Ai Koyanagi1,2, Hans Oh3, Davy Vancampfort4,5, Andre F Carvalho6,7, Nicola Veronese8, Brendon Stubbs9,10,11, Elvira Lara12,13. 1. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spaina.koyanagi@pssjd.org. 2. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spaina.koyanagi@pssjd.org. 3. School of Social Work, University of Southern California, Los Angeles, California, USA. 4. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. 5. University Psychiatric Center, KU Leuven, Leuven-Kortenberg, Belgium. 6. Centre for Addiction & Mental Health, Toronto, Ontario, Canada. 7. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 8. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. 9. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom. 10. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. 11. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom. 12. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. 13. Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
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.
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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Authors: Lee Smith; Nicola Veronese; Guillermo F López-Sánchez; Lin Yang; Damiano Pizzol; Laurie T Butler; Yvonne Barnett; Mireia Felez-Nobrega; Louis Jacob; Jae Il Shin; Mark A Tully; Trish Gorely; Hans Oh; Ai Koyanagi Journal: J Clin Med Date: 2021-03-17 Impact factor: 4.241