Paola Gilsanz1, Charles P Quesenberry1, Elizabeth Rose Mayeda2,3, M Maria Glymour3, Sarah T Farias4, Rachel A Whitmer1,3,5. 1. Kaiser Permanente Division of Research, Oakland. 2. University of California Los Angeles Fielding School of Public Health, Los Angeles. 3. Department of Epidemiology and Biostatistics, University of California, San Francisco. 4. Departments of Neurology. 5. Public Health Sciences, University of California, Davis, CA.
Abstract
BACKGROUND: Posttraumatic stress disorder is associated with increased dementia risk but less is known about stress because of everyday problems in diverse populations. METHODS: A total of 9605 health care plan members who provided information regarding midlife stressors in 1972 to 1973 (ages, 40 to 55 y) were followed for dementia diagnosis between 1996 and 2017. Cox proportional hazard models evaluated associations between midlife stressors and dementia adjusting for demographics and lifecourse health indicators. RESULTS: Reporting at least 1 midlife stressor was associated with 17% greater dementia risk [hazard ratio (HR), 1.17; 95% confidence interval (CI),1.07-1.27] versus 0 midlife stressors and 26% increased risk among those with less than equal to high school education (HR, 1.26; 95% CI,1.09-1.44) adjusting for demographics. Compared with whites without stressors, whites with ≥1 stressor had 13% greater dementia risk (HR, 1.13; 95% CI, 1.02-1.24), blacks without stressors 19% greater risk (HR, 1.19; 95% CI,1.08-1.32), and blacks with ≥1 stressors 47% greater risk (HR, 1.47; 95% CI,1.27-1.69) in fully adjusted models. Resource problems were associated with 20% greater risk (HR, 1.20; 95% CI, 1.01-1.42) than interpersonal problems. CONCLUSION: Reporting ≥1 serious midlife stressor was associated with elevated dementia risk, especially stressors related to resources problems and for those with less than equal to high school education. Everyday stressors can impact brain health over the long term and may contribute to racial inequities in dementia rates, though education can be a mitigating factor.
BACKGROUND:Posttraumatic stress disorder is associated with increased dementia risk but less is known about stress because of everyday problems in diverse populations. METHODS: A total of 9605 health care plan members who provided information regarding midlife stressors in 1972 to 1973 (ages, 40 to 55 y) were followed for dementia diagnosis between 1996 and 2017. Cox proportional hazard models evaluated associations between midlife stressors and dementia adjusting for demographics and lifecourse health indicators. RESULTS: Reporting at least 1 midlife stressor was associated with 17% greater dementia risk [hazard ratio (HR), 1.17; 95% confidence interval (CI),1.07-1.27] versus 0 midlife stressors and 26% increased risk among those with less than equal to high school education (HR, 1.26; 95% CI,1.09-1.44) adjusting for demographics. Compared with whites without stressors, whites with ≥1 stressor had 13% greater dementia risk (HR, 1.13; 95% CI, 1.02-1.24), blacks without stressors 19% greater risk (HR, 1.19; 95% CI,1.08-1.32), and blacks with ≥1 stressors 47% greater risk (HR, 1.47; 95% CI,1.27-1.69) in fully adjusted models. Resource problems were associated with 20% greater risk (HR, 1.20; 95% CI, 1.01-1.42) than interpersonal problems. CONCLUSION: Reporting ≥1 serious midlife stressor was associated with elevated dementia risk, especially stressors related to resources problems and for those with less than equal to high school education. Everyday stressors can impact brain health over the long term and may contribute to racial inequities in dementia rates, though education can be a mitigating factor.
Authors: Elizabeth Rose Mayeda; M Maria Glymour; Charles P Quesenberry; Rachel A Whitmer Journal: Alzheimers Dement Date: 2016-02-11 Impact factor: 21.566
Authors: Paola Gilsanz; Elizabeth Rose Mayeda; M Maria Glymour; Charles P Quesenberry; Rachel A Whitmer Journal: JAMA Neurol Date: 2017-09-01 Impact factor: 18.302
Authors: Jason D Flatt; Paola Gilsanz; Charles P Quesenberry; Kathleen B Albers; Rachel A Whitmer Journal: Alzheimers Dement Date: 2017-06-13 Impact factor: 21.566
Authors: Lotte Gerritsen; Hui-Xin Wang; Chandra A Reynolds; Laura Fratiglioni; Margaret Gatz; Nancy L Pedersen Journal: Am J Geriatr Psychiatry Date: 2017-03-16 Impact factor: 4.105
Authors: Sander Lamballais; Maria C Adank; Rowina F Hussainali; Sarah Schalekamp-Timmermans; Meike W Vernooij; Annemarie I Luik; Eric A P Steegers; Mohammad Arfan Ikram Journal: Eur J Epidemiol Date: 2020-12-16 Impact factor: 8.082
Authors: Suzanne E Schindler; Carlos Cruchaga; Amulya Joseph; Lena McCue; Fabiana H G Farias; Consuelo H Wilkins; Yuetiva Deming; Rachel L Henson; Robert J Mikesell; Laura Piccio; Jorge J Llibre-Guerra; Krista L Moulder; Anne M Fagan; Beau M Ances; Tammie L S Benzinger; Chengjie Xiong; David M Holtzman; John C Morris Journal: Neurol Genet Date: 2021-03-04
Authors: Yan Cheng; Ali Ahmed; Edward Zamrini; Debby W Tsuang; Helen M Sheriff; Qing Zeng-Treitler Journal: J Alzheimers Dis Date: 2020 Impact factor: 4.472
Authors: Jing Li; Jorge J Llibre-Guerra; Amal Harrati; Jordan Weiss; Ivonne Z Jiménez-Velázquez; Daisy Acosta; Juan de Jesús Llibre-Rodriguez; Mao-Mei Liu; William H Dow Journal: Alzheimers Dement (N Y) Date: 2021-09-05