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P2‐314: PERCEIVED STRESS AND RISK OF DEMENTIA IN OLDER ADULTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT
Author(s) -
Jiang Julie,
Katz Mindy Joy,
White Robert,
Zimmerman Molly E.,
Sliwinski Martin,
Kim Mimi,
Lipton Richard B.
Publication year - 2014
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2014.05.993
Subject(s) - dementia , medicine , depression (economics) , cognition , gerontology , proportional hazards model , risk factor , audiology , psychology , psychiatry , disease , economics , macroeconomics
Background: Elevated stress is associated with memory deficits and decreased hippocampal volume, which is involved in both episodic and working memory. Stress may be a remediable risk factor for cognitive decline. We hypothesize that stress may predict the transition from aMCI to dementia. Methods: We recruited community residing older adults with aMCI from the Einstein Aging Study and followed them with annual assessments for dementia onset, defined by DSM-IV criteria. The baseline wave is the first wave where participants meet criteria for aMCI and have PSS results. Multivariate Cox regression analyses were conducted to examine the relationship between baseline PSS score and the subsequent onset of dementia. A "high stress" group was defined as the top quintile of PSS scores and the other 4 quintiles formed the "low stress" group. Results: We followed 111 individuals with aMCI and a mean baseline age of 83.2 years over an average of 2.6 years of follow-up (SD1⁄41.5), 30 (27%) participants developed incident dementia. Cox regression analyses showed that the high stress group had a statistically significant increase in risk of dementia (HR1⁄43.05; 95% CI:1.33-6.99) after adjusting for age, gender, race, years of education, and baseline aMCI status. After subsequent additional adjustments for baseline cognitive status, depression, and APOE e4 status, having high stress remained a significant risk for developing dementia (HR1⁄42.67; 95% CI:1.05-6.78). Conclusions: High levels of perceived stress were associated with an increased risk of incident dementia among those with aMCI. There also appears to be a threshold at which high stress increases the vulnerability for dementia. These findings suggest that stress reduction may reduce the risk of dementia in persons with aMCI.