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Experts say meditation and other relaxation techniques can help lower stress. THAIS RAMOS VARELA/Stocksy
  • Reserchers report that cognitive stimulation and personal relationships can protect against dementia, but stress can undermine that protection.
  • Sources of stress may include acting as a caregiver as well as dealing with cognitive decline itself.
  • Experts say stress management techniques should be a part of dementia and Alzheimer’s disease prevention and care.

Stress can undermine lifestyle factors known to improve cognition among people with Alzheimer’s disease and other forms of dementia, according to a new research.

In a study published in the journal Alzheimer’s & Dementia, researchers from the Karolinska Institute in Sweden report that the cognitive benefits associated with stimulating and rewarding life experiences can be reduced by physiological and psychological stress.

“These results might have clinical implications as an expanding body of research suggests that mindfulness exercises and meditation may reduce cortisol levels and improve cognition,” said Manasa Shanta Yerramalla, PhD, a a lead study author and a postdoctoral researcher at the Karolinska Institute’s Department of Neurobiology, Care Sciences and Society, in a statement. “Different stress management strategies could be a good complement to existing lifestyle interventions in Alzheimer’s prevention.”

Past studies have shown that strong cognitive reserve index (CRI) scores seem to have a protective benefit against cognitive decline among people with Alzheimer’s disease.

These CRI scores are tabulated through cognitively stimulating and enriching life experiences as well as factors such as higher educational attainment, complex jobs, continued physical and leisure activities, and healthy social interactions.

In the latest research, the association among CRI scores, cognition, and biomarkers for Alzheimer’s disease in 113 participants from the memory clinic at the Karolinska University Hospital was examined alongside levels of perceived stress in combination with biomarkers for psychological stress, namely cortisol levels in saliva.

The study concluded that while higher CRI scores were associated with better cognition, adjusting for cortisol measures reduced this beneficial association.

Higher CRI scores also were associated with better working memory in individuals with healthier cortisol levels, but not among individuals with cortisol levels that indicated a high level of psychological stress.

Dr. Logan DuBose, a resident physician at George Washington University in Washington, D.C., and the chief operating officer at the elder-care company Olera who was not involved in the new study, told Medical News Today that “chronic stress, which can be caused by a variety of factors including caregiving responsibilities, can lead to elevated cortisol levels. This can damage the hippocampus — the center of the brain associated with memory formation — and negate the benefits of cognitive reserve and neuroplasticity, potentially worsening dementia symptoms.”

A complex occupation such as a pilot, medical professional, or financial analyst might help build a cognitive reserve, noted Irv Seldin, the owner and chief executive officer of the eldercare company Visiting Angels, ”but the high levels of persistent stress from these professions can also lead to the increase of cortisol levels… which can implicate an increased risk of dementia.”

“In order to maintain healthy cognitive functions, people in these complicated professions must maintain stress management strategies such as meditation, physical exercise or therapy in order to reduce the risk of furthering cognitive decline,” Seldin, who was not involved in the study, told Medical News Today. “Stress reduction is a well-known approach to management of symptoms and behaviors associated with Alzheimer’s disease. We teach our caregivers to create a quiet, tranquil environment to keep our clients calm.”

“Engaging in mentally stimulating activities can help strengthen neural pathways and improve memory, problem-solving, and communication skills in people with cognitive decline,” added Angela Morrell, a speech-language pathologist at Georgetown University Hospital. “For example, language-based activities like storytelling, word games, or discussions on current events can be great tools… to use with memory clinic patients.”

“The impact of stress on cognition is important to consider,” Morrell, who was not involved in the study, told Medical News Today. “Chronic stress can negatively affect memory and communication in people with dementia. As speech-language pathologists, we often incorporate stress management techniques into our therapy plans, such as relaxation exercises or mindfulness practices. Additionally, understanding how best to manage stress alongside cognitive stimulation programs would be valuable … in creating personalized treatment plans with the goal of improving the quality of life for people with dementia.”

The new study was limited by its small sample size and the fact that lack of sleep — known to impair cognition — was not thoroughly controlled other than to ascertain whether participants took sleep medications.