The impact of stress and cognitive impairment on mortality in individuals aged 55 and older: data from a population-based study

Perceived stress is a complex of cognitive and emotional reactions that reflect both the level of distress caused by a stressor and the ability to cope with it. Recently, there has been growing interest in its connection with cognitive functions (CF).

Objective: to investigate the relationship between perceived stress and reduced CF, and to assess their impact on mortality in the population aged 55 and older.

Material and methods. This study was conducted as part of the epidemiological study ‘Stress, Aging, and Health.’ The study included 1,876 participants aged 55 years and older. A decrease in CF was recorded when assessed using the Mini-mental State Examination scale <25 points. High levels of perceived stress were defined as values corresponding to the fifth quintile on the Cohen scale for men and women (≥21 and ≥24 points, respectively). During the entire observation period (median – 13 years), 948 study participants died.

Results. Decreased CF was more common in men, individuals without higher education, and patients with a history of cardiovascular disease. The level of perceived stress was significantly higher in the group of individuals with cognitive impairment (19.9±5.8 vs 17.0±5.8 points; p=0.001). Multivariate analysis data showed a significant association between cognitive dysfunction and high stress (OR=2.33; 95% CI 1.75–3.11). Moreover, the simultaneous presence of reduced CF and high stress increased the risk of death by 1.74 times (95% CI 1.37–2.20) compared to those in whom these pathologies were not detected.

Conclusion. The associations between high levels of perceived stress and reduced CF, as well as their combined adverse effect on mortality in individuals aged 55 and older, indicate the need to develop a comprehensive approach that includes regular screening of cognitive functions and assessment of psycho-emotional status in this age group.

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