Perceived stress is associated with subclinical cerebrovascular disease in older adults

Neelum T. Aggarwal, Cari J Clark, Todd L. Beck, Carlos F.Mendes De Leon, Charles DeCarli, Denis A. Evans, Susan Everson-Rose

Research output: Contribution to journalArticle

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Abstract

Objective: To examine the association of perceived stress with magnetic resonance imaging (MRI) markers of subclinical cerebrovascular disease in an elderly cohort. Methods: Using a cross-sectional study of a community-based cohort in Chicago, 571 adults (57% women; 58.1% African American; 41.9% non-Hispanic white; mean [SD] age: 79.8 [5.9] years) from the Chicago Health and Aging Project, an epidemiologic study of aging, completed questionnaires on perceived stress, medical history, and demographics as part of an in-home assessment and 5 years later underwent a clinical neurologic examination and MRI of the brain. Outcome measures were volumetric MRI assessments of white matter hyperintensity volume (WMHV), total brain volume (TBV), and cerebral infarction. Results: Stress was measured with six items from the Perceived Stress Scale (PSS); item responses, ranging from never (0) to often (3), were summed to create an overall stress score (mean [SD]: 4.9 [3.3]; range: 0-18). Most participants had some evidence of vascular disease on MRI, with 153 participants (26.8%) having infarctions. In separate linear and logistic regression models adjusted for age, sex, education, race, and time between stress assessment and MRI, each one-point increase in PSS score was associated with significantly lower TBV (coefficient = -0.111, SE = 0.049, t[563] = -2.28, p = 0.023) and 7% greater odds of infarction (odds ratio: 1.07; 95% confidence interval: 1.01, 1.13; Wald × 2 [1] = 4.90; p = 0.027). PSS scores were unrelated to WMHV. Results wereunchanged with further adjustment for smoking, body mass index, physical activity, history of heart disease, stroke, diabetes, hypertension, depressive symptoms, and dementia. Conclusions: Greater perceived stress was significantly and independently associated with cerebral infarction and lower brain volume assessed 5 years later in this elderly cohort.

Original languageEnglish (US)
Pages (from-to)53-62
Number of pages10
JournalAmerican Journal of Geriatric Psychiatry
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2014

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Cerebrovascular Disorders
Magnetic Resonance Imaging
Cerebral Infarction
Infarction
Brain
Logistic Models
Brain Infarction
Sex Education
Neurologic Examination
Vascular Diseases
African Americans
Dementia
Epidemiologic Studies
Linear Models
Heart Diseases
Body Mass Index
Cross-Sectional Studies
Smoking
Stroke
Odds Ratio

Keywords

  • Biracial population sample
  • MR measures
  • Perceived stress

Cite this

Perceived stress is associated with subclinical cerebrovascular disease in older adults. / Aggarwal, Neelum T.; Clark, Cari J; Beck, Todd L.; De Leon, Carlos F.Mendes; DeCarli, Charles; Evans, Denis A.; Everson-Rose, Susan.

In: American Journal of Geriatric Psychiatry, Vol. 22, No. 1, 01.01.2014, p. 53-62.

Research output: Contribution to journalArticle

Aggarwal, Neelum T. ; Clark, Cari J ; Beck, Todd L. ; De Leon, Carlos F.Mendes ; DeCarli, Charles ; Evans, Denis A. ; Everson-Rose, Susan. / Perceived stress is associated with subclinical cerebrovascular disease in older adults. In: American Journal of Geriatric Psychiatry. 2014 ; Vol. 22, No. 1. pp. 53-62.
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abstract = "Objective: To examine the association of perceived stress with magnetic resonance imaging (MRI) markers of subclinical cerebrovascular disease in an elderly cohort. Methods: Using a cross-sectional study of a community-based cohort in Chicago, 571 adults (57{\%} women; 58.1{\%} African American; 41.9{\%} non-Hispanic white; mean [SD] age: 79.8 [5.9] years) from the Chicago Health and Aging Project, an epidemiologic study of aging, completed questionnaires on perceived stress, medical history, and demographics as part of an in-home assessment and 5 years later underwent a clinical neurologic examination and MRI of the brain. Outcome measures were volumetric MRI assessments of white matter hyperintensity volume (WMHV), total brain volume (TBV), and cerebral infarction. Results: Stress was measured with six items from the Perceived Stress Scale (PSS); item responses, ranging from never (0) to often (3), were summed to create an overall stress score (mean [SD]: 4.9 [3.3]; range: 0-18). Most participants had some evidence of vascular disease on MRI, with 153 participants (26.8{\%}) having infarctions. In separate linear and logistic regression models adjusted for age, sex, education, race, and time between stress assessment and MRI, each one-point increase in PSS score was associated with significantly lower TBV (coefficient = -0.111, SE = 0.049, t[563] = -2.28, p = 0.023) and 7{\%} greater odds of infarction (odds ratio: 1.07; 95{\%} confidence interval: 1.01, 1.13; Wald × 2 [1] = 4.90; p = 0.027). PSS scores were unrelated to WMHV. Results wereunchanged with further adjustment for smoking, body mass index, physical activity, history of heart disease, stroke, diabetes, hypertension, depressive symptoms, and dementia. Conclusions: Greater perceived stress was significantly and independently associated with cerebral infarction and lower brain volume assessed 5 years later in this elderly cohort.",
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AU - DeCarli, Charles

AU - Evans, Denis A.

AU - Everson-Rose, Susan

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