A new analysis of health data on more than 24,000 people published in JAMA Network Open revealed that elevated stress levels were likely to increase the risk of cognitive decline — impacting memory, concentration, ability to reason, and other brain functions.
Previous research has established that chronic stress can wear a body down and have a negative impact on almost all aspects of health. With the brain in particular, higher levels of the stress hormone cortisol have been associated with memory impairments and a reduction in the volume of the hippocampus, a brain region important for memory functions.
“Our study finds that even general stress can lead to cognitive decline,” says lead author Ambar Kulshreshtha, MD, an associate professor of preventive medicine and epidemiology at the Emory University School of Medicine in Atlanta.
“While eliminating stress is not always possible, we can learn to develop healthier responses to manage stress using some self-care,” says Dr. Kulshreshtha. Practicing mindfulness and prioritizing healthy lifestyle choices like staying active, getting good sleep, and socializing are all ways to cope with stress in constructive ways, he adds.
“People’s way of coping with stress may be different, but it is essential to have a few tools in hand,” says Kulshreshtha. “All this would ultimately keep our mind sharp and promote good brain health.”
Women and Black Adults Reported Higher Levels of Stress
Kulshreshtha and his collaborators found that elevated levels of perceived stress were associated with 37 percent higher odds of poor cognition. Their findings were based on data from 10,177 Black participants (42 percent) and 14,271 white participants (58 percent). Individuals ranged in age from 45 to 98. Six out of 10 subjects were women, and nearly 23 percent of participants reported elevated stress levels.
Study authors note that participants with higher perceived stress were more likely to be female, more likely to be Black, and more likely to be younger.
Results showed that 70 percent of female participants experienced elevated stress compared with 30 percent of males. Just over half of Black participants reported elevated stress compared with just under half of white participants. The average age for those with high stress was 62, compared with 64 for those with low stress.
Among those with higher stress, researchers also more frequently observed cardiovascular disease risk factors including hypertension, diabetes, and high cholesterol.
Why Are Certain Groups More Likely to Experience Stress?
As to why younger participants may have more stress, Yuko Hara, PhD, director of aging and prevention at the Alzheimer’s Drug Discovery Foundation, suggests that those in their forties and fifties may have high-stress job responsibilities, along with the financial and emotional stress of raising children.
When it comes to women experiencing more stress, the imbalance may be due to greater responsibilities women may have balancing childcare and household responsibilities, often while holding a job, according to Dr. Hara, who was not involved in the study.
“Women have twice the risk of developing depression than men,” she says. “And women have a higher caregiver burden than men. Caregiving for a family member can be extremely stressful.”
The study authors note that African Americans are more likely to experience stress related to discrimination and poverty. The findings reveal that while white individuals may experience higher levels of stress for different reasons, they still experience a similar worsening of cognitive decline from stress.
Individuals with low education and low family income are also more likely to have higher stress. “They face day-to-day challenges with food, income, housing insecurity, childcare, and elderly support,” says Kulshreshtha.
People with elevated stress were also more likely to be living in the southeastern United States. This region of the country is referred to as the “Stroke Belt” by epidemiologists, because stroke rates are more than 30 percent higher than the national average.
Taking Steps to Reduce Stress
For Percy Griffin, PhD, director of scientific engagement for the Alzheimer’s Association, the study is important because it raises awareness on stress-related factors that may raise the risk of cognitive decline and Alzheimer’s disease and dementia.
“The more we know about how lifestyle and behavioral issues impact cognition and dementia risk, the better prepared we will be to design and implement effective multi-component strategies to reduce risk of cognitive decline and dementia,” he says.
Hara highlights several ways individuals help keep stress at bay, including eating a healthy diet, sleeping seven to eight hours every night, getting enough physical activity, and seeking out counseling when needed.
“It is also important to make time to unwind and connect with people you trust,” she says. “There are relaxation methods you can try, including taking deep breaths, meditating, and practicing yoga. Spending time on activities that you enjoy, such as hobbies, can also be helpful.”