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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

Published online by Cambridge University Press:  12 June 2012

Y. Leng ,
N. W. J. Wainwright ,
S. Hayat ,
B. C. M. Stephan ,
F. E. Matthews ,
R. Luben ,
P. G. Surtees ,
K.-T. Khaw  and
C. Brayne
Y. Leng*
Affiliation:
Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, UK
N. W. J. Wainwright
Affiliation:
Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, UK
S. Hayat
Affiliation:
Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, UK
B. C. M. Stephan
Affiliation:
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
F. E. Matthews
Affiliation:
MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK
R. Luben
Affiliation:
Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, UK
P. G. Surtees
Affiliation:
Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, UK
K.-T. Khaw
Affiliation:
Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, UK
C. Brayne
Affiliation:
Department of Public Health and Primary Care, University Forvie Site, University of Cambridge, UK
*
*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: [email protected])
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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.

Keywords

Cognitive functionlife eventsMini Mental State Examinationpsychological stressSF-MMSE
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 3 , March 2013 , pp. 655 - 666
Copyright
Copyright © Cambridge University Press 2012

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References

Albright, TD, Kandel, ER, Posner, MI (2000). Cognitive neuroscience. Current Opinion in Neurobiology 10, 612–624.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
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, 2210–2216.CrossRefGoogle ScholarPubMed
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, 160–164.CrossRefGoogle ScholarPubMed
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. 217–244. John Wiley: New York.Google Scholar
Burke, MA, Goodkin, K (1997). Stress and the development of breast cancer: a persistent and popular link despite contrary evidence. Cancer 79, 1055–1059.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Cagney, KA, Lauderdale, DS (2002). Education, wealth, and cognitive function in later life. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 57, P163–P172.CrossRefGoogle ScholarPubMed
Caplan, PJ (1997). Gender Differences in Human Cognition. Oxford University Press: New York.CrossRefGoogle Scholar
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, 746–752.CrossRefGoogle ScholarPubMed
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), i111–i120.CrossRefGoogle ScholarPubMed
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), 95–103.Google Scholar
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.CrossRefGoogle ScholarPubMed
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, 152–157.CrossRefGoogle ScholarPubMed
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, 321–325.CrossRefGoogle Scholar
Grimby, A, Berg, S (1995). Stressful life events and cognitive functioning in late life. Aging 7, 35–39.Google ScholarPubMed
Helmuth, L (2002). Neuroscience. A generation gap in brain activity. Science 296, 2131–2133.CrossRefGoogle ScholarPubMed
Hodges, JR (2007). Cognitive Assessment for Clinicians. Oxford University Press: Oxford.Google Scholar
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, 729–731.CrossRefGoogle ScholarPubMed
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, 2217–2224.CrossRefGoogle ScholarPubMed
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, 483–488.CrossRefGoogle ScholarPubMed
Kuhlmann, S, Piel, M, Wolf, OT (2005). Impaired memory retrieval after psychosocial stress in healthy young men. Journal of Neuroscience 25, 2977–2982.CrossRefGoogle ScholarPubMed
Lee, S, Kawachi, I, Berkman, LF, Grodstein, F (2003). Education, other socioeconomic indicators, and cognitive function. American Journal of Epidemiology 157, 712–720.CrossRefGoogle ScholarPubMed
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, 2070–2075.Google ScholarPubMed
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, 209–237.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
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, 1005–1013.CrossRefGoogle ScholarPubMed
McEwen, BS, Sapolsky, RM (1995). Stress and cognitive function. Current Opinion in Neurobiology 5, 205–216.CrossRefGoogle ScholarPubMed
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, 247–263.CrossRefGoogle ScholarPubMed
Merz, CJ, Wolf, OT, Hennig, J (2010). Stress impairs retrieval of socially relevant information. Behavioral Neuroscience 124, 288–293.CrossRefGoogle ScholarPubMed
Mizoguchi, K, Kunishita, T, Chui, DH, Tabira, T (1992). Stress induces neuronal death in the hippocampus of castrated rats. Neuroscience Letters 138, 157–160.CrossRefGoogle ScholarPubMed
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, 357–367.CrossRefGoogle ScholarPubMed
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, 1384–1391.CrossRefGoogle ScholarPubMed
Persson, G, Skoog, I (1996). A prospective population study of psychosocial risk factors for late onset dementia. International Journal of Geriatric Psychiatry 11, 15–22.3.0.CO;2-5>CrossRefGoogle Scholar
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, 686–697.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
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, 612–629.CrossRefGoogle Scholar
Sandi, C, Pinelo-Nava, MT (2007). Stress and memory: behavioral effects and neurobiological mechanisms. Neural Plasticity 2007, 78970.CrossRefGoogle ScholarPubMed
Sapolsky, RM, Krey, LC, McEwen, BS (1985). Prolonged glucocorticoid exposure reduces hippocampal neuron number: implications for aging. Journal of Neuroscience 5, 1222–1227.CrossRefGoogle ScholarPubMed
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, 80–94.CrossRefGoogle ScholarPubMed
Shors, TJ, Weiss, C, Thompson, RF (1992). Stress-induced facilitation of classical conditioning. Science 257, 537–539.CrossRefGoogle ScholarPubMed
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, 247–255.CrossRefGoogle ScholarPubMed
Stawski, RS, Sliwinski, MJ, Smyth, JM (2006). Stress-related cognitive interference predicts cognitive function in old age. Psychology and Aging 21, 535–544.CrossRefGoogle ScholarPubMed
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, 95–111.CrossRefGoogle Scholar
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, 114–122.CrossRefGoogle Scholar
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, 748–758.CrossRefGoogle ScholarPubMed
Surtees, PG, Wainwright, NW, Khaw, KT, Day, NE (2003). Functional health status, chronic medical conditions and disorders of mood. British Journal of Psychiatry 183, 299–303.CrossRefGoogle ScholarPubMed
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, 169–174.CrossRefGoogle ScholarPubMed
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, 515–523.CrossRefGoogle ScholarPubMed
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, 51–54.CrossRefGoogle ScholarPubMed
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, 1705–1711.CrossRefGoogle ScholarPubMed
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, 60–70.CrossRefGoogle ScholarPubMed
Wainwright, NW, Surtees, PG (2004). Places, people, and their physical and mental functional health. Journal of Epidemiology and Community Health 58, 333–339.CrossRefGoogle ScholarPubMed
Ward, L, Mathias, JL, Hitchings, SE (2007). Relationships between bereavement and cognitive functioning in older adults. Gerontology 53, 362–372.CrossRefGoogle ScholarPubMed
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, 473–483.CrossRefGoogle ScholarPubMed
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, 143–153.CrossRefGoogle ScholarPubMed
Wilson, RS, Arnold, SE, Schneider, JA, Li, Y, Bennett, DA (2007 a). Chronic distress, age-related neuropathology, and late-life dementia. Psychosomatic Medicine 69, 47–53.CrossRefGoogle ScholarPubMed
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, 380–382.CrossRefGoogle Scholar
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, 1479–1485.CrossRefGoogle ScholarPubMed
Wilson, RS, Schneider, JA, Boyle, PA, Arnold, SE, Tang, Y, Bennett, DA (2007 b). Chronic distress and incidence of mild cognitive impairment. Neurology 68, 2085–2092.CrossRefGoogle ScholarPubMed
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, 14075–14079.CrossRefGoogle ScholarPubMed