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The association between social stress and global cognitive function in a population-based study: the European Prospective Investigation into Cancer (EPIC)-Norfolk study

  • Y. Leng (a1), N. W. J. Wainwright (a1), S. Hayat (a1), B. C. M. Stephan (a2), F. E. Matthews (a3), R. Luben (a1), P. G. Surtees (a1), K.-T. Khaw (a1) and C. Brayne (a4)...
Abstract
Background

Stress is thought to exert both positive and negative effects on cognition, but the precise cognitive effects of social stress and individuals' response to stress remain unclear. We aimed to investigate the association between different measures of social stress and cognitive function in a middle- to older-aged population using data from the European Prospective Investigation into Cancer (EPIC)-Norfolk study.

Method

Participants completed a comprehensive assessment of lifetime social adversity between 1993 and 1997 and the short form of the Mini Mental State Examination (SF-MMSE), an assessment of global cognitive function, during the third health check between 2004 and 2011 (a median of 10.5 years later). A low MMSE score was defined as a score in the bottom quartile (20–26).

Results

Completed MMSE scores and stress measures were available for 5129 participants aged 48–90 years. Participants who reported that their lives had been more stressful over the previous 10 years were significantly more likely to have low MMSE scores [odds ratio (OR) 1.14, 95% confidence interval (CI) 1.04–1.24 per unit increase in perceived stress], independently of sociodemographic factors, physical and emotional health. The effects were restricted to the highest level of stress and the association was stronger among participants with a lower educational level. Adaptation following life event experiences also seemed to be associated with MMSE scores after adjusting for sociodemographic factors, but the association was attenuated with further adjustment.

Conclusions

In this generally high-functioning population, individuals' interpretations and responses to stressful events, rather than the events themselves, were associated with cognitive function.

Copyright
Corresponding author
*Address for correspondence: Y. Leng, M.Phil., Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK. (Email: yl411@cam.ac.uk)
References
Hide All
Albright TD, Kandel ER, Posner MI (2000). Cognitive neuroscience. Current Opinion in Neurobiology 10, 612624.
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.
Brayne C, Ince PG, Keage HA, McKeith IG, Matthews FE, Polvikoski T, Sulkava R (2010). Education, the brain and dementia: neuroprotection or compensation? Brain 133, 22102216.
Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, Westlake L (1992). Validating the SF-36 health survey questionnaire: new outcome measure for primary care. British Medical Journal 305, 160164.
Brown GW (1974). Meaning, measurement and stress of life events. In Stressful Life Events: Their Nature and Effects(ed. Dohrenwend B. S. and Dohrenwend B. P.), pp. 217244. John Wiley: New York.
Burke MA, Goodkin K (1997). Stress and the development of breast cancer: a persistent and popular link despite contrary evidence. Cancer 79, 10551059.
Cagney KA, Lauderdale DS (2002). Education, wealth, and cognitive function in later life. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 57, P163P172.
Caplan PJ (1997). Gender Differences in Human Cognition. Oxford University Press: New York.
Charles E, Bouby-Serieys V, Thomas P, Clement JP (2006). Links between life events, traumatism and dementia: an open study including 565 patients with dementia. Encephale 32, 746752.
Comijs HC, van den Kommer TN, Minnaar RW, Penninx BW, Deeg DJ (2011). Accumulated and differential effects of life events on cognitive decline in older persons: depending on depression, baseline cognition, or ApoE epsilon4 status? Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 66 (Suppl. 1), i111i120.
Day N, Oakes S, Luben R, Khaw KT, Bingham S, Welch A, Wareham N (1999). EPIC-Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer. British Journal of Cancer 80 (Suppl. 1), 95103.
Deary IJ, Whiteman MC, Pattie A, Starr JM, Hayward C, Wright AF, Carothers A, Whalley LJ (2002). Cognitive change and the APOE epsilon 4 allele. Nature 418, 932.
Denissen JJ, Geenen R, van Aken MA, Gosling SD, Potter J (2008). Development and validation of a Dutch translation of the Big Five Inventory (BFI). Journal of Personality Assessment 90, 152157.
de Rooij SR, Veenendaal MV, Raikkonen K, Roseboom TJ (2012). Personality and stress appraisal in adults prenatally exposed to the Dutch famine. Early Human Development 88, 321325.
Grimby A, Berg S (1995). Stressful life events and cognitive functioning in late life. Aging 7, 3539.
Helmuth L (2002). Neuroscience. A generation gap in brain activity. Science 296, 21312133.
Hodges JR (2007). Cognitive Assessment for Clinicians. Oxford University Press: Oxford.
Jeong YH, Park CH, Yoo J, Shin KY, Ahn SM, Kim HS, Lee SH, Emson PC, Suh YH (2006). Chronic stress accelerates learning and memory impairments and increases amyloid deposition in APPV717I-CT100 transgenic mice, an Alzheimer's disease model. FASEB Journal 20, 729731.
Johansson L, Guo X, Waern M, Ostling S, Gustafson D, Bengtsson C, Skoog I (2010). Midlife psychological stress and risk of dementia: a 35-year longitudinal population study. Brain 133, 22172224.
Klein LE, Roca RP, McArthur J, Vogelsang G, Klein GB, Kirby SM, Folstein M (1985). Diagnosing dementia. Univariate and multivariate analyses of the mental status examination. Journal of the American Geriatrics Society 33, 483488.
Kuhlmann S, Piel M, Wolf OT (2005). Impaired memory retrieval after psychosocial stress in healthy young men. Journal of Neuroscience 25, 29772982.
Lee S, Kawachi I, Berkman LF, Grodstein F (2003). Education, other socioeconomic indicators, and cognitive function. American Journal of Epidemiology 157, 712720.
Lupien SJ, Gaudreau S, Tchiteya BM, Maheu F, Sharma S, Nair NP, Hauger RL, McEwen BS, Meaney MJ (1997). Stress-induced declarative memory impairment in healthy elderly subjects: relationship to cortisol reactivity. Journal of Clinical Endocrinology and Metabolism 82, 20702075.
Lupien SJ, Maheu F, Tu M, Fiocco A, Schramek TE (2007). The effects of stress and stress hormones on human cognition: implications for the field of brain and cognition. Brain and Cognition 65, 209237.
Marioni RE, Chatfield M, Brayne C, Matthews FE (2011). The reliability of assigning individuals to cognitive states using the Mini-Mental State Examination: a population-based prospective cohort study. BMC Medical Research Methodology 11, 127.
Matthews FE, Stephan BC, Khaw KT, Hayat S, Luben R, Bhaniani A, Moore S, Brayne C (2011). Full-scale scores of the Mini Mental State Examination can be generated from an abbreviated version. Journal of Clinical Epidemiology 64, 10051013.
McEwen BS, Sapolsky RM (1995). Stress and cognitive function. Current Opinion in Neurobiology 5, 205216.
McHorney CA, Ware Jr. JE, Raczek AE (1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care 31, 247263.
Merz CJ, Wolf OT, Hennig J (2010). Stress impairs retrieval of socially relevant information. Behavioral Neuroscience 124, 288293.
Mizoguchi K, Kunishita T, Chui DH, Tabira T (1992). Stress induces neuronal death in the hippocampus of castrated rats. Neuroscience Letters 138, 157160.
Park JY, Mitrou PN, Keogh RH, Luben RN, Wareham NJ, Khaw KT (2011). Effects of body size and sociodemographic characteristics on differences between self-reported and measured anthropometric data in middle-aged men and women: the EPIC-Norfolk study. European Journal of Clinical Nutrition 65, 357367.
Peavy GM, Salmon DP, Jacobson MW, Hervey A, Gamst AC, Wolfson T, Patterson TL, Goldman S, Mills PJ, Khandrika S, Galasko D (2009). Effects of chronic stress on memory decline in cognitively normal and mildly impaired older adults. American Journal of Psychiatry 166, 13841391.
Persson G, Skoog I (1996). A prospective population study of psychosocial risk factors for late onset dementia. International Journal of Geriatric Psychiatry 11, 1522.
Price MA, Tennant CC, Butow PN, Smith RC, Kennedy SJ, Kossoff MB, Dunn SM (2001). The role of psychosocial factors in the development of breast carcinoma: Part II. Life event stressors, social support, defense style, and emotional control and their interactions. Cancer 91, 686697.
Rosnick CB, Small BJ, McEvoy CL, Borenstein AR, Mortimer JA (2007). Negative life events and cognitive performance in a population of older adults. Journal of Aging and Health 19, 612629.
Sandi C, Pinelo-Nava MT (2007). Stress and memory: behavioral effects and neurobiological mechanisms. Neural Plasticity 2007, 78970.
Sapolsky RM, Krey LC, McEwen BS (1985). Prolonged glucocorticoid exposure reduces hippocampal neuron number: implications for aging. Journal of Neuroscience 5, 12221227.
Schlotz W, Yim IS, Zoccola PM, Jansen L, Schulz P (2011). The Perceived Stress Reactivity Scale: measurement invariance, stability, and validity in three countries. Psychological Assessment 23, 8094.
Shors TJ, Weiss C, Thompson RF (1992). Stress-induced facilitation of classical conditioning. Science 257, 537539.
Stansfeld SA, Bosma H, Hemingway H, Marmot MG (1998). Psychosocial work characteristics and social support as predictors of SF-36 health functioning: the Whitehall II study. Psychosomatic Medicine 60, 247255.
Stawski RS, Sliwinski MJ, Smyth JM (2006). Stress-related cognitive interference predicts cognitive function in old age. Psychology and Aging 21, 535544.
Surtees PG, Wainwright NW (2007). The shackles of misfortune: social adversity assessment and representation in a chronic-disease epidemiological setting. Social Science and Medicine 64, 95111.
Surtees PG, Wainwright NW, Brayne C (2000). Psychosocial aetiology of chronic disease: a pragmatic approach to the assessment of lifetime affective morbidity in an EPIC component study. Journal of Epidemiology and Community Health 54, 114122.
Surtees PG, Wainwright NW, Khaw KT (2004). Obesity, confidant support and functional health: cross-sectional evidence from the EPIC-Norfolk cohort. International Journal of Obesity and Related Metabolic Disorders 28, 748758.
Surtees PG, Wainwright NW, Khaw KT, Day NE (2003). Functional health status, chronic medical conditions and disorders of mood. British Journal of Psychiatry 183, 299303.
Surtees PG, Wainwright NW, Luben RN, Khaw KT, Bingham SA (2010). No evidence that social stress is associated with breast cancer incidence. Breast Cancer Research and Treatment 120, 169174.
Surtees PG, Wainwright NW, Luben RN, Wareham NJ, Bingham SA, Khaw KT (2008). Depression and ischemic heart disease mortality: evidence from the EPIC-Norfolk United Kingdom prospective cohort study. American Journal of Psychiatry 165, 515523.
Tsolaki M, Papaliagkas V, Kounti F, Messini C, Boziki M, Anogianakis G, Vlaikidis N (2010). Severely stressful events and dementia: a study of an elderly Greek demented population. Psychiatry Research 176, 5154.
Uno H, Tarara R, Else JG, Suleman MA, Sapolsky RM (1989). Hippocampal damage associated with prolonged and fatal stress in primates. Journal of Neuroscience 9, 17051711.
VonDras DD, Powless MR, Olson AK, Wheeler D, Snudden AL (2005). Differential effects of everyday stress on the episodic memory test performances of young, mid-life, and older adults. Aging and Mental Health 9, 6070.
Wainwright NW, Surtees PG (2004). Places, people, and their physical and mental functional health. Journal of Epidemiology and Community Health 58, 333339.
Ward L, Mathias JL, Hitchings SE (2007). Relationships between bereavement and cognitive functioning in older adults. Gerontology 53, 362372.
Ware Jr. JE, Sherbourne CD (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care 30, 473483.
Wilson RS, Arnold SE, Schneider JA, Kelly JF, Tang Y, Bennett DA (2006). Chronic psychological distress and risk of Alzheimer's disease in old age. Neuroepidemiology 27, 143153.
Wilson RS, Arnold SE, Schneider JA, Li Y, Bennett DA (2007 a). Chronic distress, age-related neuropathology, and late-life dementia. Psychosomatic Medicine 69, 4753.
Wilson RS, Barnes LL, Bennett DA, Li Y, Bienias JL, Mendes de Leon CF, Evans DA (2005). Proneness to psychological distress and risk of Alzheimer disease in a biracial community. Neurology 64, 380382.
Wilson RS, Evans DA, Bienias JL, Mendes de Leon CF, Schneider JA, Bennett DA (2003). Proneness to psychological distress is associated with risk of Alzheimer's disease. Neurology 61, 14791485.
Wilson RS, Schneider JA, Boyle PA, Arnold SE, Tang Y, Bennett DA (2007 b). Chronic distress and incidence of mild cognitive impairment. Neurology 68, 20852092.
Yuen EY, Liu W, Karatsoreos IN, Feng J, McEwen BS, Yan Z (2009). Acute stress enhances glutamatergic transmission in prefrontal cortex and facilitates working memory. Proceedings of the National Academy of Sciences USA 106, 1407514079.
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Psychological Medicine
  • ISSN: 0033-2917
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