Stress in midlife may increase the risk of Alzheimer’s – 04/11/2024 – Balance

Experiences of great stress experienced in middle age can leave longer-lasting marks than one might think. A new study published in the scientific journal Annals of Neurology shows that these events may be associated with an increased risk of developing Alzheimer’s and other dementias at the end of life.

According to Paulo Caramelli, professor of neurology at UFMG (Federal University of Minas Gerais), the evidence is especially alarming for Brazil. According to the WHO (World Health Organization), the country is the 2nd with the highest level of stress in the world, and the first in terms of anxiety.

In the research, conducted in Barcelona, ​​experts interviewed more than a thousand participants to assess the number of stressful events they had experienced. In addition, tests were carried out to identify biomarkers related to the occurrence of Alzheimer’s, such as brain inflammation (also called neuroinflammation).

A challenge of the study was to objectively evaluate experiences that are experienced subjectively. To overcome this problem, the authors used a preliminary list with 18 possible events capable of causing changes in people’s lives in general.

Caramelli explains that there are major stressful events that are universally recognized, such as financial crisis, job loss, marital separation or death of a close family member. It is based on experiences like this, and not on the individual’s general level of stress, that the study was done.

Neuroinflammation and betamyloid accumulation are key factors in the development of various dementias, such as Alzheimer’s. Typical of old age, increasing evidence indicates that the roots of these diseases may also be present in the first years of life.

In the research, the researchers’ main hypothesis was not confirmed. They believed that stressful events in general could favor neuroinflammation, but the data does not support this assumption. However, when analyzing the phase of life, it was seen that these events can have neurodegenerative effects in a certain period of adult life: middle age.

The results reveal that the concentration of events in middle age is associated with an increase in the accumulation of betamyloid protein in the brain, in addition to childhood, which is also a sensitive phase. Furthermore, women and people with neurological diseases were more vulnerable to the effects.

Orestes Forlenza, professor of psychiatry at USP (University of São Paulo), explains that the direct relationship between stress and neurodegenerative diseases is widely observed in clinical practice, but is still little explored scientifically.

On the other hand, it is well established that stressful events at this stage of life are capable of triggering other conditions, such as depression, which are directly linked to dementia.

The study, however, is still preliminary. “The work associates inflammatory changes that appear in Alzheimer’s with stressful events throughout life. There is a suggestion, but there is no confirmation”, says Caramelli. He emphasizes that more robust studies are needed to confirm the evidence, but recognizes that the data is informative and consistent with what researchers already knew.

Brazilians’ mental health deficiencies have harmful effects on their physical health that have been known for a long time. In 2004, with the publication of the Interheart study conducted in 52 different countries, Brazil was where stress had the greatest impact associated with myocardial infarction.

“We have to look at Brazilian society, considering stress as one of the triggers that predict illness, with serious consequences for the health of the population”, says Caramelli.

In 2023, depression was identified as an important predictor of early dementia in a study published in the scientific journal Jama Neurology. In the work, experts analyzed data from the UK Biobank, a genetic bank with information from more than 350,000 patients in the United Kingdom.

Although genetics is responsible for some of the 14 predictors identified by the study, evidence increasingly points out that lifestyle changes can reduce the risks of dementia and Alzheimer’s.

If combined with chronic stress, the potential risk of depression almost doubles. Research carried out in Sweden with data from more than a million patients shows that diagnoses of psychiatric problems are especially harmful in cases of Alzheimer’s.

For Caramelli, taking care of mental health not only brings immediate benefits, but also promotes neuroprotection. The expert states that stress management can be done through physical activity, social support, meditation and mindfulness, therapy and analysis, with the use of medication in some cases and even seeking more connection with spirituality, regardless of the religious matrix.