Stress and Memory Decline Linked 

< Jun. 13, 2007 > -- If you want your mind to stay healthy into your golden years, don't worry, be happy, according to a recent article published in Neurology.

That could be the message of new research that shows those prone to worry, anxiety, or depression are more likely to develop mild cognitive impairment (MCI), a condition often considered a precursor to the more debilitating Alzheimer's disease.

"MCI is now recognized as a very early sign of incipient Alzheimer's disease," says Dr. Robert S. Wilson, lead author of the study and a neuropsychologist at the Rush Alzheimer's Disease Center in Chicago. "We found that among healthy elderly people without evidence of cognitive dysfunction at the beginning of the study, chronic distress predicted the development of MCI."

Stress is Difficult to Measure

"This is consistent with 20 years of literature on the subject," adds Dr. Sam Gandy, chairman of the Alzheimer's Association's medical and scientific advisory council and director of the Farber Institute for Neurosciences at Thomas Jefferson University in Philadelphia.

But moving from these findings to knowledge that can really help individuals could be problematic.

"Quantifying stress is like quantifying mental activity," Dr. Gandy says. "These are things that are very difficult to standardize and quantify and measure from one human to the next. It's a big challenge to get to something specific."

"The most important implications are down the road," Dr. Wilson adds.

Half with Mild Cognitive Impairment Do Not Develop Dementia

For now, even stressed people should not get more stressed by the research, another expert advises.

"Fifty percent of individuals who have mild cognitive impairment do not go on to develop dementia," says Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. "It's not what's called a stable, highly reliable diagnosis. People should not be alarmed by the study."

Dr. Wilson and his colleagues had hypothesized that distress might play a role in the beginnings of Alzheimer's.

The authors used data from two larger studies - the Religious Orders Study and the Memory and Aging Project - to explore the relationship between psychological distress and mild cognitive impairment.

At the beginning of the study, 1,256 participants with no signs of cognitive impairment completed a test designed to assess how prone they were to distress and negative emotions. They were asked their degree of agreement with such statements as "I am not a worrier," "I often feel tense and jittery," and "I often get angry at the way people treat me."

Participants were further evaluated every year for 12 years.

During that time, 482 people - 38 percent - developed mild cognitive impairment.

Negative Emotions Tied to Problem

Those who most often experienced negative emotions were more than 40 percent more likely to develop mild cognitive impairment than those who were least prone to these emotions. This suggests that chronic psychological distress is a risk factor for mild cognitive impairment, the researchers say.

And the findings were independent of depression. "We do think depression is somehow associated with an increased risk of dementia, but this [study] controlled for depression," Dr. Kennedy says.

It is unclear why this might be the case.

"If this is a vulnerability factor for developing Alzheimer's, the big question is how is it working, what's the neurobiology connecting this," Dr. Wilson says. "If we could understand the mechanism, it could open up new avenues for preventing or at least delaying the onset of symptoms."

Always consult your physician for more information.

A to Z on Alzheimer's

According to the Alzheimer's Association, Alzheimer’s (AHLZ-high-merz) disease is a progressive brain disorder that gradually destroys a person's memory and ability to learn, reason, make judgments, communicate, and carry out daily activities.

As Alzheimer’s progresses, individuals may also experience changes in personality and behavior, such as anxiety, suspiciousness or agitation, as well as delusions or hallucinations.

Alzheimer's disease is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination during autopsy.

Brains affected by Alzheimer's disease often show presence of the following:

• fiber tangles within nerve cells (neurofibrillary tangles)

• clusters of degenerating nerve endings (neuritic plaques)

Another characteristic of Alzheimer's disease is the reduced production of certain brain chemicals necessary for communication between nerve cells, especially acetylcholine, as well as norepinephrine, serotonin, and somatostatin.

There is not a single, comprehensive test for diagnosing Alzheimer's disease. By ruling out other conditions through a process of elimination, physicians or other specialists can obtain a diagnosis of probable Alzheimer's disease with approximately 90 percent accuracy.

At this time, there is no cure for Alzheimer's, no way of slowing down the progression of this disease, and no treatment available to reverse the deterioration of Alzheimer's disease.

New research findings give reason for hope, and several drugs are being studied in clinical trials to determine if they can slow the progress of the disease or improve memory for a period of time.

There are some medications available to assist in managing some of the most troubling symptoms of Alzheimer's disease, including the following:

• depression

• behavioral disturbance

• sleeplessness

In managing the disease, physical exercise and social activity are important, as are proper nutrition, health maintenance, and a calm and well-structured environment.

Always consult your physician for more information.