Perceived Stress and Cognitive Decline in Different Cognitive Domains in a Cohort of Older African Americans

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.

Keywords: African Americans; cognition; cognitive decline; cognitive domains; perceived stress.

Figure 1

Graphical representation of the rate of change in global cognition over time in individual with higher levels of stress (90^th percentile perceived stress) versus those with lower levels of stress (10^th percentile perceived stress).

Figure 2

Graphical representation of the rate of change in episodic memory over time in individual with higher levels of stress (90^th percentile perceived stress) versus those with lower levels of stress (10^th percentile perceived stress).

Figure 3

Graphical representation of the rate of change in visuospatial ability over time in individual with higher levels of stress (90^th percentile perceived stress) versus those with lower levels of stress (10^th percentile perceived stress).