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Palpatzis E, Akinci M, Aguilar-Dominguez P, Garcia-Prat M, Blennow K, Zetterberg H, Carboni M, Kollmorgen G, Wild N, Fauria K, Falcon C, Gispert JD, Suárez-Calvet M, Grau-Rivera O, Sánchez-Benavides G, Arenaza-Urquijo EM. Lifetime Stressful Events Associated with Alzheimer's Pathologies, Neuroinflammation and Brain Structure in a Risk Enriched Cohort. Ann Neurol 2024; 95:1058-1068. [PMID: 38466157 DOI: 10.1002/ana.26881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/22/2024] [Accepted: 01/27/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Along with the known effects of stress on brain structure and inflammatory processes, increasing evidence suggest a role of chronic stress in the pathogenesis of Alzheimer's disease (AD). We investigated the association of accumulated stressful life events (SLEs) with AD pathologies, neuroinflammation, and gray matter (GM) volume among cognitively unimpaired (CU) individuals at heightened risk of AD. METHODS This cross-sectional cohort study included 1,290 CU participants (aged 48-77) from the ALFA cohort with SLE, lumbar puncture (n = 393), and/or structural magnetic resonance imaging (n = 1,234) assessments. Using multiple regression analyses, we examined the associations of total SLEs with cerebrospinal fluid (1) phosphorylated (p)-tau181 and Aβ1-42/1-40 ratio, (2) interleukin 6 (IL-6), and (3) GM volumes voxel-wise. Further, we performed stratified and interaction analyses with sex, history of psychiatric disease, and evaluated SLEs during specific life periods. RESULTS Within the whole sample, only childhood and midlife SLEs, but not total SLEs, were associated with AD pathophysiology and neuroinflammation. Among those with a history of psychiatric disease SLEs were associated with higher p-tau181 and IL-6. Participants with history of psychiatric disease and men, showed lower Aβ1-42/1-40 with higher SLEs. Participants with history of psychiatric disease and women showed reduced GM volumes in somatic regions and prefrontal and limbic regions, respectively. INTERPRETATION We did not find evidence supporting the association of total SLEs with AD, neuroinflammation, and atrophy pathways. Instead, the associations appear to be contingent on events occurring during early and midlife, sex and history of psychiatric disease. ANN NEUROL 2024;95:1058-1068.
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Affiliation(s)
- Eleni Palpatzis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- University of Pompeu Fabra (UPF), Barcelona, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Muge Akinci
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- University of Pompeu Fabra (UPF), Barcelona, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Pablo Aguilar-Dominguez
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- University of Pompeu Fabra (UPF), Barcelona, Spain
| | - Marina Garcia-Prat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, United Kingdom
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | | | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Eider M Arenaza-Urquijo
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
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Franks KH, Rowsthorn E, Bransby L, Lim YY, Chong TTJ, Pase MP. Association of Self-Reported Psychological Stress with Cognitive Decline: A Systematic Review. Neuropsychol Rev 2023; 33:856-870. [PMID: 36456767 DOI: 10.1007/s11065-022-09567-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/31/2022] [Accepted: 09/12/2022] [Indexed: 12/04/2022]
Abstract
Psychological stress is a potential modifiable risk factor for cognitive decline. However, the extent to which self-reported psychological stress is differentially associated with decline in specific cognitive domains remains unclear. Differences may be due to heterogeneity in the aspects of psychological stress investigated, for example, neuroticism (which is linked to vulnerability to stress), perceived stress, or exposure to stressful life events. This review aims to establish the associations between these aspects of self-reported psychological stress and cognitive decline. PsychINFO, Embase and MEDLINE were searched from database inception to September 2021. Studies were included if they were observational, prospective, and if they investigated the association between self-reported psychological stress and cognitive decline in adults with a minimum mean age of 40 years at baseline. Thirty studies satisfied the inclusion criteria, with most examining neuroticism (n = 17) as a predictor of cognitive decline. Fewer examined perceived stress (n = 7) or stressful life events (n = 6). There was evidence of an association between neuroticism and cognitive decline, particularly in the domain of memory. Similarly, across studies, perceived stress was also associated with memory decline. Research investigating the relationship between stressful life events and cognitive decline had fewer outcomes to interpret. Overall, the findings highlight that memory may be particularly susceptible to high levels of neuroticism and perceived stress. We identified a lack of research into some cognitive domains, such as executive function, which should be addressed by future studies.
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Affiliation(s)
- Katherine H Franks
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, 3168, Clayton, VIC, Australia.
| | - Ella Rowsthorn
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, 3168, Clayton, VIC, Australia
| | - Lisa Bransby
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, 3168, Clayton, VIC, Australia
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, 3168, Clayton, VIC, Australia
| | - Trevor T-J Chong
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, 3168, Clayton, VIC, Australia
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
- Department of Clinical Neurosciences, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Matthew P Pase
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, 3168, Clayton, VIC, Australia
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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3
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James KA, Stromin JI, Steenkamp N, Combrinck MI. Understanding the relationships between physiological and psychosocial stress, cortisol and cognition. Front Endocrinol (Lausanne) 2023; 14:1085950. [PMID: 36950689 PMCID: PMC10025564 DOI: 10.3389/fendo.2023.1085950] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
Stress is viewed as a state of real or perceived threat to homeostasis, the management of which involves the endocrine, nervous, and immune systems. These systems work independently and interactively as part of the stress response. The scientific stress literature, which spans both animal and human studies, contains heterogeneous findings about the effects of stress on the brain and the body. This review seeks to summarise and integrate literature on the relationships between these systems, examining particularly the roles of physiological and psychosocial stress, the stress hormone cortisol, as controlled by the hypothalamic-pituitary-adrenal (HPA) axis, and the effects of stress on cognitive functioning. Health conditions related to impaired HPA axis functioning and their associated neuropsychiatric symptoms will also be considered. Lastly, this review will provide suggestions of clinical applicability for endocrinologists who are uniquely placed to measure outcomes related to endocrine, nervous and immune system functioning and identify areas of intervention.
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Affiliation(s)
- Katharine Ann James
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT) Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
- Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Juliet Ilena Stromin
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT) Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Nina Steenkamp
- Applied Cognitive Science and Experimental Neuropsychology Team (ACSENT) Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Marc Irwin Combrinck
- Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Christensen DS, Garde E, Siebner HR, Mortensen EL. Midlife perceived stress is associated with cognitive decline across three decades. BMC Geriatr 2023; 23:121. [PMID: 36870969 PMCID: PMC9985854 DOI: 10.1186/s12877-023-03848-8] [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: 04/27/2022] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Research indicates detrimental effects of stress on brain health and cognitive functioning, but population-based studies using comprehensive measures of cognitive decline is lacking. The present study examined the association of midlife perceived stress with cognitive decline from young adulthood to late midlife, controlling for early life circumstances, education and trait stress (neuroticism). METHODS The sample consisted of 292 members of the Copenhagen Perinatal Cohort (1959-1961) with continued participation in two subsequent follow-up studies. Cognitive ability was assessed in young adulthood (mean age 27 years) and midlife (mean age 56 years) using the full Wechsler Adult Intelligence Scale (WAIS), and perceived stress was measured at midlife using the Perceived Stress Scale. The association of midlife perceived stress with decline in Verbal, Performance and Full-Scale IQ was assessed in multiple regression models based on Full Information Maximum Likelihood estimation. RESULTS Over a mean retest interval of 29 years, average decline in IQ score was 2.42 (SD 7.98) in Verbal IQ and 8.87 (SD 9.37) in Performance IQ. Mean decline in Full-scale IQ was 5.63 (SD 7.48), with a retest correlation of 0.83. Controlling for parental socio-economic position, education and young adult IQ, higher perceived stress at midlife was significantly associated with greater decline in Verbal (β = - 0.012), Performance (β = - 0.025), and Full-scale IQ (β = - 0.021), all p < .05. Across IQ scales, additionally controlling for neuroticism in young adulthood and change in neuroticism had only minor effects on the association of midlife perceived stress with decline. CONCLUSIONS Despite very high retest correlations, decline was observed on all WAIS IQ scales. In fully adjusted models, higher midlife perceived stress was associated with greater decline on all scales, indicating a negative association of stress with cognitive ability. The association was strongest for Performance and Full-scale IQ, perhaps reflecting the greater decline on these IQ scales compared to Verbal IQ.
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Affiliation(s)
- Dinne Skjærlund Christensen
- Department of Psychology and Behavioural Science, Unit for Psychooncology and Health Psychology (Epos), Aarhus University, Bartholins Alle 11, Bld. 1351, 8000, Aarhus, Denmark. .,Department of Oncology, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus, Denmark. .,Department of Public Health, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5A, 1353, Copenhagen, Denmark. .,Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2700, Copenhagen, Denmark.
| | - Ellen Garde
- Department of Public Health, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5A, 1353, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2700, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Kettegård Allé 30, 2650, Hvidovre, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, Section of Environmental Health, University of Copenhagen, Øster Farimagsgade 5A, 1353, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2700, Copenhagen, Denmark
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Steffens DC, Manning KJ, Wu R, Grady JJ. Effects of Longitudinal Changes in Neuroticism and Stress on Cognitive Decline. Am J Geriatr Psychiatry 2023; 31:171-179. [PMID: 36376230 DOI: 10.1016/j.jagp.2022.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The relationships among depression, personality factors, stress, and cognitive decline in the elderly are complex. Depressed elders score higher in neuroticism than nondepressed older individuals. Independently, the presence of neuroticism and the number of stressful life events are each associated with worsening cognitive decline in depressed older adults. Yet little is known about combined effects of changes in neuroticism and changes in stress on cognitive decline among older depressed adults. DESIGN Longitudinal observational study. SETTING Academic Health Center. PARTICIPANTS The authors examined 62 participants in the Neurobiology of Late-life depression (NBOLD) study to test the hypothesis that, compared with older depressed subjects who experience improved neuroticism and lower psychosocial stressors over time, those with worsening neuroticism and greater psychosocial stressors will demonstrate more cognitive decline. MEASUREMENTS The authors measured neuroticism using the NEO-Personality Inventory-Revised at baseline and 1 year. Study psychiatrists measured depression using the Montgomery-Ǻsberg Depression Rating Scale. At annual assessments, subjects reported the number of psychosocial stressors in the prior year and completed a neuropsychological evaluation. Participants completed a detailed neuropsychological battery at baseline and annually over 3 years. The battery included a test of delayed story memory (Logical Memory-2 or LMII). The outcome 3-year change in cognitive scores was regressed against 3-year change scores of neuroticism and number of psychosocial stressors, plus their interaction, while adjusting for sex, age, race, education, baseline cognitive score, and 3-year change in MADRS score as covariates. RESULTS In multivariable linear regression analysis with the above covariates, the interaction effect of 3-year change in Total Neuroticism score and 3-year change in Total Stressors on change in LMII performance was statistically significant (B = -0.080[95%CL: -0.145 to -0.015], T = -2.48, df = 52, p = 0.017). Further exploration of this finding showed that 1) when total stressors increased by 2 or more over 3 years, LMII change was inversely associated with neuroticism change; and 2) when neuroticism improved less, LMII change score was inversely associated with total stressor change. There were no other significant interactions between stress and neuroticism on cognition. CONCLUSION Our findings document the importance of tracking change in neuroticism and monitoring psychosocial stress over the long-term course of treatment in geriatric depression. Both factors exert important combined effects on memory over time. Future studies in larger samples are needed to confirm our results and to extend them to examine both cognitive change and development of dementia.
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Affiliation(s)
- David C Steffens
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT.
| | - Kevin J Manning
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - Rong Wu
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT
| | - James J Grady
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT
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Lee J, Kim J, Park A, Hong RK, Ko M, Heo M, Kim H, Chung JY. Efficacy of a Mobile-Based Multidomain Intervention to Improve Cognitive Function and Health-Related Outcomes Among Older Korean Adults with Subjective Cognitive Decline. J Alzheimers Dis 2023; 93:1551-1562. [PMID: 37212108 PMCID: PMC10357136 DOI: 10.3233/jad-221299] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is a self-reported experience of declining cognitive function showing normal performance in cognitive assessments, which is a known risk factor for dementia. Recent studies highlight the importance of nonpharmacological multidomain interventions that can target multiple risk factors of dementia in older adults. OBJECTIVE This study investigated the efficacy of the Silvia program, a mobile-based multidomain intervention, to improve cognitive function and health-related outcomes of older adults with SCD. We compare its effects to a conventional paper-based multidomain program on various health indicators related to risk factors of dementia. METHODS This prospective randomized controlled trial involved 77 older adults with SCD recruited from the Dementia Prevention and Management Center in Gwangju, South Korea during May to October 2022. Participants were randomly assigned to either the mobile- or paper-based group. Interventions were administered for 12 weeks, where pre- and post-assessments were conducted. RESULTS The K-RBANS total score did not show significant differences between groups. The mobile group showed better improvement in K-PRMQ scores and PSS scores than the paper group. Differences within groups showed that mobile-based interventions significantly improved K-PRMQ, STAI-X-1, PSS, and EQ-5D-5 L scores, while paper-based interventions significantly improved PSS, and EQ-5D-5 L scores. Patient adherence rate was 76.6%. CONCLUSION Overall, the Silvia program was effective for improving self-reported memory failures, stress, anxiety, and health-related quality of life in older adults with SCD. However, longer periods of administration for more than 12 weeks may be needed to achieve significant improvements in cognitive function by objective measures.
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Affiliation(s)
| | | | | | | | | | - Mina Heo
- Gwangju Alzheimer’s Disease and Related Dementia Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Hoowon Kim
- Department of Neurology, School of Medicine, Chosun University, Chosun University Hospital, Gwangju, South Korea
| | - Ji Yeon Chung
- Department of Neurology, School of Medicine, Chosun University, Chosun University Hospital, Gwangju, South Korea
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Stebbins RC, Maselko J, Yang YC, Plassman BL, Edwards JK, Aiello AE. Lifecourse Traumatic Events and Cognitive Aging in the Health and Retirement Study. Am J Prev Med 2022; 63:818-826. [PMID: 35798618 PMCID: PMC10493076 DOI: 10.1016/j.amepre.2022.05.007] [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: 12/20/2021] [Revised: 04/26/2022] [Accepted: 05/17/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Much of the heterogeneity in the rate of cognitive decline and the age of dementia onset remains unexplained, and there is compelling data supporting psychosocial stressors as important risk factors. However, the literature has yet to come to a consensus on whether there is a causal relationship and, if there is, its direction and strength. This study estimates the relationship between lifecourse traumatic events and cognitive trajectories and predicted dementia incidence. METHODS Using data on 7,785 participants aged ≥65 years from the Health and Retirement Study, this study estimated the association between lifecourse experience of 10 traumatic events (e.g., losing a child) and trajectories of Telephone Interview for Cognitive Status from 2006 to 2016 using linear mixed-effects models and predicted incident dementia from 2006 to 2014 using cumulative incidence functions (data analysis was in 2020-2022). Inverse probability weights accounted for loss to follow-up and confounding by sex, education, race/ethnicity, and age. RESULTS Experiencing 1 or more traumatic events over the lifecourse was associated with accelerated decline compared with experiencing no events (e.g., β= -0.05 [95% CI= -0.07, -0.02] Health and Retirement Study-Telephone Interview for Cognitive Status units/year; 1 vs 0 events). In contrast, experiencing traumatic events was associated with better cognitive function cross-sectionally. Furthermore, the impact of trauma on cognitive decline was of greater magnitude when it occurred after the age of 64 years. However, the magnitude and direction of association varied by the specific traumatic event. There were no associations with predicted incident dementia. CONCLUSIONS These results suggest that researchers and clinicians should not aggregate traumatic events for understanding the risk of accelerated cognitive decline.
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Affiliation(s)
- Rebecca C Stebbins
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
| | - Joanna Maselko
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Y Claire Yang
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Sociology, College of Arts and Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Brenda L Plassman
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina; Department of Neurology, Duke University School of Medicine, Durham, North Carolina
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Allison E Aiello
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Joshi RS, Vigoureux TFD, Lee S. Daily association of stressors with perceived cognitive performance: Moderating role of age. Stress Health 2022; 39:449-459. [PMID: 36074811 DOI: 10.1002/smi.3195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 08/24/2022] [Accepted: 08/28/2022] [Indexed: 11/07/2022]
Abstract
Stress can elicit both positive and negative impacts on cognition. Less is known about whether and how daily stressors are associated with perceived cognitive performance in healthcare workers. We examined daily associations between stressors and perceived cognitive performance in nurses and whether these associations differed by age or nursing tenure. Using 14-day smartphone-based ecological momentary assessment, 60 inpatient nurses at a U.S. cancer hospital reported the frequency and severity of daily stressors (e.g., arguments, accidents). Each day, participants subjectively evaluated their mental focus, memory, and processing speed. Multilevel modelling examined the within- and between-person associations of daily stressors with cognitive performance. More stressors were associated with poorer perceived cognitive performance at both within- and between-person levels for both daily stressor frequency and severity. For moderation by age, the within-person stressor severity-cognitive performance relationship was only significant for nurses who were younger, but not for those who were older. Similarly, the within-person associations of daily stressor frequency and severity with cognitive performance were only significant for nurses with a shorter tenure. Findings suggest daily stressors may degrade perceived cognitive performance in nurses and the impact may be stronger for those who are younger or with less experience on the job.
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Affiliation(s)
- Rhitik Samir Joshi
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | | | - Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
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Luo J, Zhang B, Cao M, Roberts BW. The Stressful Personality: A Meta-Analytical Review of the Relation Between Personality and Stress. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2022; 27:128-194. [PMID: 35801622 DOI: 10.1177/10888683221104002] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study presented the first meta-analytic review on the associations between the Big Five personality traits and stress measured under different conceptualizations (stressor exposure, psychological and physiological stress responses) using a total of 1,575 effect sizes drawn from 298 samples. Overall, neuroticism was found to be positively related to stress, whereas extraversion, agreeableness, conscientiousness, and openness were negatively linked to stress. When stress assessed under different conceptualizations was tested, only neuroticism, agreeableness, and conscientiousness were related to stressor exposure. All of the Big Five personality traits were significantly associated with psychological stress perception, whereas the five personality traits showed weak to null associations with physiological stress response. Further moderation analyses suggested that the associations between personality traits and stress under different conceptualizations were also contingent upon different characteristics of stress, sample, study design, and measures. The results supported the important role of personality traits in individual differences in stress.
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Affiliation(s)
- Jing Luo
- Northwestern University, Chicago, IL, USA
| | - Bo Zhang
- Texas A&M University, College Station, USA.,University of Illinois at Urbana-Champaign, USA
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10
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Sasaki H, Jono T, Fukuhara R, Honda K, Ishikawa T, Boku S, Takebayashi M. Late-manifestation of attention-deficit/hyperactivity disorder in older adults: an observational study. BMC Psychiatry 2022; 22:354. [PMID: 35610630 PMCID: PMC9128193 DOI: 10.1186/s12888-022-03978-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The age of attention-deficit/hyperactivity disorder onset is usually during the first 12 years of life; however, there have been recent reports of late-onset attention-deficit/hyperactivity disorder. These reports have been limited to that of young adults, and details in older adults remain unknown. As such, we had previously presented the first case report of "very" late-onset attention-deficit/hyperactivity disorder, wherein the symptoms presented in senile age. In this observational study, we aimed to investigate the prevalence and clinical features of such attention-deficit/hyperactivity disorders in older adults visiting our dementia clinic. METHODS Four hundred forty-six consecutive patients visiting our specialty outpatient clinic for dementia during the 2-year period from April 1, 2015 to March 31, 2017 were included in this study. First, the patients were examined for the presence or absence of dementia in our specialty outpatient clinic for dementia. Those not diagnosed with dementia were examined for the presence or absence of attention-deficit/hyperactivity disorder in our specialty outpatient clinic for developmental disorders. Finally, these patients who were diagnosed with attention-deficit/hyperactivity disorder were investigated in detail to clarify their clinical characteristics. RESULTS Of 446 patients (246 women and 200 men), 7 patients were finally diagnosed with attention-deficit/hyperactivity disorder. Although these 7 patients were initially suspected to have Alzheimer's disease (considering their age, 6 of these 7 patients were suspected to have early onset Alzheimer's disease), it was found that these symptoms were due to attention-deficit/hyperactivity disorder. These patients had four characteristics in common: (1) they were significantly younger than the complete study population; (2) they predominantly showed inattention-related symptoms; (3) they showed latent manifestation; and (4) they experienced a stressful life event before manifestation. CONCLUSIONS Our previous case report suggested that very late-onset attention-deficit/hyperactivity disorder patients could be incorrectly diagnosed with dementia. In this observational study, 1.6% of patients who were initially suspected of having dementia were actually diagnosed with attention-deficit/hyperactivity disorder. This study also showed that the "late-onset" described in our previous report would be better described as "late-manifestation." A clinician should consider late-manifestation of attention-deficit/hyperactivity disorder in the differential diagnosis when encountering dementia patients, especially early onset Alzheimer's disease.
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Affiliation(s)
- Hiroyuki Sasaki
- grid.411152.20000 0004 0407 1295Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556 Japan ,grid.411152.20000 0004 0407 1295Medical Center for Developmental Disorders, Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Tadashi Jono
- grid.411152.20000 0004 0407 1295Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556 Japan ,grid.411152.20000 0004 0407 1295Medical Center for Developmental Disorders, Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Ryuji Fukuhara
- grid.411152.20000 0004 0407 1295Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556 Japan ,grid.411152.20000 0004 0407 1295Medical Center for Dementia-related Disease, Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Kazuki Honda
- grid.411152.20000 0004 0407 1295Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556 Japan ,grid.411152.20000 0004 0407 1295Medical Center for Dementia-related Disease, Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Tomohisa Ishikawa
- grid.411152.20000 0004 0407 1295Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556 Japan ,grid.411152.20000 0004 0407 1295Medical Center for Dementia-related Disease, Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Shuken Boku
- grid.411152.20000 0004 0407 1295Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556 Japan
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Faculty of Life Science, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto-shi, Kumamoto, 860-8556, Japan. .,Institute for Clinical Research, National Hospital Organization Kure Medical Center Chugoku Cancer Center, Hiroshima, Japan.
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11
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Demystifying mobile banking apps security through gender, education, privacy, and trust intervention. INTERNATIONAL JOURNAL OF E-ADOPTION 2022. [DOI: 10.4018/ijea.294859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The escalating of mobile banking apps has decongested the banking hall, especially in developing countries, and the penetration of mobile banking apps is crucial for both financial institutions and customers. This study reviewed existing relevant literature from the Web of Science to position this study well and dwelled on a theoretical foundation for the exposition of the interrelation of trust and privacy as an antecedent of mobile banking app security. The quantitative method was employed and banking customers data using SmartPLS 3.0 version with different data analysis techniques such as structural equation modelling, multigroup data analysis, interaction effects, and importance-performance analysis. This study results show the intervention of gender and education. It also indicates that the orientation and persuasion of banking customers to the point of higher trust is a determinant of security assurance of using mobile banking apps. This study discusses the theoretical and managerial impacts with the limitation of the study and projects into the future.
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12
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Bougea A, Anagnostouli M, Angelopoulou E, Spanou I, Chrousos G. Psychosocial and Trauma-Related Stress and Risk of Dementia: A Meta-Analytic Systematic Review of Longitudinal Studies. J Geriatr Psychiatry Neurol 2022; 35:24-37. [PMID: 33205677 DOI: 10.1177/0891988720973759] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Stress has deleterious effects on brain health and yet, the prognostic value of psychosocial stress regarding the most common types of dementias, including Alzheimer disease, is still unclear. The primary aim of this systematic review was to explore the association between psychosocial stress and late onset dementia. We classified 24articles from Medline, PsycINFO, CINAHL, and Web of Science, as pertaining toxic categories of psychosocial and trauma-related stress (low socio-economic status [SES] related inequalities, marital status, posttraumatic stress disorder, work stress, "vital exhaustion" [VE], and, combined stressors). Using the Quality of Prognosis Studies in Systematic Reviews tool, we judged the quality of evidence to be low. This systematic review provided some non-robust, yet suggestive evidence that the above psychosocial types of stress are associated with increased risk of dementia in later life. Future robust, longitudinal studies with repeated validated measures of psychosocial stress and dementiaare required to strengthen or refute these findings.
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Affiliation(s)
- Anastasia Bougea
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anagnostouli
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Demyelinating Diseases Clinic, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
| | - Efthalia Angelopoulou
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Spanou
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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13
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Exploring Recent Adverse and Positive Life Events: A Qualitative Study Among Lonely Older Adults. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09433-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Stebbins RC, Noppert GA, Yang YC, Dowd JB, Simanek A, Aiello AE. Association Between Immune Response to Cytomegalovirus and Cognition in the Health and Retirement Study. Am J Epidemiol 2021; 190:786-797. [PMID: 33094810 DOI: 10.1093/aje/kwaa238] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/12/2020] [Accepted: 10/20/2020] [Indexed: 12/26/2022] Open
Abstract
Chronic infections and the subsequent immune response have recently been shown to be risk factors for cognitive decline and Alzheimer disease and related dementias (ADRD). While some studies have shown an association between cytomegalovirus (CMV), a chronic and highly prevalent infection, and cognition and/or ADRD, these studies have been limited by nonrepresentative and small samples. Using 2016 data on 5,617 adults aged 65 years or more from the Health and Retirement Study, we investigated the cross-sectional associations of both CMV serostatus and immunoglobulin G (IgG) antibody response with cognitive function using linear regression models adjusting for age, sex, race/ethnicity, and educational attainment. We further investigated potential effect-measure modification by educational attainment. Overall, both CMV seropositivity and higher IgG antibody response were associated with lower cognitive function, though the relationship was not statistically significant in adjusted models. Among participants with less than a high school diploma, CMV seropositivity and being in the first tertile of IgG response, relative to seronegative persons, were associated with lower scores on the Telephone Interview for Cognitive Status (-0.56 points (95% confidence interval: -1.63, 0.52) and -0.89 points (95% confidence interval: -2.07, 0.29), respectively), and the relationship was attenuated among those with higher education. Our results suggest that CMV may be a risk factor for cognitive impairment, particularly among persons with fewer educational resources.
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15
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Solianik R, Mickevičienė D, Žlibinaitė L, Čekanauskaitė A. Tai chi improves psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic. Exp Gerontol 2021; 150:111363. [PMID: 33887380 PMCID: PMC8054611 DOI: 10.1016/j.exger.2021.111363] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/28/2021] [Accepted: 04/17/2021] [Indexed: 01/21/2023]
Abstract
The aim of this study was to determine the effect of a 10-week tai chi intervention on psychoemotional state, cognition, and motor learning in older adults during the COVID-19 pandemic. Participants aged 60–78 years were randomized to either a control group (n = 15) or a tai chi group (n = 15) for a 10-week period. The tai chi group received two, 8-form tai chi classes of 60 min duration per week. Changes in psychoemotional state, cognition, and the learning of fast and accurate reaching movements were assessed. In addition, the potential roles of the autonomic nervous system and brain-derived neurotrophic factor (BDNF) were investigated. Tai chi practice decreased (P < 0.05) perceived stress, whereas no change in autonomic nervous system activity was observed. Improvements in mental switching correlated with decreased depressive symptoms and increased BDNF levels (P < 0.05), whereas improvements in inhibitory control tended to correlate with BDNF levels (P = 0.08). Improvements in visuospatial processing tended to correlate with decreased depressive symptoms (P = 0.07) while improved visuospatial processing correlated with improved motor planning during learning tasks (P < 0.05). This study suggests that tai chi is an effective intervention that can be delivered under pandemic conditions to improve mental and physical function in older adults.
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Affiliation(s)
- Rima Solianik
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania; Institute of Sports Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania.
| | - Dalia Mickevičienė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania; Institute of Sports Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Laura Žlibinaitė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
| | - Agnė Čekanauskaitė
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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16
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Dong GC, Li M. Potential Traumatic Events through the Life Cycle in an Immigrant Population. Geriatrics (Basel) 2021; 6:geriatrics6020039. [PMID: 33917656 PMCID: PMC8167569 DOI: 10.3390/geriatrics6020039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 12/05/2022] Open
Abstract
Existing studies on traumatic events focused on children, while it has been understudied in older adults. This study aims to examine prevalence, frequency, and severity of life events in older Chinese Americans. The data were drawn from the Population Study of Chinese Elderly (PINE) in 2017–2019. Twenty life events were evaluated, including natural disasters, personal traumatic events, and historical events. Among 3125 participants, the mean age was 75.33 (standard deviation (SD) = 8.22) with 61.06% female. Cultural Revolution (73.27%) has the highest prevalence. A total of 1819 (58.39%) participants reported typhoon and experienced multiple times. Falsely accused of crime was reported as the most severe event. Women were more likely to report family-related life events. Those with higher education were more likely to report personal traumatic events. This study is among the first to profile life events in older Chinese Americans. Age cohorts, gender roles, and socioeconomic status shape individuals’ exposure to life events. This study could help identify which vulnerable groups have high risks of exposure to traumatic events.
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Affiliation(s)
- Gabriella C. Dong
- Princeton High School, Princeton, NJ 08540, USA
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA;
- Correspondence:
| | - Mengting Li
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA;
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
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17
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McIntosh RC, Khambaty T, Llabre MM, Perreira KM, Gonzalez HM, Kansal MM, Tarraf W, Schneiderman N. Paradoxical effect of cumulative stress exposure on information processing speed in Hispanics/Latinos with elevated heart rate variability. Int J Psychophysiol 2021; 164:1-8. [PMID: 33524438 DOI: 10.1016/j.ijpsycho.2021.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 11/19/2022]
Abstract
Chronic stress has a deleterious effect on prefrontal lobe functioning. Empirical evidence suggests elevated vagal tone, indexed by elevated heart rate variability (HRV), mitigates the effect of mental stress on frontal lobe function. Here, the mitigating effect of HRV on stress-related decrements in cognitive performance is assessed based on information processing speed (DSST), word fluency and verbal learning task performance. Artifact free electrocardiogram (ECG) data was analyzed from 1420 Hispanic/Latino adults from the Sociocultural Ancillary of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). A 12-lead ECG was used to collect short-term recordings of the root mean square of successive differences in all normal R-peak to R-peak intervals (RMSSD) and the change between adjacent beats and the standard deviation of those intervals (SDNN) as indices of total HRV. As predicted, an interaction emerged for HRV and stress on the task presumed to require the greatest prefrontal lobe involvement, i.e., the DSST. After accounting for sociodemographic factors, chronic stress was associated with better DSST performance amongst individuals at higher quartile of SDNN, but not RMSSD. The paradoxical effect for greater stress exposure on DSST performance may in part be explained by increased speed of information processing and decision making often reported in high-stress cohorts. The nature of this interaction highlights the importance of examining the relationship between stress and cognition across a spectrum of vagal tone.
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Affiliation(s)
- Roger C McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County, MD 21250, United States of America.
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
| | - Krista M Perreira
- Department of Social Medicine, UNC at Chapel Hill, Chapel Hill 27599, United States of America.
| | - Hector M Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, CA 92093, United States of America.
| | - Mayank M Kansal
- Internal Medicine/Cardiology, University of Illinois at Chicago, Chicago, IL 60612, United States of America.
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI 48202, United States of America.
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
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18
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Lydon-Staley DM, Cornblath EJ, Blevins AS, Bassett DS. Modeling brain, symptom, and behavior in the winds of change. Neuropsychopharmacology 2021; 46:20-32. [PMID: 32859996 PMCID: PMC7689481 DOI: 10.1038/s41386-020-00805-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/19/2020] [Accepted: 07/22/2020] [Indexed: 02/08/2023]
Abstract
Neuropsychopharmacology addresses pressing questions in the study of three intertwined complex systems: the brain, human behavior, and symptoms of illness. The field seeks to understand the perturbations that impinge upon those systems, either driving greater health or illness. In the pursuit of this aim, investigators often perform analyses that make certain assumptions about the nature of the systems that are being perturbed. Those assumptions can be encoded in powerful computational models that serve to bridge the wide gulf between a descriptive analysis and a formal theory of a system's response. Here we review a set of three such models along a continuum of complexity, moving from a local treatment to a network treatment: one commonly applied form of the general linear model, impulse response models, and network control models. For each, we describe the model's basic form, review its use in the field, and provide a frank assessment of its relative strengths and weaknesses. The discussion naturally motivates future efforts to interlink data analysis, computational modeling, and formal theory. Our goal is to inspire practitioners to consider the assumptions implicit in their analytical approach, align those assumptions to the complexity of the systems under study, and take advantage of exciting recent advances in modeling the relations between perturbations and system function.
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Affiliation(s)
- David M Lydon-Staley
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Eli J Cornblath
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ann Sizemore Blevins
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Electrical & Systems Engineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Physics & Astronomy, College of Arts & Sciences, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- The Santa Fe Institute, Santa Fe, NM, 87501, USA.
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19
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Kiely KM, Anstey KJ, Butterworth P. Testing Age Differences in the links between Recent Financial Difficulties and Cognitive Deficits: Longitudinal Evidence from the PATH Through Life Study. J Gerontol B Psychol Sci Soc Sci 2020; 76:1993-2002. [PMID: 33254226 DOI: 10.1093/geronb/gbaa215] [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: 08/04/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE This study investigates whether the within-person associations between a recent major financial crisis and deficits in cognitive performance vary across the lifecourse. METHOD Four waves of data from 7442 participants (49% men) spanning 12-years and comprising three narrow age birth cohorts (baseline age: 20-25, 40-45, and 60-65) were drawn from a representative prospective survey from Canberra, Australia (1999-2014). Cognitive performance was assessed by the California Verbal Leaning Test (CVLT) immediate recall trails, Symbol Digit Modalities Test (SDMT), Backwards Digitspan (BDS), and Trail Making Test B (TMT B). A single item from the Threatening Life Experiences Questionnaire assessed self-reported major financial crisis in the past 6-months. Multi-variable adjusted fixed effect regression models tested the time-dependent association between financial crisis and cognition. RESULTS A recent financial crisis coincided with contemporaneous declines in CVLT (Mean change = -0.14, 95% CI = -0.262, -0.025), SDMT (Mean change = -0.08, 95% CI = -0.147,-0.004) and TMT-B (Mean change = -0.17, 95% CI = -0.293,-0.039) for adults in the oldest age group, and these associations were larger than in the younger age groups. In contrast, there was an overall association between financial crisis and deficits in BDS (Mean change = -0.06, 95% CI = -0.105, -0.007), with weak evidence of stronger associations in mid-life relative to other age groups. These associations were independent of changes in health and socio-economic circumstances. DISCUSSION This study provides important new evidence that financial difficulties in later life are potent stressors associated with occasion specific deficits in cognitive performance.
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Affiliation(s)
- Kim M Kiely
- School of Psychology, The University of New South Wales, Australia.,Neuroscience Research Australia (NeuRA), Australia
| | - Kaarin J Anstey
- School of Psychology, The University of New South Wales, Australia.,Neuroscience Research Australia (NeuRA), Australia.,Centre for Research on Ageing Health and Wellbeing, Research School of Population Health, The Australian National University, Australia
| | - Peter Butterworth
- Centre for Research on Ageing Health and Wellbeing, Research School of Population Health, The Australian National University, Australia.,Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Australia
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20
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Andersson C, Marklund K, Walles H, Hagman G, Miley-Akerstedt A. Lifestyle Factors and Subjective Cognitive Impairment in Patients Seeking Help at a Memory Disorder Clinic: The Role of Negative Life Events. Dement Geriatr Cogn Disord 2020; 48:196-206. [PMID: 31982880 DOI: 10.1159/000505573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 12/19/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS A large proportion of patients at memory disorders clinics are classified as having subjective cognitive impairment (SCI). Previous research has investigated whether particular lifestyle factors known to affect cognition can be useful in differentiating patients who do not show objective evidence of memory decline. There may also exist subgroups of patients with respect to lifestyle factors that could help clinicians to understand the patient group that presents to memory clinics. These may differ in diagnostic outcome. Very little is known about potential subgroups; however, but such information may help guide interventions and potentially eliminate unnecessary diagnostic procedures. The current study investigated patterns of lifestyle-related variables, including stress, sleep, sensory sensitivity, depression, and negative life events in patients presenting to a memory disorders clinic. The aim was to determine whether subgroups existed and whether it was possible to distinguish those with objectively impaired cognition. METHODS One hundred and seventy-eight patients (mean age 58 years) from a University Hospital Memory Disorders Clinic. RESULTS Cluster analysis identified three groups of lifestyle-related variables. Strong determinants of clusters were negative life events and age. Patients with a high number of negative life events also tended to have highest self-reported memory complaint, higher levels of stress, depression, and sensory sensitivity. However, they did not perform the worst on memory testing. In contrast, individuals who performed the worst on memory tests were older, tended to have the least memory complaints, and less negative lifestyle factors; this group also included the highest proportion of patients with mild cognitive impairment and had the lowest median amyloid A-beta 42 (Aβ42). The group with the best cognitive performance were younger, included the highest proportion of patients with SCI and the highest median Aβ42. On lifestyle variables, their ratings fell in between the other groups. CONCLUSIONS Lifestyle subgroups of patients were determined by stress, emotional problems, and age. The groups were significantly associated with Aβ42 and diagnostic outcome. This pattern may confound the differentiation between objective and subjective memory problems. Asking about lifestyle variables, in conjunction with neuropsychological testing, could potentially identify individuals who are not likely to have objective memory impairment and guide interventions.
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Affiliation(s)
- Christin Andersson
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Division of Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Håkan Walles
- Department of Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Göran Hagman
- Department of Aging, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Anna Miley-Akerstedt
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden, .,Department of Aging, Karolinska University Hospital, Stockholm, Sweden,
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21
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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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22
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Tsui-Caldwell YHW, Farrer TJ, McDonnell Z, Christensen Z, Finuf C, Bigler ED, Tschanz JT, Norton MC, Welsh-Bohmer KA. MRI Clinical Ratings and Cognitive Function in a Cross-Sectional Population Study of Dementia: The Cache County Memory Study. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2019; 6:100-107. [PMID: 30756116 DOI: 10.14283/jpad.2019.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND White matter integrity in aging populations is associated with increased risk of cognitive decline, dementia diagnosis, and mortality. Population-based data can elucidate this association. OBJECTIVES To examine the association between white matter integrity, as measured by a clinical rating scale of hyperintensities, and mental status in older adults including advanced aging. DESIGN Scheltens Ratings Scale was used to qualitatively assess white matter (WM) hyperintensities in participants of the Cache County Memory Study (CCMS), an epidemiological study of Alzheimer's disease in an exceptionally long-lived population. Further, the relation between Mini-Mental State Exam (MMSE) and WM hyperintensities were explored. METHOD Participants consisted of 415 individuals with dementia and 22 healthy controls. RESULTS CCMS participants, including healthy controls, had high levels of WM pathology as measured by Scheltens Ratings Scale score. While age did not significantly relate to WM pathology, higher Scheltens Ratings Scale scores were associated with lower MMSE findings (correlation between -0.14 and -0.22; p < .05). CONCLUSIONS WM pathology was common in this county-wide population sample of those ranging in age from 65 to 106. Increased WM burden was found to be significantly associated with decreased overall MMSE performance.
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Affiliation(s)
- Y H W Tsui-Caldwell
- Thomas J. Farrer Ph.D., 932 Morreene Road, Durham, NC 27710, USA, (919)-668-6802,
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Psychotic experiences and subjective cognitive complaints among 224 842 people in 48 low- and middle-income countries. Epidemiol Psychiatr Sci 2018; 29:e11. [PMID: 30585571 PMCID: PMC8061242 DOI: 10.1017/s2045796018000744] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS Cognitive deficits are an important factor in the pathogenesis of psychosis. Subjective cognitive complaints (SCCs) are often considered to be a precursor of objective cognitive deficits, but there are no studies specifically on SCC and psychotic experiences (PE). Thus, we assessed the association between SCC and PE using data from 48 low- and middle-income countries. METHODS Community-based cross-sectional data of the World Health Survey were analysed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 to 10 with higher scores representing more severe SCC. The Composite International Diagnostic Interview was used to identify past 12-month PE. Multivariable logistic regression and mediation analyses were performed. RESULTS The final sample consisted of 224 842 adults aged ⩾18 years [mean (SD) age 38.3 (16.0) years; 49.3% males]. After adjustment for sociodemographic factors, a one-unit increase in the SCC scale was associated with a 1.17 (95% CI 1.16-1.18) times higher odds for PE in the overall sample, with this association being more pronounced in younger individuals: age 18-44 years OR = 1.19 (95% CI 1.17-1.20); 45-64 years OR = 1.15 (95% CI 1.12-1.17); ⩾65 years OR = 1.14 (95% CI 1.09-1.19). Collectively, other mental health conditions (perceived stress, depression, anxiety, sleep problems) explained 43.4% of this association, and chronic physical conditions partially explained the association but to a lesser extent (11.8%). CONCLUSIONS SCC were associated with PE. Future longitudinal studies are needed to understand temporal associations and causal inferences, while the utility of SCC as a risk marker for psychosis especially for young adults should be scrutinised.
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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: 37] [Impact Index Per Article: 6.2] [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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Martinez-Ruiz A, Huang Y, Gee S, Jamieson H, Cheung G. Individual risk factors for possible undetected dementia amongst community-dwelling older people in New Zealand. DEMENTIA 2018; 19:750-765. [PMID: 29989431 DOI: 10.1177/1471301218786277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is general acknowledgement of the importance of early diagnosis of dementia, yet there are still high rates of undetected dementia internationally. The aim of this cross-sectional study was to determine the sociodemographic characteristics associated with possible undetected dementia in a large sample of community-dwelling older New Zealanders. The sample consisted of older people (age ≥ 65) who had received the homecare version of the international Residential Home Care Assessment version 9.1 over a two-year period and who were screened positive for possible dementia on the international Residential Assessment’s Cognitive Performance Scale. People with possible alternative explanations for impaired cognitive performance such as depression and other neurological conditions were excluded from analysis. The 5202 eligible individuals were categorized into two groups: (1) those with a recorded diagnosis of dementia (64%) and (2) those without a recorded diagnosis of dementia (i.e. possible undetected dementia group) (36%). Logistic regression was used to evaluate the association between individual characteristics and possible undetected dementia. Significant risk factors for being in the possible undetected dementia group included Asian ethnicity, living alone, not having participated in long-standing social activities recently, major life stressors, and limited accessibility of their house. The knowledge gained from this study could enable targeting of services and resources for the groups at risk of undetected dementia to have a more equitable access to early diagnosis.
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Affiliation(s)
- Adrian Martinez-Ruiz
- National Institute of Geriatrics of Mexico, México.,University of Auckland, New Zealand
| | - Ying Huang
- University of Auckland, New Zealand.,University of Auckland, New Zealand
| | - Susan Gee
- Canterbury District Health Board, New Zealand.,University of Auckland, New Zealand
| | - Hamish Jamieson
- University of Otago, New Zealand.,University of Auckland, New Zealand
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Hunter S, Smailagic N, Brayne C. Dementia Research: Populations, Progress, Problems, and Predictions. J Alzheimers Dis 2018; 64:S119-S143. [DOI: 10.3233/jad-179927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Sally Hunter
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Nadja Smailagic
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Institute of Public Health, University of Cambridge, Cambridge, UK
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Vitaliano PP, Fitzpatrick AL, Williams LE, Montano MA, Russo JE. Demographic-Specific Rates for Life Events in the Cardiovascular Health Study and Comparisons With Other Studies. Innov Aging 2018; 2:igy005. [PMID: 30911687 DOI: 10.1093/geroni/igy005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose of the Study (1a) We use the Cardiovascular Health Study (CHS), a multi-site heterogeneous sample of Medicare enrollees (N = 5,849) to provide rates for specific life events experienced within 6 months; (1b) We present rates for 29 other studies of community-residing older adults (N = 41,308); (2) For the CHS, we provide demographic-specific rates and predicted probabilities for age [young-old (65-75) vs old-old (≥75)], gender, race, marital status, and education. Design/Methods The CHS sample is 57.6% women, 84.2% white (15.8% black), and 66.3% married. Mean age is 72.8 years (standard deviation [SD] = 5.6, range = 65-100) and education is 13.7 years (SD = 4.8). Life events were interviewer-assessed. Regressions estimated associations of life event rates with demographic groups (e.g., age), controlling for other demographic variables (e.g., gender, etc.). Results (1a) CHS rates ranged from 44.7% (death of someone close) to 1.1% (retirement/work changes). (1b) Most life event studies used total scores and only 5 that met our inclusion criteria used time intervals <1 year; longer intervals were associated with higher rates. (2) In the CHS, the life event for illnesses was related to 5 demographic variables (net the other 4 demographic variables), difficulties caregiving to 4, and worse relationships to 3 demographic variables. Race was related to 8 life events, marital status to 7, education to 6, and age to 4 events. Implications By identifying demographic groups at highest risk for life events, this research focuses on older adults at greatest risk for health problems. These data are necessary for translating research into interventions, practice, and policy.
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Affiliation(s)
- Peter P Vitaliano
- Department of Psychiatry and Behavioral Sciences, University of Washington Seattle
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington Seattle.,Department of Epidemiology, University of Washington Seattle
| | - Lee E Williams
- Department of Bioengineering, University of Washington Seattle
| | | | - Joan E Russo
- Department of Psychiatry and Behavioral Sciences, University of Washington Seattle
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Xu H, Zhang Y, Wu B. Association between migration and cognitive status among middle-aged and older adults: a systematic review. BMC Geriatr 2017; 17:184. [PMID: 28818064 PMCID: PMC5561610 DOI: 10.1186/s12877-017-0585-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 08/09/2017] [Indexed: 12/22/2022] Open
Abstract
Background This study aimed to synthesize the current literature examining the association between migration and cognitive function among middle-aged and older adults. Methods We used the PRISMA as a guideline for this systematic review and searched the following databases: PubMed, CINAHL, EMBASE, and Global Health. Results Twenty-five published studies were included. Twenty-two studies were focused on international migrants, while only 3 studied internal migrants. Fourteen studies were conducted in the United States, followed by UK (n = 2), Israel (n = 2), India (n = 2) and other countries like Canada and Australia. Some studies showed that middle-aged and older migrants demonstrated poorer cognitive function comparing to non-migrants in hosting places; while other studies indicated no association between migration and cognitive function. A higher level of acculturation was associated with better performance on cognitive function tests among migrants. Conclusion It is unclear how or whether migration and cognitive function are related. The quality of current literature suffered from methodological deficiencies. Additional research is needed to examine the linkages using more comprehensive measures of migration and cognitive function.
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Affiliation(s)
- Hanzhang Xu
- Duke University School of Nursing, Durham, NC, USA. .,Duke Global Health Institute, Duke University Medical Center, Durham, NC, USA.
| | - Yinan Zhang
- Chinese Center for Health Education, Beijing, China
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York, NY, USA
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Wilson RS, Bennett DA. How Does Psychosocial Behavior Contribute to Cognitive Health in Old Age? Brain Sci 2017; 7:brainsci7060056. [PMID: 28545247 PMCID: PMC5483629 DOI: 10.3390/brainsci7060056] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 11/16/2022] Open
Abstract
With the aging of the U.S. population, the number of cognitively disabled persons is expected to substantially increase in coming decades, underscoring the urgent need for effective interventions. Here, we review the current evidence linking psychosocial factors to late-life cognitive loss and consider the study design needed to illuminate the biologic bases of the associations. We then examine an ongoing study that includes several of the key design elements, the Rush Memory and Aging Project. In this longitudinal clinical-pathological cohort study, indicators of personality, social connectedness, and psychological well-being were shown to predict late-life cognitive outcomes. Participants who died underwent a uniform neuropathologic examination to quantify common dementia-related pathologies. Some psychosocial indicators were associated with cerebral infarction; some indicators modified the association of neurodegenerative pathologies with cognitive loss; and the association of some indicators with cognitive outcomes appears to be independent of the pathologies traditionally associated with late-life dementia. These findings suggest that psychosocial behavior influences late-life cognitive health through multiple neurobiologic mechanisms. A better understanding of these mechanisms may lead to novel strategies for preserving cognitive health in old age.
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Affiliation(s)
- Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
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Andersson MA, Gadarian SK, Almeling R. Does educational attainment shape reactions to genetic risk for Alzheimer's disease? Results from a national survey experiment. Soc Sci Med 2017; 180:101-105. [PMID: 28334652 DOI: 10.1016/j.socscimed.2017.03.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 11/30/2022]
Abstract
While higher education is associated with healthy lifestyles and health literacy, it remains unclear whether education shapes reactions to varying levels of genetic risk for Alzheimer's disease (AD). In this study, participants (N = 701) in the National Genetic Risk Survey Experiment (NGRISE) received a hypothetical genetic risk assessment for AD (ranging from 20 to 80% lifetime risk) and then completed items on their cognitive (perceived threat to health), emotional (general negative affect), and anticipated behavioral (seek information, improve health behaviors, engage in public or private civic action) reactions to this risk. Individuals with a college education showed reactions to increasing genetic risk approximately twice or several times as strong relative to those of individuals with lower (high school, HS) education. In fact, behavioral reactions do not significantly increase with AD risk among those with HS education. Some educational differences in risk response widen at older ages.
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Turner AD, James BD, Capuano AW, Aggarwal NT, Barnes LL. Perceived Stress and Cognitive Decline in Different Cognitive Domains in a Cohort of Older African Americans. Am J Geriatr Psychiatry 2017; 25:25-34. [PMID: 28231871 PMCID: PMC5327822 DOI: 10.1016/j.jagp.2016.10.003] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 09/14/2016] [Accepted: 10/04/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Research indicates that stress is linked to cognitive dysfunction. However, few community-based studies have explored the relationship between perceived stress and cognitive decline, and fewer still have utilized cognitive domains rather than a global measure of cognition. OBJECTIVE We examined the relation between perceived stress and the rate of decline in different cognitive domains. METHODS Participants were older African Americans without dementia from the Minority Aging Research Study (MARS; N = 467, mean age: 73 years, SD: 6.1 years). A battery of 19 cognitive tests was administered at baseline and at annual intervals for up to 9 years (mean follow-up: 4 years), from which composite measures of global cognitive function and five specific cognitive domains were derived. The four-item Cohen's Perceived Stress Scale (PSS) was also administered at baseline. RESULTS In linear mixed-effects models adjusted for age, sex, education, and vascular risk factors, higher perceived stress was related to faster declines in global cognition (β = -0.019; SE: 0.008; t(1951) = -2.46), episodic memory (β = -0.022; SE: 0.011; t(1954) = -1.99), and visuospatial ability (β = -0.021; SE: 0.009; t(1939) = -2.38) all p < 0.05. Findings were similar in subsequent models adjusted for demographics, vascular diseases, and depressive symptoms. CONCLUSIONS Results indicate that older African Americans with higher levels of perceived stress have more rapid declines in global cognition than those with lower levels, most notably for episodic memory and visuospatial ability.
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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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Experienced stress produces inhibitory deficits in old adults' Flanker task performance: First evidence for lifetime stress effects beyond memory. Biol Psychol 2015; 113:1-11. [PMID: 26542527 DOI: 10.1016/j.biopsycho.2015.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 10/22/2015] [Accepted: 10/24/2015] [Indexed: 11/21/2022]
Abstract
Studies regarding aged individuals' performance on the Flanker task differ with respect to reporting impaired or intact executive control. Past work has explained this discrepancy by hypothesising that elderly individuals use increased top-down control mechanisms advantageous to Flanker performance. This study investigated this mechanism, focussing on cumulative experienced stress as a factor that may impact on its execution, thereby leading to impaired performance. Thirty elderly and thirty young participants completed a version of the Flanker task paired with electroencephalographic recordings of the alpha frequency, whose increased synchronisation indexes inhibitory processes. Among high stress elderly individuals, findings revealed a general slowing of reaction times for congruent and incongruent stimuli, which correlated with alpha desynchronisation for both stimulus categories. Results found high performing (low stress) elderly revealed neither a behavioural nor electrophysiological difference compared to young participants. Therefore, rather than impacting on top-down compensatory mechanisms, findings indicate that stress may affect elderly participants' inhibitory control in attentional and sensorimotor domains.
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Marshall AC, Cooper NR, Geeraert N. The impact of experienced stress on aged spatial discrimination: Cortical overreliance as a result of hippocampal impairment. Hippocampus 2015; 26:329-40. [PMID: 26332910 DOI: 10.1002/hipo.22525] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 11/05/2022]
Abstract
A large body of neuroscientific work indicates that exposure to experienced stress causes damage to both cortical and hippocampal cells and results in impairments to cognitive abilities associated with these structures. Similarly, work within the domain of cognitive aging demonstrates that elderly participants who report experiencing greater amounts of stress show reduced levels of cognitive functioning. The present article attempted to combine both findings by collecting data from elderly and young participants who completed a spatial discrimination paradigm developed by Reagh and colleagues [Reagh et al. (2013) Hippocampus 24:303-314] to measure hippocampal-mediated cognitive processes. In order to investigate the effect of stress on the cortex and, indirectly, the hippocampus, it paired the paradigm with electroencephalographic recordings of the theta frequency band, which is thought to reflect cortical/hippocampal interactions. Findings revealed that elderly participants with high levels of experienced stress performed significantly worse on target recognition and lure discrimination and demonstrated heightened levels of cortical theta synchronization compared with young and elderly low stress counterparts. Results therefore provided further evidence for the adverse effect of stress on cognitive aging and indicate that impaired behavioral performance among high stress elderly may coincide with an overreliance on cortical cognitive processing strategies as a result of early damage to the hippocampus.
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Affiliation(s)
- Amanda C Marshall
- Department of Psychology, Centre for Brain Science, University of Essex, Colchester, CO4 3SQ, United Kingdom
| | - Nicholas R Cooper
- Department of Psychology, Centre for Brain Science, University of Essex, Colchester, CO4 3SQ, United Kingdom
| | - Nicolas Geeraert
- Department of Psychology, University of Essex, Colchester, CO4 3SQ, United Kingdom
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Munoz E, Sliwinski MJ, Scott SB, Hofer S. Global perceived stress predicts cognitive change among older adults. Psychol Aging 2015; 30:487-499. [PMID: 26121285 DOI: 10.1037/pag0000036] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Research on stress and cognitive aging has primarily focused on examining the effects of biological and psychosocial indicators of stress, with little attention provided to examining the association between perceived stress and cognitive aging. We examined the longitudinal association between global perceived stress (GPS) and cognitive change among 116 older adults (M(age) = 80, SD = 6.40, range = 67-96) in a repeated measurement burst design. Bursts of 6 daily cognitive assessments were repeated every 6 months over a 2-year period, with self-reported GPS assessed at the start of every burst. Using a double-exponential learning model, 2 parameters were estimated: (a) asymptotic level (peak performance), and (b) asymptotic change (the rate at which peak performance changed across bursts). We hypothesized that greater GPS would predict slowed performance in tasks of attention, working memory, and speed of processing and that increases in GPS across time would predict cognitive slowing. Results from latent growth curve analyses were consistent with our first hypothesis and indicated that level of GPS predicted cognitive slowing across time. Changes in GPS did not predict cognitive slowing. This study extends previous findings by demonstrating a prospective association between level of GPS and cognitive slowing across a 2-year period, highlighting the role of psychological stress as a risk factor for poor cognitive function.
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Grech LB, Kiropoulos LA, Kirby KM, Butler E, Paine M, Hester R. The effect of executive function on stress, depression, anxiety, and quality of life in multiple sclerosis. J Clin Exp Neuropsychol 2015; 37:549-62. [DOI: 10.1080/13803395.2015.1037723] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Marshall AC, Cooper NR, Segrave R, Geeraert N. The effects of long-term stress exposure on aging cognition: a behavioral and EEG investigation. Neurobiol Aging 2015; 36:2136-44. [PMID: 25834937 DOI: 10.1016/j.neurobiolaging.2015.02.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/17/2015] [Accepted: 02/23/2015] [Indexed: 12/17/2022]
Abstract
A large field of research seeks to explore and understand the factors that may cause different rates of age-related cognitive decline within the general population. However, the impact of experienced stress on the human aging process has remained an under-researched possibility. This study explored the association between cumulative stressful experiences and cognitive aging, addressing whether higher levels of experienced stress correlate with impaired performance on 2 working memory tasks. Behavioral performance was paired with electroencephalographic recordings to enable insight into the underlying neural processes impacted on by cumulative stress. Thus, the electroencephalogram was recorded while both young and elderly performed 2 different working memory tasks (a Sternberg and N-back paradigm), and cortical oscillatory activity in the theta, alpha, and gamma bandwidths was measured. Behavioral data indicated that a higher stress score among elderly participants related to impaired performance on both tasks. Electrophysiological findings revealed a reduction in alpha and gamma event-related synchronization among high-stress-group elderly participants, indicating that higher levels of experienced stress may impact on their ability to actively maintain a stimulus in working memory and inhibit extraneous information interfering with successful maintenance. Findings provide evidence that cumulative experienced stress adversely affects cognitive aging.
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Affiliation(s)
- Amanda C Marshall
- Department of Psychology, Centre for Brain Science, University of Essex, Colchester, UK.
| | - Nicholas R Cooper
- Department of Psychology, Centre for Brain Science, University of Essex, Colchester, UK
| | - Rebecca Segrave
- Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia
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Hedden T, Schultz AP, Rieckmann A, Mormino EC, Johnson KA, Sperling RA, Buckner RL. Multiple Brain Markers are Linked to Age-Related Variation in Cognition. Cereb Cortex 2014; 26:1388-400. [PMID: 25316342 DOI: 10.1093/cercor/bhu238] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Age-related alterations in brain structure and function have been challenging to link to cognition due to potential overlapping influences of multiple neurobiological cascades. We examined multiple brain markers associated with age-related variation in cognition. Clinically normal older humans aged 65-90 from the Harvard Aging Brain Study (N = 186) were characterized on a priori magnetic resonance imaging markers of gray matter thickness and volume, white matter hyperintensities, fractional anisotropy (FA), resting-state functional connectivity, positron emission tomography markers of glucose metabolism and amyloid burden, and cognitive factors of processing speed, executive function, and episodic memory. Partial correlation and mediation analyses estimated age-related variance in cognition shared with individual brain markers and unique to each marker. The largest relationships linked FA and striatum volume to processing speed and executive function, and hippocampal volume to episodic memory. Of the age-related variance in cognition, 70-80% was accounted for by combining all brain markers (but only ∼20% of total variance). Age had significant indirect effects on cognition via brain markers, with significant markers varying across cognitive domains. These results suggest that most age-related variation in cognition is shared among multiple brain markers, but potential specificity between some brain markers and cognitive domains motivates additional study of age-related markers of neural health.
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Affiliation(s)
- Trey Hedden
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron P Schultz
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna Rieckmann
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA Department of Radiation Sciences, Umeå University, Umeå SE-901 87, Sweden
| | - Elizabeth C Mormino
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Randy L Buckner
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Psychology and Center for Brain Science, Harvard University, Cambridge, MA, USA
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39
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Chaudhry M, Hasnain S, Snitz BE, Wang X, Rosenthal S, Demirci FY, Kamboh MI. Association of APOE polymorphisms and stressful life events with dementia in a Pakistani population. Neurosci Lett 2014; 570:42-6. [PMID: 24746929 DOI: 10.1016/j.neulet.2014.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 03/03/2014] [Accepted: 04/07/2014] [Indexed: 01/01/2023]
Abstract
Dementia is a major public health problem worldwide. Alzheimer's disease (AD) is a major form of dementia and the APOE 4 allele is an established genetic risk factor for AD. Similarly, stressful life events are also associated with dementia. The objective of this study was to examine the association of APOE 4 and stressful life events with dementia in a Pakistani sample, which to our knowledge has not been reported previously. We also tested for an interaction between stressful life events and APOE 4 on dementia risk. A total of 176 subjects (61 cases and 115 controls) were recruited. All cases and healthy controls were interviewed to assess cognition, co-morbidities, history of stressful life events and demographics. Blood genotyping for the APOE polymorphism (E2/E3/E4) was performed. APOE 4 and stressful life events were each independently and significantly associated with the risk of dementia (APOE 4: P=0.00697; stressful life events: P=5.29E-09). However, we did not find a significant interaction between APOE 4 carrier status and stressful life events on risk of dementia (P=0.677). Although the sample size of this study was small, the established association of APOE 4 with dementia was confirmed the first time in a Pakistani sample. Furthermore, stressful life events were also found to be significantly associated with dementia in this population.
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Affiliation(s)
- M Chaudhry
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan.
| | - S Hasnain
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan; The Women University Multan, Multan, Pakistan
| | - B E Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - X Wang
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - S Rosenthal
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - F Y Demirci
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - M I Kamboh
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
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40
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Tschanz JT, Norton MC, Zandi PP, Lyketsos CG. The Cache County Study on Memory in Aging: factors affecting risk of Alzheimer's disease and its progression after onset. Int Rev Psychiatry 2013; 25:673-85. [PMID: 24423221 PMCID: PMC4089882 DOI: 10.3109/09540261.2013.849663] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The Cache County Study on Memory in Aging is a longitudinal, population-based study of Alzheimer's disease (AD) and other dementias. Initiated in 1995 and extending to 2013, the study has followed over 5,000 elderly residents of Cache County, Utah (USA) for over twelve years. Achieving a 90% participation rate at enrolment, and spawning two ancillary projects, the study has contributed to the literature on genetic, psychosocial and environmental risk factors for AD, late-life cognitive decline, and the clinical progression of dementia after its onset. This paper describes the major study contributions to the literature on AD and dementia.
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Affiliation(s)
- JoAnn T. Tschanz
- Department of Psychology, Utah State University,Center for Epidemiologic Studies, Utah State University
| | - Maria C. Norton
- Center for Epidemiologic Studies, Utah State University,Department of Family, Consumer & Human Development, Utah State University
| | - Peter P. Zandi
- Bloomberg School of Public Health, Johns Hopkins University
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