National Health and Aging Trends Study were adopted (N = 2,515). Multinomial logistic regressions were used to examine associations among variables and interactive analyses were conducted to examine moderating effects. Results indicated significant relationships between the experience of hearing loss and possible dementia and between severe or profound hearing loss and probable dementia. Interactive models suggested that residing in neighborhoods with physical disorder and low social cohesion were negatively associated with possible dementia among older adults with moderate and severe or profound hearing loss, respectively, compared to those without hearing loss. Findings underscore the necessity of environmental and social interventions to enhance cognitive health among older adults with varying degrees of hearing challenges.
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Affiliation(s)
| | - Zhe Zhang
- Teachers College, Columbia University, New York, NY, USA
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4
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Sutin AR, Luchetti M, Stephan Y, Sesker AA, Terracciano A. Purpose in life and stress: An individual-participant meta-analysis of 16 samples. J Affect Disord 2024; 345:378-385. [PMID: 38706462 PMCID: PMC11068359 DOI: 10.1016/j.jad.2023.10.149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Background Purpose in life is a psychological resource that has been associated with better regulation of stress. The present research reports a coordinated analysis of the association between purpose in life and subjective stress and evaluates potential sociodemographic and mental health moderators of this association. Methods With individual participant data from 16 samples (total N=108,391), linear regression examined the association between purpose in life and general subjective feelings of stress, controlling for sociodemographic characteristics. Results Greater purpose in life was associated with less subjective stress (meta-analytic estimate=-.228, 95% Confidence Interval=-.292, -.164; p<.001). Interaction terms between sociodemographic factors and purpose tested in the individual samples and synthesized with meta-analysis were not significant, which indicated that the association between purpose and stress was similar across age, sex, race, ethnicity, and education. The association was also not moderated by psychological distress. Meta-regressions further indicated that this association was generally similar across scale length, content of the purpose measure, and across samples from Eastern and Western countries. Limitations The associations reported are observational. Experimental work is needed to evaluate causality. Conclusions Purpose in life is associated with less subjective stress across populations. Less subjective stress may be one mechanism through which purpose contributes to better mental and physical health.
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Affiliation(s)
| | | | | | - Amanda A. Sesker
- Florida State University College of Medicine
- University of Minnesota Medical School–Duluth
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5
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Warren A. The relationship between perceived stigma and perceived stress in cognitive decline: a survey of persons with mild cognitive impairment and their caregivers. Front Psychol 2023; 14:1293284. [PMID: 38144994 PMCID: PMC10740212 DOI: 10.3389/fpsyg.2023.1293284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction While Alzheimer's disease and other causes of dementia have rapidly become a global health crisis with growing incidence that is unabated, the incidence of Mild Cognitive Impairment (MCI) far exceeds that of Alzheimer's disease. Persons with MCI demonstrate some level of cognitive impairment, but daily functions remain intact and there is no certainty that they will develop dementia. Yet, the possibility conjures a considerable amount of fear and anxiety, further fueled by a vast array of misconceptions and stigma. The pervasive nature of this stigma permeates society and culture at many levels. Persons with MCI who are at higher risk for development of dementia may be especially vulnerable to fear and stigma associated with the diagnosis. Based on this premise, the primary aim of this study was to examine the relationship between perceived stigma and perceived stress in persons with MCI and their care partners, including the relationship between income and the study variables. The secondary aim was to examine the effect of a combined cognitive rehabilitation and wellness program on these perceptions. Methods Thirty participants were recruited from Mayo Clinic's Health Action to Benefit Independence and Thinking (HABIT) program. MCI (n = 15) and care partner (n = 15) participants completed the Stigma Impact Scale (SIS) and the Perceived Stress Scale (PSS) before and after the HABIT program. Results Average SIS and PSS scores decreased in the MCI, care partner, and combined groups, both pre- and post-HABIT. Linear regression was used to assess the relationship between perceived stigma and stress, controlling for income. A significant relationship was found between perceived stigma and perceived stress both pre and post-HABIT. Discussion The results suggest a relationship exists between perceived stigma and perceived stress in persons with MCI and their care partners, and an educational program such as HABIT may strengthen this relationship by informing participants of potential challenges that occur in cognitive decline. Understanding these relationships may provide an opportunity to provide tools for this vulnerable population.
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Affiliation(s)
- Alison Warren
- The Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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6
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Tian YM, Wang J, Zhang WS, Jiang CQ, Jin YL, Zhu T, Zhu F, Cheng KK, Lam TH, Xu L. Association of perceived stress with memory decline in older Chinese: The Guangzhou Biobank Cohort Study. J Affect Disord 2023; 341:256-264. [PMID: 37634823 DOI: 10.1016/j.jad.2023.08.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Previous studies on associations of perceived stress with poor memory performance in older adults showed inconsistent results. We examined the prospective associations of perceived stress with memory decline using data from Guangzhou Biobank Cohort Study (GBCS). METHODS Perceived stress was measured by the Perceived Stress Scale (PSS) at baseline (2003-2006), with greater scores indicating greater stress. Memory function was measured by delayed 10-word recall test (DWRT) and immediate 10-word recall test (IWRT), with greater scores indicating better performance, at baseline and follow-up (2008-2012) examinations, analyzed as mean annual change in scores. RESULTS 9656 participants (72 % women) with mean age 61.6 (standard deviation = 6.4) years were included. During an average of 4.4 years of follow-up, after adjusting for confounders, each one-point greater PSS score was associated with mean annual decline in DWRT scores (β (95 % CI) = -0.005 (-0.008 to -0.002)). Greater Perceived Helplessness (PH) scores, but not Perceived Self-efficacy scores, was associated with greater mean annual decline in DWRT and IWRT scores (β (95 % CI) = -0.005 (-0.009 to -0.001) and - 0.012 (-0.018 to -0.005), respectively), and similar patterns were observed in five out of seven PH items (βs from -0.02 to -0.07). Interaction analysis showed that the association of greater PSS with greater decline in DWRT scores was observed only in those with low family income (β (95 % CI) = -0.08 (-0.13 to -0.04), P for interaction = 0.03). CONCLUSIONS Greater perceived stress was associated with a greater decline in delayed recall memory, especially in those with low family income.
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Affiliation(s)
- Yu Meng Tian
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiao Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wei Sen Zhang
- Guangzhou Twelfth People's Hospital, Guangzhou, China.
| | | | - Ya Li Jin
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Tong Zhu
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Feng Zhu
- Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tai Hing Lam
- School of Public Health, the University of Hong Kong, Hong Kong
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, the University of Hong Kong, Hong Kong; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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7
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Smith L, López Sánchez GF, Shin JI, Soysal P, Pizzol D, Barnett Y, Kostev K, Jacob L, Veronese N, Butler L, Odell-Miller H, Bloska J, Underwood BR, Koyanagi A. Pain and mild cognitive impairment among adults aged 50 years and above residing in low- and middle-income countries. Aging Clin Exp Res 2023:10.1007/s40520-023-02434-7. [PMID: 37227581 DOI: 10.1007/s40520-023-02434-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/04/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Previous studies on the association between pain and cognitive decline or impairment have yielded mixed results, while studies from low- and middle-income countries (LMICs) or specifically on mild cognitive impairment (MCI) are scarce. Thus, we investigated the association between pain and MCI in LMICs and quantified the extent to which perceived stress, sleep/energy problems, and mobility limitations explain the pain/MCI relationship. METHODS Data analysis of cross-sectional data from six LMICs from the Study on Global Ageing and Adult Health (SAGE) were performed. MCI was based on the National Institute on Aging-Alzheimer's Association criteria. "Overall in the last 30 days, how much of bodily aches or pain did you have?" was the question utilized to assess pain. Associations were examined by multivariable logistic regression analysis and meta-analysis. RESULTS Data on 32,715 individuals aged 50 years and over were analysed [mean (SD) age 62.1 (15.6) years; 51.7% females]. In the overall sample, compared to no pain, mild, moderate, and severe/extreme pain were dose-dependently associated with 1.36 (95% CI = 1.18-1.55), 2.15 (95% CI = 1.77-2.62), and 3.01 (95% CI = 2.36-3.85) times higher odds for MCI, respectively. Mediation analysis showed that perceived stress, sleep/energy problems, and mobility limitations explained 10.4%, 30.6%, and 51.5% of the association between severe/extreme pain and MCI. CONCLUSIONS Among middle-aged to older adults from six LMICs, pain was associated with MCI dose-dependently, and sleep problems and mobility limitations were identified as potential mediators. These findings raise the possibility of pain as a modifiable risk factor for developing MCI.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Yvonne Barnett
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | | | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
- Department of Physical and Rehabilitation Medicine, Lariboisière-Fernand Widal Hospital, AP-HP, University Paris Cité, Paris, France
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge , CB2 0SZ, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Windsor Unit, Fulbourn Hospital, Cambridge, CB21 5EF, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
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Kulshreshtha A, Alonso A, McClure LA, Hajjar I, Manly JJ, Judd S. Association of Stress With Cognitive Function Among Older Black and White US Adults. JAMA Netw Open 2023; 6:e231860. [PMID: 36881411 PMCID: PMC9993177 DOI: 10.1001/jamanetworkopen.2023.1860] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
IMPORTANCE Perceived stress can have long-term physiological and psychological consequences and has shown to be a modifiable risk factor for Alzheimer disease and related dementias. OBJECTIVE To investigate the association between perceived stress and cognitive impairment in a large cohort study of Black and White participants aged 45 years or older. DESIGN, SETTING, AND PARTICIPANTS The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study is a national population-based cohort of 30 239 Black and White participants aged 45 years or older, sampled from the US population. Participants were recruited from 2003 to 2007, with ongoing annual follow-up. Data were collected by telephone, self-administered questionnaires, and an in-home examination. Statistical analysis was performed from May 2021 to March 2022. EXPOSURES Perceived stress was measured using the 4-item version of the Cohen Perceived Stress Scale. It was assessed at the baseline visit and during 1 follow-up visit. MAIN OUTCOMES AND MEASURES Cognitive function was assessed with the Six-Item Screener (SIS); participants with a score below 5 were considered to have cognitive impairment. Incident cognitive impairment was defined as a shift from intact cognition (SIS score >4) at the first assessment to impaired cognition (SIS score ≤4) at the latest available assessment. RESULTS The final analytical sample included 24 448 participants (14 646 women [59.9%]; median age, 64 years [range, 45-98 years]; 10 177 Black participants [41.6%] and 14 271 White participants [58.4%]). A total of 5589 participants (22.9%) reported elevated levels of stress. Elevated levels of perceived stress (dichotomized as low stress vs elevated stress) were associated with 1.37 times higher odds of poor cognition after adjustment for sociodemographic variables, cardiovascular risk factors, and depression (adjusted odds ratio [AOR], 1.37; 95% CI, 1.22-1.53). The association of the change in the Perceived Stress Scale score with incident cognitive impairment was significant in both the unadjusted model (OR, 1.62; 95% CI, 1.46-1.80) and after adjustment for sociodemographic variables, cardiovascular risk factors, and depression (AOR, 1.39; 95% CI, 1.22-1.58). There was no interaction with age, race, and sex. CONCLUSIONS AND RELEVANCE This study suggests that there is an independent association between perceived stress and both prevalent and incident cognitive impairment. The findings suggest the need for regular screening and targeted interventions for stress among older adults.
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Affiliation(s)
- Ambar Kulshreshtha
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Ihab Hajjar
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York
| | - Suzanne Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
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Jain N, Wang Y, Zhang Y, Jacobsen E, Andreescu C, Snitz BE, Chang CCH, Ganguli M. It goes both ways: The relationship between anxiety and mild cognitive impairment. Int J Geriatr Psychiatry 2023; 38:e5899. [PMID: 36855309 DOI: 10.1002/gps.5899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/19/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To investigate the relationship between anxiety and mild cognitive impairment (MCI), and whether it is mediated by perceived stress, at the population level. METHOD AND DESIGN In a longitudinal study of 368 adults aged 65+ from a population-based cohort, we annually assessed anxiety symptoms (GAD-7), perceived stress (PSS-4), and ratings on the Clinical Dementia Rating (CDR®), where CDR = 0.5 was operationalized as MCI. Examining data from three consecutive assessment waves, we first determined the associations between anxiety at the first wave with MCI at the third wave, and vice versa. We then used mediation analyses to determine whether the pathways in both directions were mediated by perceived stress at the second wave, adjusting for demographics and other relevant covariates. RESULTS We confirmed significant bidirectional longitudinal associations between anxiety and MCI. Perceived stress was detected as a significant mediator for both pathways between anxiety and MCI, explaining 37.1% of the total effect (TE) of anxiety on incident MCI while conversely explaining 27.1% of the TE of MCI on anxiety. CONCLUSIONS A bidirectional relationship with a 2-year lag between anxiety and MCI was mediated through perceived stress. Clinicians should be sensitive both to potential consequent anxiety when patients present with cognitive impairment, and to potential incipient MCI when the presenting complaint is anxiety. Managing stress may help mitigate adverse outcomes.
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Affiliation(s)
- Neha Jain
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Yueting Wang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Yingjin Zhang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
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Yoshida S, Hamada Y, Narita M, Sato D, Tanaka K, Mori T, Tezuka H, Suda Y, Tamura H, Aoki K, Kuzumaki N, Narita M. Elucidation of the mechanisms underlying tumor aggravation by the activation of stress-related neurons in the paraventricular nucleus of the hypothalamus. Mol Brain 2023; 16:18. [PMID: 36732798 PMCID: PMC9896675 DOI: 10.1186/s13041-023-01006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/13/2023] [Indexed: 02/04/2023] Open
Abstract
A growing body of evidence suggests that excess stress could aggravate tumor progression. The paraventricular nucleus (PVN) of the hypothalamus plays an important role in the adaptation to stress because the hypothalamic-pituitary-adrenal (HPA) axis can be activated by inducing the release of corticotropin-releasing hormone (CRH) from the PVN. In this study, we used pharmacogenetic techniques to investigate whether concomitant activation of CRHPVN neurons could directly contribute to tumor progression. Tumor growth was significantly promoted by repeated activation of CRHPVN neurons, which was followed by an increase in the plasma levels of corticosterone. Consistent with these results, chronic administration of glucocorticoids induced tumor progression. Under the concomitant activation of CRHPVN neurons, the number of cytotoxic CD8+ T cells in the tumor microenvironment was dramatically decreased, and the mRNA expression levels of hypoxia inducible factor 1 subunit α (HIF1α), glucocorticoid receptor (GR) and Tsc22d3 were upregulated in inhibitory lymphocytes, tumor-associated macrophages (TAMs) and myeloid-derived suppressor cells (MDSCs). Furthermore, the mRNA levels of various kinds of driver molecules related to tumor progression and tumor metastasis were prominently elevated in cancer cells by concomitant activation of CRHPVN neurons. These findings suggest that repeated activation of the PVN-CRHergic system may aggravate tumor growth through a central-peripheral-associated tumor immune system.
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Affiliation(s)
- Sara Yoshida
- grid.412239.f0000 0004 1770 141XDepartment of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501 Japan ,grid.272242.30000 0001 2168 5385Division of Cancer Pathophysiology, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Yusuke Hamada
- grid.412239.f0000 0004 1770 141XDepartment of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501 Japan ,grid.272242.30000 0001 2168 5385Division of Cancer Pathophysiology, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Michiko Narita
- grid.272242.30000 0001 2168 5385Division of Cancer Pathophysiology, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Daisuke Sato
- grid.412239.f0000 0004 1770 141XDepartment of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501 Japan ,grid.272242.30000 0001 2168 5385Division of Cancer Pathophysiology, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Kenichi Tanaka
- grid.412239.f0000 0004 1770 141XDepartment of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501 Japan ,grid.272242.30000 0001 2168 5385Division of Cancer Pathophysiology, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Tomohisa Mori
- grid.412239.f0000 0004 1770 141XDepartment of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501 Japan
| | - Hiroyuki Tezuka
- grid.256115.40000 0004 1761 798XDepartment of Cellular Function Analysis, Research Promotion Headquarters, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi 470-1192 Japan
| | - Yukari Suda
- grid.412239.f0000 0004 1770 141XDepartment of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501 Japan ,grid.272242.30000 0001 2168 5385Division of Cancer Pathophysiology, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Hideki Tamura
- grid.412239.f0000 0004 1770 141XInstitute for Advanced Life Sciences, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501 Japan ,grid.412239.f0000 0004 1770 141XLaboratory of Biofunctional Science, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501 Japan
| | - Kazunori Aoki
- grid.272242.30000 0001 2168 5385Department of Immune Medicine, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045 Japan
| | - Naoko Kuzumaki
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501, Japan. .,Division of Cancer Pathophysiology, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
| | - Minoru Narita
- Department of Pharmacology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501, Japan. .,Division of Cancer Pathophysiology, National Cancer Center Research Institute (NCCRI), 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
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11
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García C, Moreno L, Alacreu M, Muñoz FJ, Martínez LA. Addressing Psychosocial Factors in Cognitive Impairment Screening from a Holistic Perspective: The DeCo-Booklet Methodology Design and Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12911. [PMID: 36232215 PMCID: PMC9565987 DOI: 10.3390/ijerph191912911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Cognitive impairment (CI), an intermediate phase between the decline in physiological cognition and dementia, is known to be mediated by a variety of risk and protective factors, with age being the most influential of these. The multifactorial nature of CI and the worldwide phenomenon of an aging population makes decoupling old age from disease through the concept of healthy aging (HA) a matter of major interest. Focusing on psychosocial variables and psychological constructs, here we designed and piloted a data collection booklet (DeCo-B) to assess CI and HA from a holistic perspective. The DeCo-B comprises six sections: sociodemographic factors, CI, meaning in life, psychosocial factors, health problems, and lifestyle. The estimated prevalence of CI and HA in our cohort were 24.4% and 6.6%, respectively. Spearman correlations mainly identified pairwise associations between the meaning in life domains and psychosocial variables. Moreover, age, marital status, purpose in life, resilience, chronic pain, cognitive reserve, and obstructive sleep apnea were significantly associated with an increased risk of CI. Our results showed that DeCo-B is a suitable tool for researching how modifiable risk and protective factors influence cognitive status. The complex interrelationships between variables should be further investigated and, for practical reasons, the questionnaire should be optimized in future work.
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Affiliation(s)
- Cristina García
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
- Community Pharmacist, 02161 Albacete, Spain
| | - Lucrecia Moreno
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - Mónica Alacreu
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
| | - Francisco J. Muñoz
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
| | - Luis A. Martínez
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain
- Community Pharmacist, 02161 Albacete, Spain
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12
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Harris BN, Cooke JT, Littlefield AK, Tucker CA, Campbell CM, King KS. Relations among CRFR1 and FKBP5 genotype, cortisol, and cognitive function in aging humans: A Project FRONTIER study. Physiol Behav 2022; 254:113884. [PMID: 35718217 DOI: 10.1016/j.physbeh.2022.113884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/04/2022] [Accepted: 06/13/2022] [Indexed: 01/23/2023]
Abstract
Here we use the glucocorticoid cascade hypothesis framework to address the role of baseline cortisol on changes in cognitive function over a 3-year span in non-demented rural Americans. We also determine if genotype at 4 different single nucleotide polymorphisms (SNPs) relates to change in cognitive function. We predicted 1) over time, increases in baseline cortisol will be associated with decline in cognitive function, 2) individuals homozygous for 3 CRFR1 SNP rare alleles (AA rs110402, TT rs7209436, and TT rs242924 vs. others) will show less cognitive decline and this will be particularly pronounced in those with lower baseline cortisol, and 3) FKBP5 T carriers (TT or CT vs. CC homozygotes) will have decreased cognitive performance and this will be particularly pronounced in individuals with higher baseline cortisol. Collectively, our data do not robustly support the glucocorticoid cascade hypothesis. In several cases, higher baseline cortisol related to better cognitive performance over time, but within individuals, increased cortisol over time related to decreased performance on some cognitive domains over time. Contrary to our predictions, individuals with the rare CRFR1 haplotype (AA, TT, TT) performed worse than individuals with the common haplotype across multiple domains of cognitive function. FKBP5 genotype status had minimal impacts on cognitive outcomes. Genotype effects were largely not dependent on cortisol. The Project FRONTIER dataset is supported by Texas Tech University Health Sciences Center Garrison Institute on Aging.
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Affiliation(s)
- Breanna N Harris
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States of America.
| | - Jeffrey T Cooke
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States of America
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States of America
| | - Cody A Tucker
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States of America
| | - Callie M Campbell
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States of America
| | - Kaleb S King
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States of America
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13
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Hoogendoorn CJ, Qin J, Wang C, Roque N, Laurenceau JP, Katz MJ, Derby CA, Lipton RB, Gonzalez JS. Depressive symptoms mediate the relationship between diabetes and cognitive performance in a community-based sample of older adults. J Diabetes Complications 2022; 36:108183. [PMID: 35718600 DOI: 10.1016/j.jdiacomp.2022.108183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 02/07/2023]
Abstract
AIMS To evaluate whether diabetes and prediabetes are associated with impaired cognitive performance among older adults and examine depressive symptoms as a mediator. METHODS We used cross-sectional data from the Einstein Aging Study, a systematically recruited, community-based cohort study of diverse older adults (N = 794; Age Mean (SD) = 78.9 (5.3); 64.4% Non-Hispanic White, 28.7% Non-Hispanic Black, 5.7% Hispanic). Diabetes status was established via self-reported diagnosis, prescribed medications, and fasting blood glucose. Depressive symptoms were assessed using the Geriatric Depression Scale. Cognitive tests included Digit Symbol, Trails-B, Free Recall, Category Fluency, Boston Naming, and Block Design. Linear regression and mediation analyses were applied. RESULTS Compared to those without diabetes, diabetes was associated with worse performance on all cognitive tests (ps < 0.05), except Trails-B (p = 0.53), and increased depressive symptoms (p < 0.01). For diabetes, mediation via increased depressive symptoms was observed for Free Recall (p = 0.044), Category Fluency (p = 0.033), and Boston Naming (p = 0.048). CONCLUSIONS Diabetes was consistently associated with worse cognitive performance and increased depressive symptoms among this older cohort, while prediabetes was not. Mediation findings suggest depressive symptoms may be a biobehavioral pathway linking diabetes and cognition, though the temporal sequence is unclear. If causal, addressing both diabetes and depressive symptoms among older adults may protect cognitive function.
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Affiliation(s)
| | - Jiyue Qin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nelson Roque
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carol A Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA; Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
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14
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Jain D, Verma V, Parashar N, Kumar S, Kiran U, Satija A, Tiwari N. A Study on the Willingness to Use Meditation for Maintaining Psychological Well-Being During the COVID-19 Pandemic. Cureus 2022; 14:e25950. [PMID: 35855240 PMCID: PMC9284473 DOI: 10.7759/cureus.25950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background and objective Several studies have indicated an escalation in the stress and anxiety levels among all sections of the population at large during the ongoing coronavirus disease 2019 (COVID-19) pandemic. In this challenging environment, meditation or yoga can help in maintaining the quality of life. This pilot study aimed to assess the willingness to practice meditation as a tool to manage anxiety, perceived stress levels, and psychological well-being (quality of life) during the COVID-19 pandemic in India. Materials and methods Bivariate and multivariate logistic regression models were employed to characterize the attitude of healthy Indian adults toward meditation as a stress management tool and its impact on psychological well-being. Primary data of 241 participants were collected using Google Forms circulated via email and social media platforms through the snowball sampling technique. The self-reported data on four different psychosocial scales, viz., for anxiety measurement [the Seven-Item Generalized Anxiety Disorder Scale (GAD-7) and Coronavirus Anxiety Scale (CAS)], for stress measurement [Perceived Stress Scale (PSS)], and to quantify well-being levels [the Five-Item World Health Organization Well-Being Index (WHO-5)], along with those on their perception toward meditation were obtained. Results Our findings suggest that the anxiety and perceived stress scores are lower among those practicing some form of relaxation or meditation than those not practicing it, along with those who already report better psychological well-being and perceived stress. The bivariate results indicated that willingness to meditate among those who were practicing some form of meditation and those not mediating significantly differed based on their age, presence of comorbidities, and GAD and PSS levels. The multivariate logistic regression showed that only those individuals aged 35 years and above and those who have some comorbidity symptoms showed a significant level of willingness to opt for meditation. Conclusions In order to attain proper relief from psychological issues during a pandemic situation such as the current one, a more specific remedial module for meditation procedure needs to be devised as an intervention, and it should be kept in mind that age and comorbidity status also play a significant role with respect to individuals' attitude toward meditation as a tool for psychological relief.
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15
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Rimmele U, Ballhausen N, Ihle A, Kliegel M. In Older Adults, Perceived Stress and Self-Efficacy Are Associated with Verbal Fluency, Reasoning, and Prospective Memory (Moderated by Socioeconomic Position). Brain Sci 2022; 12:brainsci12020244. [PMID: 35204007 PMCID: PMC8870367 DOI: 10.3390/brainsci12020244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 12/04/2022] Open
Abstract
Despite evidence that stress relates negatively to cognitive functioning in older adults, little is known how appraisal of stress and socioeconomic meso-level factors influence different types of cognitive functions in older adults. Here, we assess the relationship between perceived stress (PSS scale) and a battery of cognitive functions, including prospective memory in 1054 older adults (65+). A moderator analysis assessed whether this relationship varies with neighborhood socioeconomic status using an area-based measure of Socioeconomic Position (SEP). Perceived stress was associated with worse processing speed, verbal fluency, and inductive reasoning. The perceived self-efficacy subscale of the PSS is related to better performance in these measures. Higher self-efficacy was also associated with better prospective memory; this relationship was more pronounced for people with high neighborhood SEP. These findings indicate that not only do perceived stress and perceived self-efficacy relate to cognitive functioning in older age but also that neighborhood SEP is a moderator of this relationship.
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Affiliation(s)
- Ulrike Rimmele
- Swiss National Centre of Competence in Research LIVES–Overcoming Vulnerability: Life Course Perspectives, University of Geneva, 1205 Geneva, Switzerland; (N.B.); (A.I.); (M.K.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerabilities, University of Geneva, 1205 Geneva, Switzerland
- Emotion and Memory Laboratory, Department of Psychology, FPSE, University of Geneva, 1205 Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, 1205 Geneva, Switzerland
- Geneva Neuroscience Center, University of Geneva, 1211 Geneva, Switzerland
- Correspondence: ; Tel.: +41-379-37-97
| | - Nicola Ballhausen
- Swiss National Centre of Competence in Research LIVES–Overcoming Vulnerability: Life Course Perspectives, University of Geneva, 1205 Geneva, Switzerland; (N.B.); (A.I.); (M.K.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerabilities, University of Geneva, 1205 Geneva, Switzerland
- Department of Developmental Psychology, Tilburg University, 5037 AB Tilburg, The Netherlands
- Cognitive Aging Lab, Department of Psychology, FPSE, University of Geneva, 1205 Geneva, Switzerland
| | - Andreas Ihle
- Swiss National Centre of Competence in Research LIVES–Overcoming Vulnerability: Life Course Perspectives, University of Geneva, 1205 Geneva, Switzerland; (N.B.); (A.I.); (M.K.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerabilities, University of Geneva, 1205 Geneva, Switzerland
- Cognitive Aging Lab, Department of Psychology, FPSE, University of Geneva, 1205 Geneva, Switzerland
| | - Matthias Kliegel
- Swiss National Centre of Competence in Research LIVES–Overcoming Vulnerability: Life Course Perspectives, University of Geneva, 1205 Geneva, Switzerland; (N.B.); (A.I.); (M.K.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerabilities, University of Geneva, 1205 Geneva, Switzerland
- Cognitive Aging Lab, Department of Psychology, FPSE, University of Geneva, 1205 Geneva, Switzerland
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16
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Yang CH, Hakun JG, Roque N, Sliwinski MJ, Conroy DE. Mindful walking and cognition in older adults: A proof of concept study using in-lab and ambulatory cognitive measures. Prev Med Rep 2021; 23:101490. [PMID: 34336559 PMCID: PMC8313589 DOI: 10.1016/j.pmedr.2021.101490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 11/25/2022] Open
Abstract
Mindfulness practice and walking have been linked individually to sustain cognition in older adults. This early-phase study aimed to establish proof-of-concept by evaluating whether an intervention that integrates light-intensity walking with mindfulness practices shows promising signs of improving cognition in older adults. Participants (N = 25, Mage = 72.4 ± 6.45) were community-dwelling older adults who engaged in a supervised mindful walking program over one month (8 sessions total, 2 sessions per week, 30-minute slow walking containing mindfulness skills). They completed performance-based and subjective ratings of cognitive measures in field before and after two mindful walking bouts using a smartphone app. They also completed in-lab performance-based and self-report cognitive measures at baseline and after the entire program. Controlling for demographics, potential covariates, and time trends, short-term improvements in perceived cognition and processing speed were observed from pre- to post-mindful walking sessions (i.e., 30 min) across multiple ambulatory cognitive measures (Cohen's ds range = 0.46-0.66). Longer-term improvements in processing speed and executive function were observed between baseline and end of the program (i.e., one month) across various performance-based cognitive measures (ds range = 0.43-1.28). No significant changes were observed for other cognitive domains. This early-phase study (Phase IIa) provides preliminary support that mindful walking activity is promising for sustaining cognition in older adults. Our promising findings form the building blocks of evidence needed to advance this intervention to a fully powered randomized controlled trial that examines program efficacy with a comparator. Favorable outcomes will inform the development of this lifestyle behavioral strategy for promoting healthy brain aging in late adulthood.
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Affiliation(s)
- Chih-Hsiang Yang
- Department of Exercise Science, University of South Carolina, USA
| | - Jonathan G. Hakun
- Departments of Neurology, The Pennsylvania State University, USA
- Departments of Psychology, The Pennsylvania State University, USA
| | - Nelson Roque
- Center for Healthy Aging, The Pennsylvania State University, USA
| | - Martin J. Sliwinski
- Center for Healthy Aging, The Pennsylvania State University, USA
- Department of Human Development and Family Studies, The Pennsylvania State University, USA
| | - David E. Conroy
- Department of Kinesiology, The Pennsylvania State University, USA
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17
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Franks KH, Bransby L, Saling MM, Pase MP. Association of Stress with Risk of Dementia and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2021; 82:1573-1590. [PMID: 34366334 DOI: 10.3233/jad-210094] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although many studies have investigated the association between stress and risk of dementia, findings are inconsistent due to the variation in the measures used to assess stress. OBJECTIVE We conducted a systematic review and meta-analysis to investigate the association between psychological stress (including neuroticism, stressful life events, and perceived stress) and the risk of incident dementia and mild cognitive impairment in adults. METHODS PsycINFO, Embase, and MEDLINE were searched to October 2020 for eligible observational, prospective studies. Of the 1,607 studies screened, 26 (24 unique cohorts) were included in the qualitative analysis and 16 (15 unique cohorts) were included in the quantitative analysis. RESULTS Across studies, higher perceived stress was significantly associated with an increased risk of mild cognitive impairment (Cases/Total N = 207/860: hazard ratio [HR] = 1.19, 95% confidence interval [CI] = 1.03-1.38) and all-cause dementia (Cases/Total N = 203/1,882: HR = 1.44, 95% CI = 1.07-1.95). Exposure to two or more stressful life events (versus none) was significantly associated with an increased risk of all-cause dementia (Cases/Total N = 3,354/11,597: HR = 1.72, 95% CI = 1.14-2.60), while one or more stressful life events was not. Higher neuroticism was significantly associated with an increased risk of Alzheimer's disease dementia (Cases/Total N = 497/4,771: HR = 1.07, 95% CI = 1.01-1.12), but not all-cause dementia. CONCLUSION This review suggests that psychological stress in adulthood is associated with an increased risk of dementia. Further research is needed to clarify the mechanisms underlying these associations.
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Affiliation(s)
- Katherine H Franks
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Lisa Bransby
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Michael M Saling
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew P Pase
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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18
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Luo J, Zhang B, Willroth EC, Mroczek DK, Roberts BW. The Roles of General and Domain-Specific Perceived Stress in Healthy Aging. J Gerontol B Psychol Sci Soc Sci 2021; 77:536-549. [PMID: 34265038 DOI: 10.1093/geronb/gbab134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Theoretical and empirical evidence suggests the existence of a general perceived stress factor overarching different life domains. The present study investigated the general perceived stress relative to domain-specific perceived stress as predictors of 26 diverse health outcomes, including mental and physical health, health behaviors, cognitive functioning, and physiological indicators of health. METHOD A bifactor exploratory structural equational modelling (BiESEM) approach was adopted in two aging samples from the Health and Retirement Study (HRS; N = 8325 in Sample 1, N = 7408 in Sample 2). RESULTS Across the two samples, perceived stress was well-represented by a bifactor structure where there was a robust general perceived stress factor representing a general propensity towards stress perception. Meanwhile, after controlling for the general perceived stress factor, specific factors that represent perceived stress in different life domains were still clearly present. Results also suggested age, sex, race, education, personality traits, and past and recent stressor exposure as possible factors underlying individual differences in the general perceived stress factor. The general perceived stress factor was the most robust predictor of the majority of health outcomes, as well as changes in mental health outcomes. The specific factor of perceived neighborhood stress demonstrated incremental predictive effects across different types of health outcomes. DISCUSSION The current study provides strong evidence for the existence of a general perceived stress factor that captures variance shared among stress across life domains, and the general perceived stress factor demonstrated substantial prospective predictive effects on diverse health outcomes in older adulthood.
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Affiliation(s)
- Jing Luo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bo Zhang
- Department of Psychological and Brain Sciences, Texas A&M University, TAMU, College Station, TX, USA
| | - Emily C Willroth
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Brent W Roberts
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 E. Daniel St., Champaign, IL, USA
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Graham EK, James BD, Jackson KL, Willroth EC, Luo J, Beam CR, Pedersen NL, Reynolds CA, Katz M, Lipton RB, Boyle P, Wilson R, Bennett DA, Mroczek DK. A coordinated analysis of the associations among personality traits, cognitive decline, and dementia in older adulthood. JOURNAL OF RESEARCH IN PERSONALITY 2021; 92:104100. [PMID: 34083845 PMCID: PMC8168939 DOI: 10.1016/j.jrp.2021.104100] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There are individual differences in the rates of cognitive decline across later adulthood. Personality traits are among the factors that may account for these differences. The current project investigated whether personality traits were associated with trajectories of cognitive decline, and whether the associations were different before and after dementia diagnosis. The data was analyzed using linear mixed effects regression. Across study aims is a focus on replicability and generalizability. Each question was addressed in four independent longitudinal studies (EAS, MAP, ROS, SATSA), then meta-analyzed, providing estimates of replicability. Results indicated that low neuroticism and high openness were associated with total cognitive function. We detected evidence for cognitive decline in all four samples, and openness was associated with decline post dementia diagnosis.
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20
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Hill-Jarrett TG, Jones MK. Gendered racism and subjective cognitive complaints among older black women: The role of depression and coping. Clin Neuropsychol 2021; 36:479-502. [PMID: 33998956 DOI: 10.1080/13854046.2021.1923804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Psychosocial stress is a risk factor for cognitive impairment and a potential pathway through which disparities in cognitive functioning emerge and disproportionately disadvantage older Black adults. Gendered racism is a psychosocial stressor that has negative implications for Black women's mental and physical health. This study tested the association between lifetime experiences of gendered racism and subjective cognitive complaints, taking into account the extent to which depressive symptoms and coping styles may explain this association. Method: Data from 75 older Black women (Mage = 62.43, SD = 6.23 years) were collected using an online survey assessing lifetime experiences of gendered racism, depressive symptoms, coping styles (i.e. spirituality, social support, problem-oriented/engagement, and disengagement), and subjective cognitive complaints (i.e. memory, attention, executive functioning, language, and overall cognition). The association between gendered racism and subjective cognitive complaints was examined with simple linear regression. Two mediation models examined depressive symptoms and coping styles as independent mediators of this association. Results: More gendered racism across the lifetime was associated with more subjective cognitive complaints separately through depressive symptoms and disengagement coping, but no other coping styles. Conclusion: Gendered racism is linked to increased subjective cognitive complaints via depressive symptoms and disengagement coping. The study highlights the importance of taking into account lived experiences (gendered racism) that are inextricably linked to social positioning (race and gender) within neuropsychology. Results evidence the negative impact of psychosocial stress, specifically gendered racism, on older Black women's subjective cognitive functioning, and illuminate avenues for clinical intervention and social justice advocacy.
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Affiliation(s)
| | - Martinque K Jones
- Department of Psychology, University of North Texas, Denton, TX, USA
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21
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Mogle J, Hill NL, Turner JR. Individual Differences and Features of Self-reported Memory Lapses as Risk Factors for Alzheimer Disease Among Adults Aged 50 Years and Older: Protocol for a Coordinated Analysis Across Two Longitudinal Data Sets. JMIR Res Protoc 2021; 10:e25233. [PMID: 33988514 PMCID: PMC8164128 DOI: 10.2196/25233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/29/2021] [Accepted: 04/13/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Increasing evidence has promoted the clinical utility of self-reported memory problems for detecting early impairment associated with Alzheimer disease (AD). However, previous studies investigating memory problems often conflated the types of problems (ie, retrospective and prospective) with their features (ie, frequency and consequences). This bias limits the specificity of traditional measures of memory problems and minimizes their ability to detect differential trajectories associated with cognitive decline. In this study, we use a novel measure of self-reported memory problems that uses daily reports of memory lapses to disentangle types from features for analyzing the impact of each dimension in two longitudinal data sets. Furthermore, this study explores the individual difference factors of age and gender as potential moderators of the relationships between self-reported memory lapses and objective cognitive decline. OBJECTIVE The aim of this study is to describe the protocol for a secondary data analysis project that explores the relationship between experiences of daily memory lapses and their associations with cognitive decline in middle-aged and older adults. METHODS This study uses multilevel, coordinated analyses across two measurement burst data sets to examine the links between features and consequences of memory lapses (retrospective and prospective) and their association with objective cognitive decline. This study's sample (N=392; aged 50-85 years; n=254, 64.8% women) is drawn from two ongoing, nationally funded research studies: The Effects of Stress on Cognitive Aging, Physiology, and Emotion study and the Einstein Aging Study. Both studies assess the daily experience of memory lapses, including the type as well as the emotional and functional outcomes, and objective measures of cognition, such as processing speed and episodic memory. We will use multilevel modeling to test our conceptual model demonstrating that differences in frequency and types of memory lapses show differential trends in their relationships with cognitive decline and that these relationships vary by the age and gender of participants. RESULTS This project was funded in August 2019. The approval for secondary data analysis was given by the institutional review board in February 2020. Data analysis for this project has not yet started. CONCLUSIONS The early and accurate identification of individuals most at risk for cognitive decline is of paramount importance. Previous research exploring self-reported memory problems and AD is promising; however, limitations in measurement may explain previous reports of inconsistences. This study addresses these concerns by examining daily reports of memory lapses, how these vary by age and gender, and their relationship with objective cognitive performance. Overall, this study aims to identify the key features of daily memory lapses and the differential trajectories that best predict cognitive decline to help inform future AD risk screening tools. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25233.
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Affiliation(s)
- Jacqueline Mogle
- Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
| | - Nikki L Hill
- College of Nursing, Pennsylvania State University, University Park, PA, United States
| | - Jennifer R Turner
- Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
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22
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Bell T, Hill N, Mogle J, Sweeder L, Bhargava S. Longitudinal evaluation of perceived stress and memory complaints in the Einstein Aging Study. ANXIETY, STRESS, AND COPING 2021; 34:37-50. [PMID: 33108888 PMCID: PMC7769894 DOI: 10.1080/10615806.2020.1836621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/06/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Perceived stress decreases memory performance and escalates the risk of developing cognitive impairment. Despite these concerning cognitive outcomes, longitudinal assessment of the relationship between perceived stress and memory complaints within a racially diverse sample remains scant. METHOD 391 cognitively intact older adults (M = 77.31, SD = 4.75) from the Einstein Aging Study were measured annually for up to nine years. Memory complaint items included self-reported frequency of forgetfulness, one-year memory decline, and 10-year memory decline. Multilevel models examined between-person and within-person associations between perceived stress and memory complaints while controlling for demographic differences and neuroticism. RESULTS Strong between-person associations emerged such that older adults with generally higher perceived stress were more likely to report memory complaints, and vice versa. No significant concurrent within-person associations emerged. One lagged association emerged showing that within-person increases in perceived stress translated to a higher likelihood of reporting 10-year memory decline at the next annual screening. CONCLUSION Older adults with higher perceived stress are at risk for memory complaints over time. Further research into the relationship between perceived stress and memory complaints is necessary to augment our understanding of how risk factors of cognitive decline present throughout the aging process.
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Affiliation(s)
- Tyler Bell
- Center for Behavior Genetics of Aging, Department of Psychiatry, University of California San Diego, United States of America
| | - Nikki Hill
- College of Nursing, The Pennsylvania State University, University Park, United States of America
| | - Jacqueline Mogle
- Edna Bennet Peirce Prevention Research Center, The Pennsylvania State University, University Park, United States of America
| | - Logan Sweeder
- College of Nursing, The Pennsylvania State University, University Park, United States of America
| | - Sakshi Bhargava
- College of Nursing, The Pennsylvania State University, University Park, United States of America
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23
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Oumohand SE, Ward DD, Boenniger MM, Merten N, Kirschbaum C, Breteler MMB. Perceived stress but not hair cortisol concentration is related to adult cognitive performance. Psychoneuroendocrinology 2020; 121:104810. [PMID: 32739745 DOI: 10.1016/j.psyneuen.2020.104810] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 07/12/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022]
Abstract
Chronic stress detrimentally affects cognition but evidence from population-based studies is scarce and largely based on one-dimensional stress assessments. In this study, we aimed to investigate associations of subjective and psychological chronic stress measures with cognition in a population-based sample of adults aged 30-95 years from the Rhineland Study. Participants completed the Perceived Stress Scale (subjective measure) and a cognitive test battery (N = 1766). Hair cortisol concentration (physiological measure) was assessed by liquid chromatography tandem mass spectrometry in 1098 participants. Cross-sectional associations between the two measures of chronic stress and cognition were investigated using multivariable linear regression models. Subjective and physiological measures of chronic stress were not associated with each other (B = 0.005 [95 %CI = -0.005 - 0.015]). Participants with higher perceived stress and specifically lower perceived self-efficacy performed worse in all cognitive domains (effect sizes ranged from β = -0.129 [95 %CI = -0.177 - -0.080] to -0.054 [95 %CI = -0.099 - -0.009]; and from β = 0.052 [95 %CI = 0.005 - 0.098] to 0.120 [95 %CI = 0.072 - 0.167], respectively). Relationships between subjective chronic stress measures and executive functioning were stronger in men compared to women (interaction β = -0.144 [95 %CI = -0.221 - -0.067]). Relationships between perceived stress and working memory, and between perceived self-efficacy and executive functioning, processing speed, verbal episodic and working memory, increased with older age. Hair cortisol concentration was not associated with performance in any cognitive domain. Our results suggest that subjective and physiological measures capture different aspects of chronic stress in the general population.
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Affiliation(s)
- Sadia E Oumohand
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany
| | - David D Ward
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany
| | - Meta M Boenniger
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany
| | - Natascha Merten
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany
| | - Clemens Kirschbaum
- Faculty of Psychology, Technische Universität Dresden, 01062 Dresden, Germany
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Building 99, 53127 Bonn, Germany; Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Venusberg-Campus 1, Building 11, 53127 Bonn, Germany.
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24
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Kostev K, Bohlken J, Jacob L. Association Between Migraine Headaches and Dementia in More than 7,400 Patients Followed in General Practices in the United Kingdom. J Alzheimers Dis 2020; 71:353-360. [PMID: 31403950 DOI: 10.3233/jad-190581] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Most previous studies focusing on the migraine headache-dementia relationship have failed to simultaneously adjust for several common comorbidities. OBJECTIVE The goal of this retrospective cohort study was to investigate the association between migraine headaches and dementia in general practices in the UK. METHODS The current study sample included patients who received a migraine diagnosis in one of 67 general practices in the UK between January 1997 and December 2016 (index date). Patients without migraine diagnoses were matched 1 : 1 to patients with migraine diagnoses based on propensity scores using a greedy algorithm and derived from the logistic regression using age, sex, index year, and co-diagnoses. The main outcome of the study was the association between migraine headaches and the incidence of dementia within 10 years of the index date. RESULTS This study included 7,454 individuals with or without migraine diagnoses. Mean age was 67.7 years (SD = 5.8 years), and 72.9% of patients were women. Within 10 years of the index date, 5.2% of participants with and 3.7% of those without migraine headaches were diagnosed with dementia (log-rank p < 0.001). The respective figures were 5.8% and 3.6% in women (log-rank p < 0.001) and 4.5% and 3.4% in men (log-rank p = 0.722). We observed a positive association between migraine diagnoses and all-cause dementia (hazard ratio [HR] = 1.43) as well as Alzheimer's disease (HR = 1.87). Sensitivity analyses further revealed that these associations were only significant in women (all-cause dementia: HR = 1.65; Alzheimer's disease: HR = 2.27). CONCLUSION Migraine diagnoses were positively associated with all-cause dementia and Alzheimer's disease in women.
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Affiliation(s)
| | - Jens Bohlken
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät der Universität Leipzig
| | - Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
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25
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Hudon C, Escudier F, De Roy J, Croteau J, Cross N, Dang-Vu TT, Zomahoun HTV, Grenier S, Gagnon JF, Parent A, Bruneau MA, Belleville S. Behavioral and Psychological Symptoms that Predict Cognitive Decline or Impairment in Cognitively Normal Middle-Aged or Older Adults: a Meta-Analysis. Neuropsychol Rev 2020; 30:558-579. [PMID: 32394109 DOI: 10.1007/s11065-020-09437-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
Abstract
Epidemiological studies have revealed that behavioral and psychological (or non-cognitive) symptoms are risk factors for cognitive decline in older adults. This study aimed to systematically review the literature and determine which behavioral and psychological symptoms are most predictive of future cognitive decline among individuals with no pre-existing cognitive impairments. The selected studies included middle-aged or older adults without cognitive impairments. The predictors were assessed using behavioral and psychological questionnaires, or diagnostic interviews, to identify non-cognitive symptoms or psychiatric clinical conditions. The follow-up period was at least one year, and the design of the selected studies was either retrospective or prospective. This study compared individuals with and without non-cognitive manifestations and resulted in one of three outcomes: (a) a score change on a cognitive measure, (b) a diagnosis of mild cognitive impairment, or (c) a diagnosis of Alzheimer's disease or dementia. Four online databases were searched for eligible studies from the database inception to January 17, 2017: MEDLINE (PubMed), Embase (OVID), PsycINFO, and Web of Science. Pooled effect sizes were estimated using a random-effect model. Higgins I2, the Q statistic, and tau-squared were used to quantify the observed heterogeneity between the studies. Results indicate that depression and sleep duration (long and short) were the most consistent associations between behavioral or psychological symptoms and cognitive decline. This meta-analysis supports the need to assess behavioral and psychological symptoms in cognitively intact older adults to identify those who are at risk for cognitive decline.
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Affiliation(s)
- Carol Hudon
- École de psychologie, Université Laval, 2601, ch. de la Canardière (F-2400), Québec, QC, G1J 2G3, Canada. .,CERVO Brain Research Centre, Québec, QC, Canada.
| | - Frédérique Escudier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jessie De Roy
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | - Jordie Croteau
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Nathan Cross
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Thien Thanh Dang-Vu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Department of Health, Kinesiology and Applied Physiology, Concordia University, Montréal, QC, Canada
| | - Hervé Tchala Vignon Zomahoun
- Health and Social Services Systems, Knowledge Translation and Implementation component of the Quebec SPOR-SUPPORT Unit, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research Group, Research Centre of CHU de Québec-Université Laval, Québec, QC, Canada
| | - Sébastien Grenier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Gagnon
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Centre de recherche, Hôpital du Sacré-Cœur de Montréal, CIUSSS-NÎM, Montréal, QC, Canada
| | | | - Marie-Andrée Bruneau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychiatrie, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,Département de psychologie, Université de Montréal, Montréal, QC, Canada
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Psychological stress, cognitive decline and the development of dementia in amnestic mild cognitive impairment. Sci Rep 2020; 10:3618. [PMID: 32108148 PMCID: PMC7046646 DOI: 10.1038/s41598-020-60607-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 02/10/2020] [Indexed: 12/30/2022] Open
Abstract
To determine the relationship between psychological stress with cognitive outcomes in a multi-centre longitudinal study of people with amnestic mild cognitive impairment (aMCI) we assessed three parameters of psychological stress (Recent Life Changes Questionnaire (RLCQ); the Perceived Stress Scale (PSS) and salivary cortisol) and their relationship with rates of cognitive decline over an 18 month follow up period and conversion to dementia over a 5.5 year period. In 133 aMCI and 68 cognitively intact participants the PSS score was higher in the aMCI compared with control group but neither the RLCQ scores nor salivary cortisol measures were different between groups. In the aMCI group the RLCQ and the PSS showed no significant association with cognitive function at baseline, cognitive decline or with conversion rates to dementia but high salivary cortisol levels were associated with RLCQ scores and poorer cognitive function at baseline and lower rates of cognitive decline. No relationship was found between salivary cortisol levels and conversion rate to dementia. We conclude that psychological stress as measured by the RLCQ or PSS was not associated with adverse cognitive outcomes in an aMCI population and hypothesise that this may reflect diminished cortisol production to psychological stress as the disease progresses.
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27
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Peña-Bautista C, Casas-Fernández E, Vento M, Baquero M, Cháfer-Pericás C. Stress and neurodegeneration. Clin Chim Acta 2020; 503:163-168. [PMID: 31987795 DOI: 10.1016/j.cca.2020.01.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/13/2022]
Abstract
Neurodegenerative diseases are a great concern because of aging worldwide population. Despite substantial effort to advance our understanding of the etiology and potential treatment of neurodegeneration, there remains a paucity of information with respect to this complex disease process. Interestingly, stress has been implicated among the potential mechanisms implicated in neurodegenerative pathology. Given the increase in chronic stress in modern society, this premise warrants further investigation. The aim of this review is to evaluate the influence of stress on neurodegeneration, the effect of neurodegenerative diseases diagnosis on stress, and therapeutic strategies for neurodegenerative diseases with a special focus on stress reduction. Neurodegenerative disorders such as Alzheimer's, Parkinson's and Huntington's Disease showed an acceleration in disease progression and a worsening of symptoms under stress. Some therapies (e.g., yoga, meditation) focused on reducing stress showed beneficial effects against neurodegeneration. Nevertheless, more studies are necessary in order to completely understand the implications of stress in neurodegeneration and the usefulness of stress reduction in the treatment thereof.
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Affiliation(s)
| | | | - Máximo Vento
- Health Research Institute La Fe, Valencia, Spain
| | - Miguel Baquero
- Division of Neurology, University and Polytechnic Hospital La Fe, Valencia, Spain
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28
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Munoz E, Stawski RS, Sliwinski MJ, Smyth JM, MacDonald SWS. The Ups and Downs of Cognitive Function: Neuroticism and Negative Affect Drive Performance Inconsistency. J Gerontol B Psychol Sci Soc Sci 2020; 75:263-273. [PMID: 29590450 PMCID: PMC7179809 DOI: 10.1093/geronb/gby032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/23/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Response time inconsistency (RTI)-or trial-to-trial variability in speeded performance-is increasingly recognized as an indicator of transient lapses of attention, cognitive health status, and central nervous system integrity, as well as a potential early indicator of normal and pathological cognitive aging. Comparatively, little research has examined personality predictors of RTI across adulthood. METHODS We evaluated the association between the personality trait neuroticism and RTI in a community-dwelling sample of 317 adults between the ages of 19-83 and tested for two indirect pathways through negative affect (NA) and cognitive interference (CI). RESULTS The personality trait neuroticism predicted greater RTI independent of mean response time performance and demographic covariates; the results were age-invariant. Furthermore, NA (but not CI) accounted for this association and moderated mediation model results indicated that older adults were more vulnerable to the adverse effects of NA. DISCUSSION Neuroticism predicts greater RTI irrespective of mean performance and this effect is driven largely by heightened negative emotionality that may be particularly detrimental for older adults.
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Affiliation(s)
- Elizabeth Munoz
- Department of Psychology, University of California, Riverside
| | - Robert S Stawski
- College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Martin J Sliwinski
- Department of Human Development and Family Studies and Center for Healthy Aging
| | - Joshua M Smyth
- Department of Biobehavioral Health, Pennsylvania State University, University Park
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29
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Arnsten AFT, Datta D, Leslie S, Yang ST, Wang M, Nairn AC. Alzheimer's-like pathology in aging rhesus macaques: Unique opportunity to study the etiology and treatment of Alzheimer's disease. Proc Natl Acad Sci U S A 2019; 116:26230-26238. [PMID: 31871209 PMCID: PMC6936707 DOI: 10.1073/pnas.1903671116] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Although mouse models of Alzheimer's disease (AD) have provided tremendous breakthroughs, the etiology of later onset AD remains unknown. In particular, tau pathology in the association cortex is poorly replicated in mouse models. Aging rhesus monkeys naturally develop cognitive deficits, amyloid plaques, and the same qualitative pattern and sequence of tau pathology as humans, with tangles in the oldest animals. Thus, aging rhesus monkeys can play a key role in AD research. For example, aging monkeys can help reveal how synapses in the prefrontal association cortex are uniquely regulated compared to the primary sensory cortex in ways that render them vulnerable to calcium dysregulation and tau phosphorylation, resulting in the selective localization of tau pathology observed in AD. The ability to assay early tau phosphorylation states and perform high-quality immunoelectron microscopy in monkeys is a great advantage, as one can capture early-stage degeneration as it naturally occurs in situ. Our immunoelectron microscopy studies show that phosphorylated tau can induce an "endosomal traffic jam" that drives amyloid precursor protein cleavage to amyloid-β in endosomes. As amyloid-β increases tau phosphorylation, this creates a vicious cycle where varied precipitating factors all lead to a similar phenotype. These data may help explain why circuits with aggressive tau pathology (e.g., entorhinal cortex) may degenerate prior to producing significant amyloid pathology. Aging monkeys therefore can play an important role in identifying and testing potential therapeutics to protect the association cortex, including preventive therapies that are challenging to test in humans.
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Affiliation(s)
- Amy F. T. Arnsten
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510
| | - Dibyadeep Datta
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510
| | - Shannon Leslie
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510
| | - Sheng-Tao Yang
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510
| | - Min Wang
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510
| | - Angus C. Nairn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510
- Department of Pharmacology, Yale University School of Medicine, New Haven, CT 06510
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Antonucci TC, Ajrouch KJ, Webster NJ, Zahodne LB. Social Relations Across the Life Span: Scientific Advances, Emerging Issues, and Future Challenges. ACTA ACUST UNITED AC 2019. [DOI: 10.1146/annurev-devpsych-121318-085212] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Accumulating evidence demonstrates the importance of social relations at all stages of life (infancy, childhood, adolescence, adulthood, and old age) and in diverse domains of life (including health and well-being). To illustrate the newest advancements in the scientific study of social relations over the life course, we address five emerging areas of importance: societal and demographic changes in family structure; effects of new technologies on social relations; the fundamental influence of context on social relations, illustrated with the sample case of health; the role of social relations in the unfortunate but pressing crisis of trauma among the increasing number of refugees worldwide; and, finally, effects of social relations on cognitive functioning in late life. Each of these areas highlights critical key concepts and methodological approaches, illustrating that the study of social relations is demanding but holds great promise for meeting the urgent needs of developmental science specifically and society generally.
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Affiliation(s)
- Toni C. Antonucci
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Kristine J. Ajrouch
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106, USA
- Department of Sociology, Anthropology and Criminology, Eastern Michigan University, Ypsilanti, Michigan 48197, USA
| | - Noah J. Webster
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106, USA
| | - Laura B. Zahodne
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA
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Andreescu C, Ajilore O, Aizenstein HJ, Albert K, Butters MA, Landman BA, Karim HT, Krafty R, Taylor WD. Disruption of Neural Homeostasis as a Model of Relapse and Recurrence in Late-Life Depression. Am J Geriatr Psychiatry 2019; 27:1316-1330. [PMID: 31477459 PMCID: PMC6842700 DOI: 10.1016/j.jagp.2019.07.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/26/2019] [Accepted: 07/29/2019] [Indexed: 12/29/2022]
Abstract
The significant public health burden associated with late-life depression (LLD) is magnified by the high rates of recurrence. In this manuscript, we review what is known about recurrence risk factors, conceptualize recurrence within a model of homeostatic disequilibrium, and discuss the potential significance and challenges of new research into LLD recurrence. The proposed model is anchored in the allostatic load theory of stress. We review the allostatic response characterized by neural changes in network function and connectivity and physiologic changes in the hypothalamic-pituitary-adrenal axis, autonomic nervous system, immune system, and circadian rhythm. We discuss the role of neural networks' instability following treatment response as a source of downstream disequilibrium, triggering and/or amplifying abnormal stress response, cognitive dysfunction and behavioral changes, ultimately precipitating a full-blown recurrent episode of depression. We propose strategies to identify and capture early change points that signal recurrence risk through mobile technology to collect ecologically measured symptoms, accompanied by automated algorithms that monitor for state shifts (persistent worsening) and variance shifts (increased variability) relative to a patient's baseline. Identifying such change points in relevant sensor data could potentially provide an automated tool that could alert clinicians to at-risk individuals or relevant symptom changes even in a large practice.
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Affiliation(s)
| | | | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh,Department of Bioengineering, University of Pittsburgh
| | - Kimberly Albert
- The Center for Cognitive Medicine, the Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
| | | | - Bennett A. Landman
- Departments of Computer Science, Electrical Engineering, and Biomedical Engineering, Vanderbilt University; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center
| | | | - Robert Krafty
- Department of Biostatistics, University of Pittsburgh
| | - Warren D. Taylor
- The Center for Cognitive Medicine, the Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center,Geriatric Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System
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Sharma A, Kumar Y. Nature's Derivative(s) as Alternative Anti-Alzheimer's Disease Treatments. J Alzheimers Dis Rep 2019; 3:279-297. [PMID: 31867567 PMCID: PMC6918879 DOI: 10.3233/adr-190137] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2019] [Indexed: 12/15/2022] Open
Abstract
Alzheimer's disease (AD), the 'Plague of Twenty-First Century,' is a crippling neurodegenerative disease that affects a majority of the older population globally. By 2050, the incidence of AD is expected to rise to 135 million, while no treatment(s) that can reverse or control the progression of AD are currently available. The treatment(s) in use are limited in their ability to manage the symptoms or slow the progression of the disease and can lead to some severe side effects. The overall care is economically burdensome for the affected individuals as well as the caretakers or family members. Thus, there is a pressing need to identify and develop much safer alternative therapies that can better manage AD. This review discusses a multitude of such treatments borrowed from Ayurveda, traditional Chinese practices, meditation, and exercising for AD treatment. These therapies are in practice since ancient times and reported to be beneficial as anti-AD therapies. Ayurvedic drugs like turmeric, Brahmi, Ashwagandha, etc., management of stress by meditation, regular exercising, and acupuncture have been reported to be efficient in their anti-AD usage. Besides, a combination of vitamins and natural dietary intakes is likely to play a significant role in combating AD. We conclude that the use of such alternative strategies will be a stepping-stone in preventing, treating, curing, or managing the disease.
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Affiliation(s)
- Anuja Sharma
- Department of Biological Sciences and Engineering (BSE), Netaji Subhas University of Technology (NSUT), Formerly Netaji Subhas Institute of Technology (NSIT), Azad Hind Fauz Marg, New Delhi, India
| | - Yatender Kumar
- Department of Biological Sciences and Engineering (BSE), Netaji Subhas University of Technology (NSUT), Formerly Netaji Subhas Institute of Technology (NSIT), Azad Hind Fauz Marg, New Delhi, India
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Cuevas AG, Chen R, Thurber KA, Slopen N, Williams DR. Psychosocial Stress and Overweight and Obesity: Findings From the Chicago Community Adult Health Study. Ann Behav Med 2019; 53:NP. [PMID: 30917198 PMCID: PMC6779073 DOI: 10.1093/abm/kaz008] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Psychosocial stress has been implicated as a risk factor for overweight and obesity. However, research on psychosocial stressors and overweight and obesity has typically focused on single stressors in isolation, which may overestimate the impact of a specific stressor and fail to describe the role of cumulative stress on overweight and obesity risk. PURPOSE This study explores the association between overweight/obesity and cumulative exposure to a wide range of psychosocial stressors, among a multiracial/ethnic sample of adults. METHODS Using secondary data from the Chicago Community Adult Health Study (n = 2,983), we conducted multinomial logistic regression analyses to quantify associations between eight psychosocial stressors, individually and in combination, and measured overweight and obesity, adjusted for sociodemographic factors, alcohol use and smoking. RESULTS In separated covariate-adjusted models, childhood adversities (odds ratio [OR] = 1.16; confidence interval [CI] = [1.03, 1.30]), acute life events (OR = 1.18; CI = [1.04, 1.34]), financial strain (OR = 1.30; CI = [1.15, 1.47]), and relationship stressors (OR = 1.18; CI = [1.04, 1.35]) were associated with increased odds of obesity. In a model adjusted for all stressors simultaneously, financial strain was the only stressor independently associated with overweight (OR = 1.17; CI = [1.00, 1.36]) and obesity (OR = 1.21; CI = [1.05, 1.39]). Participants with stress exposure in the highest quintile across 2, 3, or ≥4 (compared to no) types of stressors had significantly higher odds of obesity. CONCLUSIONS Multiple types of stressors may be risk factors for obesity, and cumulative exposure to these stressors may increase the odds of obesity. Reducing exposure to stressors at the population level may have the potential to contribute to reducing the burden of obesity.
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Affiliation(s)
- Adolfo G Cuevas
- Department of Community Health, Tufts University, Suite, Medford, MA
| | - Ruijia Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Katherine A Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Natalie Slopen
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of African and African American Studies, Harvard University, Cambridge, MA
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Perales-Puchalt J, Gauthreaux K, Flatt J, Teylan MA, Resendez J, Kukull WA, Chan KCG, Burns J, Vidoni ED. Risk of dementia and mild cognitive impairment among older adults in same-sex relationships. Int J Geriatr Psychiatry 2019; 34:828-835. [PMID: 30864178 PMCID: PMC6502266 DOI: 10.1002/gps.5092] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 03/05/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Sexual minority discrimination might lead to a higher risk of mild cognitive impairment (MCI) and dementia. The aim of this study was to assess the risk of MCI and dementia between older adults in same-sex relationships (SSR) and opposite-sex relationships (OSR). METHODS We analyzed longitudinal data from the National Alzheimer's Coordinating Center up to September 2017. Analyses included cognitively normal individuals 55+ at baseline who had a spouse, partner, or companion as study partner at any assessment. Associations were calculated using survival analysis adjusting for demographics and APOE-e4 carrier status. RESULTS Hazard ratios of MCI and dementia did not differ statistically between SSR and OSR individuals in the total sample nor stratified by sex. CONCLUSION The lack of association between SSR and MCI and dementia warrants future research into their potential resilience mechanisms and the inclusion of sexual minority status questions in research and surveillance studies. The potential recruitment bias caused by nonprobabilistic sampling of the cohort and the reporting and ascertainment bias caused by using SSR to infer sexual minority status may have influenced our findings.
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Affiliation(s)
- Jaime Perales-Puchalt
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA; 913-588-3716,
| | - Kathryn Gauthreaux
- University of Washington, Department of Epidemiology, National Alzheimer’s Coordinating Center, Seattle, WA 98195, USA; 206-616-5647,
| | - Jason Flatt
- University of California San Francisco, Institute for Health Aging, San Francisco, CA 94143, USA; 415-476-9477,
| | - Merilee Ann Teylan
- University of Washington, Department of Epidemiology, National Alzheimer’s Coordinating Center, Seattle, WA 98195. USA; 206-616-6208,
| | - Jason Resendez
- LatinosAgainstAlzheimer’s Coalition; UsAgainstAlzheimer’s; 2 Wisconsin Circle, Suite 700, Chevy Chase, MD, 20815, USA; 202-280-0884,
| | - Walter A Kukull
- University of Washington, Department of Epidemiology, National Alzheimer’s Coordinating Center, Seattle, WA 98195, USA; 206-616-1765,
| | - Kwun CG Chan
- University of Washington, Department of Biostatistics, National Alzheimer’s Coordinating Center, Seattle, WA 98195, USA; 206-685-9177,
| | - Jeffrey Burns
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA; 913-588-0970,
| | - Eric D Vidoni
- University of Kansas Alzheimer’s Disease Center, MS6002, Fairway, KS 66205, USA; 913-588-5312,
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Phibbs S, Stawski RS, MacDonald SW, Munoz E, Smyth JM, Sliwinski MJ. The influence of social support and perceived stress on response time inconsistency. Aging Ment Health 2019; 23:214-221. [PMID: 29171959 PMCID: PMC8864726 DOI: 10.1080/13607863.2017.1399339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Lack of social support and high levels of stress represent potentially modifiable risk factors for cognitive aging. In this study we examined the relationships between these two risk factors and response time inconsistency (RTI), or trial-to-trial variability in choice response time tasks. RTI is an early indicator of declining cognitive health, and examining the influence of modifiable psychosocial risk factors on RTI is important for understanding and promoting cognitive health during adulthood and old age. METHODS Using data from a community sample study (n = 317; Mage = 49, range = 19-83), we examined the effects of social support, including size of network and satisfaction with support, global perceived stress, and their interactions on RTI. RESULTS Neither size of network nor satisfaction with support was associated with RTI independent of perceived stress. Stress was positively associated with increased RTI on all tasks, independent of social support. Perceived stress did not interact with either dimension of social support to predict RTI, and perceived stress effects were invariant across age and sex. CONCLUSION Perceived stress, but not social support, may be a unique and modifiable risk factor for normal and pathological cognitive aging. Discussion focuses on the importance of perceived stress and its impact on RTI in supporting cognitive health in adulthood and old age.
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Affiliation(s)
- Sandi Phibbs
- Department of Health Science and Recreation, San José State University, San Jose, CA, USA
| | - Robert S. Stawski
- College of Public Health and Human Sciences, School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR, USA
| | | | - Elizabeth Munoz
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - Joshua M. Smyth
- College of Health and Human Development, Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Martin J. Sliwinski
- College of Health and Human Development, Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
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Guerdoux-Ninot E, Trouillet R. Impact of perceived stress on cognitive performance: Moderating effect of mild cognitive impairment and Alzheimer’s disease. J Clin Exp Neuropsychol 2019; 41:364-379. [DOI: 10.1080/13803395.2018.1564250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Estelle Guerdoux-Ninot
- Department of Supportive Care, Psycho-oncology Unit, Montpellier Cancer Institute (ICM) – University of Montpellier, Montpellier, France
- Department of Neuro-geriatrics, Millénaire Private Hospital, Montpellier, France
| | - Raphaël Trouillet
- Laboratory Epsylon EA 4556, Université of Montpellier and University Paul Valéry, Montpellier, France
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Son SJ, Park B, Choi JW, Roh HW, Kim NR, Sin JE, Kim H, Lim HK, Hong CH. Psychological Resilience Enhances the Orbitofrontal Network in the Elderly With Mild Cognitive Impairment. Front Psychiatry 2019; 10:615. [PMID: 31555158 PMCID: PMC6726738 DOI: 10.3389/fpsyt.2019.00615] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 08/01/2019] [Indexed: 12/25/2022] Open
Abstract
Background: It has been suggested that maintaining the efficient organization of the brain's functional connectivity (FC) supports neuroflexibility under neurogenerative stress. This study examined psychological resilience-related FC in 112 older adults with mild cognitive impairment (MCI). Methods: Using a resting-state functional magnetic resonance imaging (fMRI) approach, we investigated reorganization of the orbitofrontal gyrus (OFG)/amygdala (AMG)/hippocampus (HP)/parahippocampal gyrus (PHG) FC according to the different levels of resilience scale. Results: Compared with the low resilient group, the high resilient group had greater connectivity strengths between the left inferior OFG and right superior OFG (P < 0.05, Bonferroni corrected), between the right inferior OFG and left PHG (P < 0.05, Bonferroni corrected), and between the right middle OFG and left PHG (false discovery rate < 0.05). Conclusion: Psychological resilience may be associated with enhancement of the orbitofrontal network in the elderly with MCI.
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Affiliation(s)
- Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Bumhee Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.,Office of Biostatistics, Ajou University School of Medicine, Suwon, South Korea
| | - Jin Wook Choi
- Department of Radiology, Ajou University School of Medicine, Suwon, South Korea
| | - Hyun Woong Roh
- Department of Brain Science, Ajou University School of Medicine, Suwon, South Korea
| | - Na-Rae Kim
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Jae Eun Sin
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Haena Kim
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Hyun Kook Lim
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Yeouido St. Mary's Hospital, Seoul, South Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
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Koyanagi A, Oh H, Vancampfort D, Carvalho AF, Veronese N, Stubbs B, Lara E. Perceived Stress and Mild Cognitive Impairment among 32,715 Community-Dwelling Older Adults across Six Low- and Middle-Income Countries. Gerontology 2018; 65:155-163. [PMID: 30199870 DOI: 10.1159/000492177] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/18/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Perceived stress may be a modifiable risk factor for mild cognitive impairment (MCI) and ultimately dementia, but studies on this topic from low- and middle-income countries (LMICs) are lacking. OBJECTIVE We assessed the association between perceived stress and MCI in six LMICs (China, Ghana, India, Mexico, Russia, and South Africa) using nationally representative data. METHODS Cross-sectional, community-based data on individuals aged ≥50 years from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. A perceived stress score (range 0 [lowest stress] to 10 [highest stress]) was computed based on two questions from the Perceived Stress Scale. Multivariable logistic regression analysis was conducted to assess the as-sociation between perceived stress and MCI. RESULTS The mean (SD) age of the 32,715 participants was 62.1 (15.6) years and 51.7% were females. After adjustment for potential confounders including depression, in the overall sample, a one-unit increase in the perceived stress score was associated with a 1.14 (95% CI = 1.11-1.18) times higher odds for MCI. The association was similar among those aged 50-64 and ≥65 years. Countrywise analysis showed that there was a moderate level of between-country heterogeneity in this association (I2 = 59.4%), with the strongest association observed in Russia (OR = 1.33, 95% CI = 1.15-1.55). CONCLUSION If our study results are confirmed in prospective studies, addressing perceived stress may have an impact in reducing the risk for MCI and subsequent dementia in LMICs.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, .,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid,
| | - Hans Oh
- School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center, KU Leuven, Leuven-Kortenberg, Belgium
| | - Andre F Carvalho
- Centre for Addiction & Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Elvira Lara
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
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Jiang JM, Seng EK, Zimmerman ME, Sliwinski M, Kim M, Lipton RB. Evaluation of the Reliability, Validity, and Predictive Validity of the Subscales of the Perceived Stress Scale in Older Adults. J Alzheimers Dis 2018; 59:987-996. [PMID: 28671128 DOI: 10.3233/jad-170289] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Perceived Stress Scale (PSS) is made up of two subscales but is typically used as a single summary measure. However, research has shown that the two subscales may have differential properties in older adults. OBJECTIVE To evaluate the internal consistency, test-retest reliability, and the concurrent and predictive validity for development of amnestic mild cognitive impairment (aMCI) of the positively-worded (PSS-PW) and negatively-worded (PSS-NW) subscale scores of the PSS in older adults. METHODS We recruited community residing older adults free of dementia from the Einstein Aging Study. Reliability of the PSS-PW and PSS-NW was assessed using Cronbach's alpha for internal consistency and intraclass correlation for one year test-retest reliability. Concurrent validity was evaluated by examining the relationship between the PSS subscales and depression, anxiety, neuroticism, and positive and negative affect. Predictive validity was assessed using multivariate Cox regression analyses to examine the relationship between baseline PSS-PW and PSS-NW score and subsequent onset of aMCI. RESULTS Both PSS-PW and PSS-NW showed adequate internal consistency and retest reliabilities. Both the PSS-PW and PSS-NW were associated with depression, neuroticism, and negative affect. The PSS-NW was uniquely associated with anxiety while the PSS-PW was uniquely associated with positive affect. Only the PSS-PW was associated with a statistically significant increased risk of incident aMCI (HR = 1.27; 95% CI: 1.06-1.51 for every 5-point increase in PSS-PW). CONCLUSIONS Evaluating the separate effects of the two PSS subscales may reveal more information than simply using a single summation score. Future research should investigate the PSS-PW and PSS-NW as separate subscales.
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Affiliation(s)
- Julie M Jiang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Elizabeth K Seng
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Molly E Zimmerman
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Martin Sliwinski
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Mimi Kim
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
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Jaroudi W, Garami J, Garrido S, Hornberger M, Keri S, Moustafa AA. Factors underlying cognitive decline in old age and Alzheimer's disease: the role of the hippocampus. Rev Neurosci 2018; 28:705-714. [PMID: 28422707 DOI: 10.1515/revneuro-2016-0086] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/18/2017] [Indexed: 11/15/2022]
Abstract
There are many factors that strongly influence the aetiology, development, and progression of cognitive decline in old age, mild cognitive impairment (MCI), and Alzheimer's disease (AD). These factors include not only different personality traits and moods but also lifestyle patterns (e.g. exercise and diet) and awareness levels that lead to cognitive decline in old age. In this review, we discuss how personality traits, mood states, and lifestyle impact brain and behaviour in older adults. Specifically, our review shows that these lifestyle and personality factors affect several brain regions, including the hippocampus, a region key for memory that is affected by cognitive decline in old age as well as AD. Accordingly, appropriate recommendations are presented in this review to assist individuals in decreasing chances of MCI, dementia, AD, and associated symptoms.
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Russell-Williams J, Jaroudi W, Perich T, Hoscheidt S, El Haj M, Moustafa AA. Mindfulness and meditation: treating cognitive impairment and reducing stress in dementia. Rev Neurosci 2018; 29:791-804. [DOI: 10.1515/revneuro-2017-0066] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 12/08/2017] [Indexed: 01/22/2023]
Abstract
Abstract
This study investigates the relationship between mindfulness, meditation, cognition and stress in people with Alzheimer’s disease (AD), dementia, mild cognitive impairment and subjective cognitive decline. Accordingly, we explore how the use of meditation as a behavioural intervention can reduce stress and enhance cognition, which in turn ameliorates some dementia symptoms. A narrative review of the literature was conducted with any studies using meditation as an intervention for dementia or dementia-related memory conditions meeting inclusion criteria. Studies where moving meditation was the main intervention were excluded due to the possible confounding of exercise. Ten papers were identified and reviewed. There was a broad use of measures across all studies, with cognitive assessment, quality of life and perceived stress being the most common. Three studies used functional magnetic resonance imaging to measure functional changes to brain regions during meditation. The interventions fell into the following three categories: mindfulness, most commonly mindfulness-based stress reduction (six studies); Kirtan Kriya meditation (three studies); and mindfulness-based Alzheimer’s stimulation (one study). Three of these studies were randomised controlled trials. All studies reported significant findings or trends towards significance in a broad range of measures, including a reduction of cognitive decline, reduction in perceived stress, increase in quality of life, as well as increases in functional connectivity, percent volume brain change and cerebral blood flow in areas of the cortex. Limitations and directions for future studies on meditation-based treatment for AD and stress management are suggested.
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Affiliation(s)
- Jesse Russell-Williams
- School of Social Sciences and Psychology , Western Sydney University , Sydney 2751, New South Wales , Australia
| | - Wafa Jaroudi
- School of Social Sciences and Psychology , Western Sydney University , Sydney 2751, New South Wales , Australia
| | - Tania Perich
- School of Social Sciences and Psychology , Western Sydney University , Sydney 2751, New South Wales , Australia
- School of Psychiatry , University of New South Wales , Sydney 2751, New South Wales , Australia
| | - Siobhan Hoscheidt
- Gerontology and Geriatric Medicine, Wake Forest School of Medicine , Winston-Salem 27157, NC , USA
| | - Mohamad El Haj
- University of Lille, CNRS, CHU Lille, UMR 9193–SCALab–Sciences Cognitive Sciences Affectives , F-59000 Lille , France
| | - Ahmed A. Moustafa
- School of Social Sciences and Psychology , Western Sydney University , Sydney 2751, New South Wales , Australia
- Marcs Institute for Brain and Behaviour , Western Sydney University , Sydney 2751, New South Wales , Australia
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Plantinga L, Lim SS, Bowling CB, Drenkard C. Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus. Lupus 2017; 26:1064-1071. [PMID: 28420055 PMCID: PMC5494014 DOI: 10.1177/0961203317693095] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To examine associations of perceived stress with cognitive symptoms among adults with systemic lupus erythematosus (SLE). Methods Among 777 adult (≥18 years) SLE patients, the association of Perceived Stress Scale (PSS) scores with two self-reported cognitive symptoms was examined: forgetfulness (severe/moderate vs. mild/none; from the Systemic Lupus Activity Questionnaire) and difficulty concentrating (all/most vs. some/little/none of the time; from the Lupus Impact Tracker). The study used multivariable logistic regression to estimate the odds ratios (ORs) per minimal important difference (MID = 0.5*SD) of PSS score and cognitive symptoms. Results Forgetfulness and difficulty concentrating were reported by 41.7% and 29.5%, respectively. Women and those with less education and high disease activity had higher PSS scores and were more likely to report cognitive symptoms than their counterparts. With adjustment for age, race, sex, education, and disease activity, each MID increase in PSS score was associated with higher prevalence of forgetfulness (OR = 1.43, 95% CI 1.29-1.47) and difficulty concentrating (OR = 2.19, 95% CI 1.90-2.52). No substantial differences in this association by age, race, sex, or disease activity were noted. Conclusions SLE patients, particularly those with high disease activity, report a high burden of cognitive symptoms, for which stress may be a modifiable risk factor.
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Affiliation(s)
- Laura Plantinga
- Division of Renal Medicine, Department of Medicine, Emory University
- Division of Geriatrics and General Medicine, Department of Medicine, Emory University
| | - S. Sam Lim
- Division of Rheumatology, Department of Medicine, Emory University
| | - C. Barrett Bowling
- Division of Geriatrics and General Medicine, Department of Medicine, Emory University
- Birmingham/Atlanta VA Geriatrics Research and Clinical Center, Atlanta, Georgia, United States
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Jiang JM, Seng EK, Zimmerman ME, Kim M, Lipton RB. Positively worded subscale score of the Perceived Stress Scale is associated with cognitive domain function. JOURNAL OF BEHAVIORAL AND BRAIN SCIENCE 2017; 7:311-324. [PMID: 29372111 PMCID: PMC5777589 DOI: 10.4236/jbbs.2017.77023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To examine the cross-sectional associations of the separate subscales of the Perceived Stress Scale (PSS) and tests measuring cognitive domains in older adults. METHODS 897 adults over the age of 70 free of amnestic mild cognitive impairment and dementia and enrolled in the Einstein Aging Study made up the study sample. The PSS-14 was used to measure stress. Three cognitive domains (language, episodic memory, and frontal-executive) had previously been found using principle component analysis. Linear regression analyses were used to determine the relationship between the PSS subscales and cognitive domain function. RESULTS The study sample had a mean age of 79.1 years and 62.8% were female. Bivariate correlations show that the PSS-14 positively worded subscale of the PSS (PSS-PW) was significantly associated with all three cognitive domains (language: r = -0.15, p < 0.001; episodic memory: r = -0.16, p < 0.001; frontal-executive: r = -0.21, p <0.001) while the negatively worded subscale of the PSS (PSS-NW) was not significantly associated with any cognitive domain. In linear regression analyses adjusted for age, white race, gender, years of education, and depressive symptoms, the PSS-PW remained significantly associated with each of the cognitive domains. The PSS-NW was not associated with any cognitive domains in any model. The PSS-14 was significantly associated with language and episodic memory, but not the frontal-executive domain. CONCLUSION Worse PSS-PW scores are associated with reduced cognitive function in the executive, memory, and language domains in nondemented older adults. The PSS-PW subscale correlated better with cognitive function than the overall PSS-14. Future research should evaluate the temporality of the association and if stress reduction therapies improve cognitive performance.
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Affiliation(s)
- Julie M Jiang
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Elizabeth K Seng
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States
| | - Molly E Zimmerman
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Mimi Kim
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
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Hoeijmakers L, Ruigrok SR, Amelianchik A, Ivan D, van Dam AM, Lucassen PJ, Korosi A. Early-life stress lastingly alters the neuroinflammatory response to amyloid pathology in an Alzheimer's disease mouse model. Brain Behav Immun 2017; 63:160-175. [PMID: 28027926 DOI: 10.1016/j.bbi.2016.12.023] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/12/2016] [Accepted: 12/23/2016] [Indexed: 12/16/2022] Open
Abstract
Exposure to stress during the sensitive period of early-life increases the risk to develop cognitive impairments and psychopathology later in life. In addition, early-life stress (ES) exposure, next to genetic causes, has been proposed to modulate the development and progression of Alzheimer's disease (AD), however evidence for this hypothesis is currently lacking. We here tested whether ES modulates progression of AD-related neuropathology and assessed the possible contribution of neuroinflammatory factors in this. We subjected wild-type (WT) and transgenic APP/PS1 mice, as a model for amyloid neuropathology, to chronic ES from postnatal day (P)2 to P9. We next studied how ES exposure affected; 1) amyloid β (Aβ) pathology at an early (4month old) and at a more advanced pathological (10month old) stage, 2) neuroinflammatory mediators immediately after ES exposure as well as in adult WT mice, and 3) the neuroinflammatory response in relation to Aβ neuropathology. ES exposure resulted in a reduction of cell-associated amyloid in 4month old APP/PS1 mice, but in an exacerbation of Aβ plaque load at 10months of age, demonstrating that ES affects Aβ load in the hippocampus in an age-dependent manner. Interestingly, ES modulated various neuroinflammatory mediators in the hippocampus of WT mice as well as in response to Aβ neuropathology. In WT mice, immediately following ES exposure (P9), Iba1-immunopositive microglia exhibited reduced complexity and hippocampal interleukin (IL)-1β expression was increased. In contrast, microglial Iba1 and CD68 were increased and hippocampal IL-6 expression was decreased at 4months, while these changes resolved by 10months of age. Finally, Aβ neuropathology triggered a neuroinflammatory response in APP/PS1 mice that was altered after ES exposure. APP/PS1 mice exhibited increased CD68 expression at 4months, which was further enhanced by ES, whereas the microglial response to Aβ neuropathology, as measured by Iba1 and CD11b, was less prominent after ES at 10months of age. Finally, the hippocampus appears to be more vulnerable for these ES-induced effects, since ES did not affect Aβ neuropathology and neuroinflammation in the entorhinal cortex of adult ES exposed mice. Overall, our results demonstrate that ES exposure has both immediate and lasting effects on the neuroinflammatory response. In the context of AD, such alterations in neuroinflammation might contribute to aggravated neuropathology in ES exposed mice, hence altering disease progression. This indicates that, at least in a genetic context, ES could aggravate AD pathology.
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Affiliation(s)
- Lianne Hoeijmakers
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Science Park 904, Amsterdam, The Netherlands
| | - Silvie R Ruigrok
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Science Park 904, Amsterdam, The Netherlands
| | - Anna Amelianchik
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Science Park 904, Amsterdam, The Netherlands
| | - Daniela Ivan
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Science Park 904, Amsterdam, The Netherlands
| | - Anne-Marie van Dam
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, De Boelelaan 1108, Amsterdam, The Netherlands
| | - Paul J Lucassen
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Science Park 904, Amsterdam, The Netherlands
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Science Park 904, Amsterdam, The Netherlands.
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Forrester S. Perceived Stress: A Mechanism for Cognitive Decline Among Minorities? Am J Geriatr Psychiatry 2017; 25:35-36. [PMID: 27889284 DOI: 10.1016/j.jagp.2016.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Sarah Forrester
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
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Abstract
OBJECTIVES The aim of this study was to assess the association between personality factors and age-related longitudinal cognitive performance, and explore interactions of stress-proneness with apolipoprotein E (APOE) ɛ4, a prevalent risk factor for Alzheimer's disease (AD). METHODS A total of 510 neuropsychiatrically healthy residents of Maricopa County recruited through media ads (mean age 57.6±10.6 years; 70% women; mean education 15.8±2.4 years; 213 APOE ɛ4 carriers) had neuropsychological testing every 2 years (mean duration follow-up 9.1±4.4 years), and the complete Neuroticism Extraversion Openness Personality Inventory-Revised. Several tests were administered within each of the following cognitive domains: memory, executive skills, language, visuospatial skills, and general cognition. Primary effects on cognitive trajectories and APOE ɛ4 interactions were ascertained with quadratic models. RESULTS With personality factors treated as continuous variables, Neuroticism was associated with greater decline, and Conscientiousness associated with reduced decline consistently across tests in memory and executive domains. With personality factors trichotomized, the associations of Neuroticism and Conscientiousness were again highly consistent across tests within memory and to a lesser degree executive domains. While age-related memory decline was greater in APOE ɛ4 carriers as a group than ɛ4 noncarriers, verbal memory decline was mitigated in ɛ4 carriers with higher Conscientiousness, and visuospatial perception and memory decline was mitigated in ɛ4 carriers with higher Openness. CONCLUSIONS Neuroticism and Conscientiousness were associated with changes in longitudinal performances on tests sensitive to memory and executive skills. APOE interactions were less consistent. Our findings are consistent with previous studies that have suggested that personality factors, particularly Neuroticism and Conscientiousness are associated with cognitive aging patterns. (JINS, 2016, 22, 765-776).
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The evaluation of perceived stress and associated factors in elderly caregivers. Arch Gerontol Geriatr 2016; 67:7-13. [PMID: 27395375 DOI: 10.1016/j.archger.2016.06.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/21/2016] [Accepted: 06/21/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Factors associated with perceived stress in older people have been studied previously, but this investigation in elderly caregivers is still scarce in the literature. Our aim was to assess factors that are associated with perceived stress in a sample of elderly caregivers. METHODS This cross-sectional investigation assessed 341 elderly caregivers who cared for a dependent older person at home. They answered questionnaires including the Perceived Stress Scale (PSS-14), a sociodemographic and care characterization, health and cognitive status, and burden related to care. RESULTS The mean score in PSS-14 was 18.5±9.9. Self-reported pain, difficult to sleep, "very poor/poor" self-rated health, impaired cognitive status, more people living in the house and higher levels of burden related to care were associated with higher levels of perceived stress. DISCUSSION The results highlight the importance of the development of stress-reduced interventions directed to elderly caregivers focusing on the associated variables in this study. Attention should be given to cognitive decline prevention and strategies to avoid or reduce burden in the elderly caregivers.
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Innes KE, Selfe TK, Khalsa DS, Kandati S. Effects of Meditation versus Music Listening on Perceived Stress, Mood, Sleep, and Quality of Life in Adults with Early Memory Loss: A Pilot Randomized Controlled Trial. J Alzheimers Dis 2016; 52:1277-98. [PMID: 27079708 PMCID: PMC5649740 DOI: 10.3233/jad-151106] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Older adults with subjective cognitive decline (SCD) are at increased risk not only for Alzheimer's disease, but for poor mental health, impaired sleep, and diminished quality of life (QOL), which in turn, contribute to further cognitive decline, highlighting the need for early intervention. OBJECTIVE In this randomized controlled trial, we assessed the effects of two 12-week relaxation programs, Kirtan Kriya Meditation (KK) and music listening (ML), on perceived stress, sleep, mood, and health-related QOL in older adults with SCD. METHODS Sixty community-dwelling older adults with SCD were randomized to a KK or ML program and asked to practice 12 minutes daily for 12 weeks, then at their discretion for the following 3 months. At baseline, 12 weeks, and 26 weeks, perceived stress, mood, psychological well-being, sleep quality, and health-related QOL were measured using well-validated instruments. RESULTS Fifty-three participants (88%) completed the 6-month study. Participants in both groups showed significant improvement at 12 weeks in psychological well-being and in multiple domains of mood and sleep quality (p's≤0.05). Relative to ML, those assigned to KK showed greater gains in perceived stress, mood, psychological well-being, and QOL-Mental Health (p's≤0.09). Observed gains were sustained or improved at 6 months, with both groups showing marked and significant improvement in all outcomes. Changes were unrelated to treatment expectancies. CONCLUSIONS Findings suggest that practice of a simple meditation or ML program may improve stress, mood, well-being, sleep, and QOL in adults with SCD, with benefits sustained at 6 months and gains that were particularly pronounced in the KK group.
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Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA, USA
| | - Terry Kit Selfe
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV, USA
- Center for the Study of Complementary and Alternative Therapies, University of Virginia Health System, Charlottesville, VA, USA
| | - Dharma Singh Khalsa
- Department of Internal Medicine and Integrative Medicine, University of New Mexico School of Medicine, Albuquerque, NM and the Alzheimer’s Research and Prevention Foundation, Tucson, AZ, USA
| | - Sahiti Kandati
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV, USA
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Fitzsimons CP, Herbert J, Schouten M, Meijer OC, Lucassen PJ, Lightman S. Circadian and ultradian glucocorticoid rhythmicity: Implications for the effects of glucocorticoids on neural stem cells and adult hippocampal neurogenesis. Front Neuroendocrinol 2016; 41:44-58. [PMID: 27234350 DOI: 10.1016/j.yfrne.2016.05.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/01/2016] [Accepted: 05/03/2016] [Indexed: 01/01/2023]
Abstract
Psychosocial stress, and within the neuroendocrine reaction to stress specifically the glucocorticoid hormones, are well-characterized inhibitors of neural stem/progenitor cell proliferation in the adult hippocampus, resulting in a marked reduction in the production of new neurons in this brain area relevant for learning and memory. However, the mechanisms by which stress, and particularly glucocorticoids, inhibit neural stem/progenitor cell proliferation remain unclear and under debate. Here we review the literature on the topic and discuss the evidence for direct and indirect effects of glucocorticoids on neural stem/progenitor cell proliferation and adult neurogenesis. Further, we discuss the hypothesis that glucocorticoid rhythmicity and oscillations originating from the activity of the hypothalamus-pituitary-adrenal axis, may be crucial for the regulation of neural stem/progenitor cells in the hippocampus, as well as the implications of this hypothesis for pathophysiological conditions in which glucocorticoid oscillations are affected.
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Affiliation(s)
- Carlos P Fitzsimons
- Neuroscience Program, Swammerdam Institute for Life Sciences, University of Amsterdam, Science Park 904, 1098XH Amsterdam, The Netherlands.
| | - Joe Herbert
- John van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | - Marijn Schouten
- Neuroscience Program, Swammerdam Institute for Life Sciences, University of Amsterdam, Science Park 904, 1098XH Amsterdam, The Netherlands
| | - Onno C Meijer
- Leiden University Medical Centre, Department of Endocrinology, Leiden, The Netherlands
| | - Paul J Lucassen
- Neuroscience Program, Swammerdam Institute for Life Sciences, University of Amsterdam, Science Park 904, 1098XH Amsterdam, The Netherlands.
| | - Stafford Lightman
- Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, United Kingdom
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