Association of psychological stress and memory decline in US adults

Abstract

AbstractBackgroundPsychological stress can have long‐term health consequences and has been linked to many chronic conditions. Recent evidence suggests that psychological stress and poor mental health may have long‐term effects on cognition. We aimed to assess the association between psychological stress and memory decline in a nationally representative sample.MethodWe assessed data on participants aged 45 years from the 2020 wave of the Behavioral Risk Factor Surveillance System (BRFSS). BRFSS is a survey of health behaviors and conditions that is administered by telephone across the US. Participants self‐reported memory decline over the past year and days of psychological stress in the past month (categorized as <15 – low, or ≥15 – high), in addition to several sociodemographic factors. The association between memory decline and psychological stress was assessed by multivariate logistic regression, adjusting for age, sex, income, lifestyle and cardiovascular risk factors. Education and race were assessed as effect modifiers.ResultOf 48,460 participants (53.9% female, 82.7% White), 4,132 (8.5%) reported memory decline over the past year. Among those with high psychological stress, 1,248 (25.1%) reported memory decline, compared to 2,884 (6.6%) among participants with low stress (p<0.001). In our crude model, high psychological stress was significantly associated with memory decline (OR = 4.72, 95% CI: 4.39, 5.09). This association persisted after adjusting for demographic, lifestyle and cardiovascular risk factors (OR = 4.18, 95% CI: 3.87, 4.52). There was significant interaction by education and race such that the association between psychological stress and memory decline was stronger in non‐whites with less education (OR = 6.56, 95% CI: 5.39, 7.99) and weaker in more educated whites (OR = 3.62, 95% CI: 3.23, 4.01).ConclusionIn this analysis of a nationally representative sample, psychological stress was significantly associated with memory decline. This association was modified by education level and race, with larger effect sizes among those who were non‐white or had less education. Since psychological stress is a modifiable risk factor, these findings suggest that access to mental health resources and stress reduction efforts may be instrumental in preventing cognitive decline. Further studies are needed to elucidate the role of psychological stress in cognitive decline.