title: Chronic psychological distress and risk of Alzheimer's disease in old age.
abstract: Clinical and pathological data from the Rush Memory and Aging Project were used to test the hypothesis that distress proneness is associated with increased risk of Alzheimer's disease (AD). More than 600 older persons without dementia completed a 6-item measure of neuroticism, a stable indicator of proneness to psychological distress. At annual intervals thereafter, they underwent uniform evaluations that included clinical classification of AD and administration of 18 cognitive tests. Those who died underwent brain autopsy from which composite measures of AD pathology were derived. During a mean of about 3 years of follow-up, 55 people were clinically diagnosed with AD. In analyses that controlled for age, sex, and education, persons with a high level of distress proneness (score = 24, 90th percentile) were 2.7 times more likely to develop AD than those not prone to distress (score = 6, 10th percentile). Adjustment for depressive symptomatology or frequency of cognitive, social, and physical activity did not substantially change this effect. Distress proneness was also associated with more rapid cognitive decline. Among 45 participants who died and underwent brain autopsy, distress proneness was unrelated to diverse measures of AD pathology and was inversely related to cognition after controlling for AD pathology. The results support the hypothesis that distress proneness is associated with increased risk of dementia and suggest that neurobiologic mechanisms other than AD pathology may underlie the association.
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Ill, USA. rwilson@rush.edu
authors.forename: Robert S
authors.initials: RS
authors.lastname: Wilson
authors.forename: Steven E
authors.initials: SE
authors.lastname: Arnold
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schneider
authors.forename: Jeremiah F
authors.initials: JF
authors.lastname: Kelly
authors.forename: Yuxiao
authors.initials: Y
authors.lastname: Tang
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D002908:Chronic Disease; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*