The Effects of Psychosocial and Traumatic Stressors on MCI Diagnosis
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Apr 24, 2024
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Abstract
Background and Objective: Toxic stress exposure can have effects across the lifespan. Studies of civilians and veterans suggest a connection between psychosocial and traumatic stressor exposure in adulthood and a diagnosis of dementia later in life. The objective of this study was to investigate the impact of psychosocial and traumatic stressors on rates of MCI (Mild Cognitive Impairment) diagnosis in Vietnam Era Twin Study of Aging participants. Methods: 1,237 twin participants from the VETSA study were aged 61.72 ± 2.44 years at the time of data collection. Traumatic stress was measured by clinical interviewing, with psychosocial stressors quantified by self-report measures. Neuropsychological assessment determined MCI diagnosis. Previously conducted genotyping determined ApoE genotype. Mixed model analysis was used to determine effects on MCI diagnosis. Results: Our results from the mixed model analysis did not find a significant relationship between psychosocial and traumatic stress exposure and MCI diagnosis. PTSD diagnosis, measured by the DIS-III-R, collected for the Harvard Drug Study in 1996 (F = 0.249, p = 0.618) does not have a significant effect on MCI diagnosis. Life stress exposure, measured by the Holmes and Rahe (1967), (F = 0.249, p = 0.618) does not have a significant effect on MCI diagnosis. Significant associations were determined using the Type III fixed effects. Associations were considered statistically significant at p < 0.05, two-tailed. Implications: Few subjects in Wave 2 of VETSA had MCI (n = 147), due in part to the age of the participants at the time (Mean 61.72 ± (2.44 years)). This led to a lack of power in our analysis. Future studies should examine all available VETSA data.
References
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Orme, D. R., Brehm, W., & Ree, M. J. (2001). Armed Forces Qualification Test as a measure of premorbid intelligence. Military Psychology, 13(4), 187-197.
Peavy GM, Salmon DP, Jacobson MW, et al. Effects of chronic stress on memory decline in
cognitively normal and mildly impaired older adults. Am J Psychiatry. Dec; 2009 166(12):1384–1391.
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Hemingway H, Marmot M. Evidence based cardiology: psycho-social factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ (Clinical research ed.). 1999;318(7196):1460-1467.
Sattler, C., Toro, P., Schönknecht, P., & Schröder, J. (2012). Cognitive activity, education and socioeconomic status as preventive factors for mild cognitive impairment and Alzheimer's disease. Psychiatry research, 196(1), 90-95.
Scott, J. C., Matt, G. E., Wrocklage, K. M., Crnich, C., Jordan, J., Southwick, S. M., ... & Schweinsburg, B. C. (2015). A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder. Psychological bulletin, 141(1), 105.
Sibener, L., Zaganjor, I., Snyder, H. M., Bain, L. J., Egge, R.; Carrillo, M. C. (2014). Alzheimer’s Disease prevalence, costs, and prevention for military personnel and veterans. Alzheimer’s and Dementia, 10, 3 SUPPL.).
Song, H., Sieurin, J., Wirdefeldt, K., Pedersen, N. L., Almqvist, C., Larsson, H., Valdimarsdóttir, U. A.; Fang, F. (2020). Association of Stress-Related Disorders With Subsequent Neurodegenerative Diseases. JAMA Neurology,77(6), 1
Tang, Z., Zhu, Y., & Wang, Z. (2023). Characterizing Alzheimer's Disease Biomarker Cascade Through Non-linear Mixed Effect Models. arXiv preprint arXiv:2304.09754
Tervo, S., Kivipelto, M., Hänninen, T., Vanhanen, M., Hallikainen, M., Mannermaa, A., & Soininen, H. (2004). Incidence and risk factors for mild cognitive impairment: a population-based three-year follow-up study of cognitively healthy elderly subjects. Dementia and geriatric cognitive disorders, 17(3), 196-203
Tsuang MT, Bar JL, Harley RM, Lyons MJ. The Harvard Twin Study of Substance Abuse: what we have learned. Harv Rev Psychiatry. 2001 Nov-Dec;9(6):267-79. PMID: 11600486.
Veitch, D., E Friedl, K., & W Weiner, M. (2013). Military risk factors for cognitive decline, dementia and Alzheimer’s disease. Current Alzheimer Research, 10(9), 907-930.
Uhlaner, J. E., & Bolanovich, D. J. (1952). Development of Armed Forces Qualification Test and Predecessor Army Screening Tests, 1946-1950. ADJUTANT GENERAL'S OFFICE (ARMY) WASHINGTON DC.
Van der Kolk, B. A. (2003). Psychobiology of posttraumatic stress disorder. Textbook of biological psychiatry, 319-344.
Wang, T. Y., Wei, H. T., Liou, Y. J., Su, T. P., Bai, Y. M., Tsai, S. J., Yang, A. C., Chen, T. J., Tsai, C. F., & Chen, M. H. (2018). Risk for developing dementia among patients with posttraumatic stress disorder: A nationwide longitudinal study. Journal of Affective Disorders, 205, 306–310. https://doi.org/10.1016/j.jad.2016.08.013
Weiner, M. W., Harvey, D., Hayes, J., Landau, S. M., Aisen, P. S., Petersen, R. C., Tosun, D., Veitch, D. P., Jack, C. R., Decarli, C., Saykin, A. J., Grafman, J., & Neylan, T. C. (2017). Effects of traumatic brain injury and posttraumatic stress disorder on development of Alzheimer’s disease in Vietnam Veterans using the Alzheimer’s Disease Neuroimaging Initiative: Preliminary report. Clinical Interventions, 3, 177–188. https://doi.org/10.1016/j.trci.2017.02.005
Yaffe, K., Vittinghoff, E., Lindquist, K., Barnes, D., Covinsky, K. E., Neylan, T., Kluse, M., & Marmar, C. (n.d.). Posttraumatic Stress Disorder and Risk of Dementia Among US Veterans.
Bougea, Anagnostouli M, Angelopoulou E, Spanou I, Chrousos G. Psychosocial and Trauma-Related Stress and Risk of Dementia: A Meta-Analytic Systematic Review of Longitudinal Studies. Journal of Geriatric Psychiatry and Neurology. 2022;35(1):24-37. doi:10.1177/0891988720973759
Brown G, Harris T: Social Origins of Depression: A Study of Psychiatric Disorders in Women. London, Tavistock, 1978
Cohen S, Kessler RC, Gordon UL. Strategies for measuring stress in studies of psychiatric and physical disorder. In: Cohen S, Kessler RC, Gordon UL, eds. Measuring Stress: A Guide for Health and Social Scientists. New York, NY: Oxford University Press; 1995:3-26
Coopers, A. M., & Michels, R. (1988). Diagnostic and statistical manual of mental disorders, revised (DSM-III-R). American journal of Psychiatry, 145(10), 1300-1301.
Corbo, I., Marselli, G., Di Ciero, V., & Casagrande, M. (2023). The protective role of cognitive reserve in mild cognitive impairment: A systematic review. Journal of Clinical Medicine, 12(5), 1759.
Eriksson Sörman, D., & Umeå universitet. Institutionen för psykologi. (2015). The influence of social relationships and leisure activity on adult cognitive functioning and risk of dementia longitudinal population-based studies. Department of Psychology, Umeå University.
First, M. B., France, A., & Pincus, H. A. (2004). DSM-IV-TR guidebook. American Psychiatric Publishing, Inc..
Fratiglioni, L., & Wang, H. X. (2007). Brain reserve hypothesis in dementia. Journal of Alzheimer's disease, 12(1), 11-22.
Gatz, M., Mortimer, J. A., Fratiglioni, L., Johansson, B., Berg, S., Reynolds, C. A., & Pedersen, N. L. (2006). Potentially modifiable risk factors for dementia in identical twins. Alzheimer’s & Dementia, 2(2), 110–117. https://doi.org/10.1016/J.JALZ.2006.01.002
Hathaway, L. M., Boals, A., & Banks, J. B. (2010). PTSD symptoms and dominant emotional response to a traumatic event: an examination of DSM-IV Criterion A2. Anxiety, Stress & Coping, 23(1), 119-126.
Hendrickson, R. C., & Raskind, M. A. (2016). Noradrenergic dysregulation in the pathophysiology of PTSD. Experimental neurology, 284, 181-195.
Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of psychosomatic research.
Jak AJ, Bondi MW, Delano-Wood L, Wierenga C, Corey-Bloom J, Salmon DP, Delis DC. Quantification of five neuropsychological approaches to defining mild cognitive impairment. Am J Geriatr Psychiatry. 2009 May;17(5):368-75. doi: 10.1097/JGP.0b013e31819431d5. PMID: 19390294; PMCID: PMC2743175.
Kremen, W. S., Franz, C. E., & Lyons, M. J. (2013). VETSA: the Vietnam era twin study of aging. Twin Research and Human Genetics, 16(1), 399-402.
Leistner, C., & Menke, A. (2020). Hypothalamic–pituitary–adrenal axis and stress. Handbook of Clinical Neurology, 175, 55-64.
Lyons, M. J., Genderson, M., Grant, M. D., Logue, M., Zink, T., McKenzie, R., ... & Kremen, W. S. (2013). Gene‐environment interaction of ApoE genotype and combat exposure on PTSD. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 162(7), 762-769.
Moon, H., Badana, A. N. S., Hwang, S. Y., Sears, J. S., & Haley, W. E. (2019). Dementia Prevalence in Older Adults: Variation by Race/Ethnicity and Immigrant Status. The American Journal of Geriatric Psychiatry, 27(3), 241–250. https://doi.org/10.1016/J.JAGP.2018.11.003
Nabe-Nielsen, K., Hansen, Å. M., Ishtiak-Ahmed, K., Grynderup, M. B., Gyntelberg, F., Islamoska, S., Mortensen, E. L., Phung, T. K. T., Rod, N. H., Waldemar, G., Westendorp, R. G. J., & Garde, A. H. (2019). Night shift work, long working hours and dementia: A longitudinal study of the Danish Work Environment Cohort Study. BMJ Open, 9(5).
Ngandu, T., von Strauss, E., Helkala, E. L., Winblad, B., Nissinen, A., Tuomilehto, J., ... & Kivipelto, M. (2007). Education and dementia: what lies behind the association?. Neurology, 69(14), 1442-1450.
Oltra-Cucarella, J., Sánchez-SanSegundo, M., Lipnicki, D. M., Sachdev, P. S., Crawford, J. D., Perez-Vicente, J. A., ... & Ferrer-Cascales, R. (2018). Using the base rate of low scores helps to identify progression from amnestic MCI to AD. Journal of the American Geriatrics Society, 66(7), 1360.
Orme, D. R., Brehm, W., & Ree, M. J. (2001). Armed Forces Qualification Test as a measure of premorbid intelligence. Military Psychology, 13(4), 187-197.
Peavy GM, Salmon DP, Jacobson MW, et al. Effects of chronic stress on memory decline in
cognitively normal and mildly impaired older adults. Am J Psychiatry. Dec; 2009 166(12):1384–1391.
Petersen, R. C. (2011). Mild cognitive impairment. New England Journal of Medicine, 364(23), 2227-2234.
Petersen R, Smith G, Waring S, Ivnik R, Tangalos T, Kokmen E. Mild cognitive impairment: Clinical characterization and outcome. Arch Neurol. 1999;56(3):303–308. doi: 10.1001/archneur.56.3.303.
Portet F, Ousset PJ, Visser PJ, et al. Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease. J Neurol Neurosurgery Psychiatry. 2006;77(6):714–718.
Hemingway H, Marmot M. Evidence based cardiology: psycho-social factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ (Clinical research ed.). 1999;318(7196):1460-1467.
Sattler, C., Toro, P., Schönknecht, P., & Schröder, J. (2012). Cognitive activity, education and socioeconomic status as preventive factors for mild cognitive impairment and Alzheimer's disease. Psychiatry research, 196(1), 90-95.
Scott, J. C., Matt, G. E., Wrocklage, K. M., Crnich, C., Jordan, J., Southwick, S. M., ... & Schweinsburg, B. C. (2015). A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder. Psychological bulletin, 141(1), 105.
Sibener, L., Zaganjor, I., Snyder, H. M., Bain, L. J., Egge, R.; Carrillo, M. C. (2014). Alzheimer’s Disease prevalence, costs, and prevention for military personnel and veterans. Alzheimer’s and Dementia, 10, 3 SUPPL.).
Song, H., Sieurin, J., Wirdefeldt, K., Pedersen, N. L., Almqvist, C., Larsson, H., Valdimarsdóttir, U. A.; Fang, F. (2020). Association of Stress-Related Disorders With Subsequent Neurodegenerative Diseases. JAMA Neurology,77(6), 1
Tang, Z., Zhu, Y., & Wang, Z. (2023). Characterizing Alzheimer's Disease Biomarker Cascade Through Non-linear Mixed Effect Models. arXiv preprint arXiv:2304.09754
Tervo, S., Kivipelto, M., Hänninen, T., Vanhanen, M., Hallikainen, M., Mannermaa, A., & Soininen, H. (2004). Incidence and risk factors for mild cognitive impairment: a population-based three-year follow-up study of cognitively healthy elderly subjects. Dementia and geriatric cognitive disorders, 17(3), 196-203
Tsuang MT, Bar JL, Harley RM, Lyons MJ. The Harvard Twin Study of Substance Abuse: what we have learned. Harv Rev Psychiatry. 2001 Nov-Dec;9(6):267-79. PMID: 11600486.
Veitch, D., E Friedl, K., & W Weiner, M. (2013). Military risk factors for cognitive decline, dementia and Alzheimer’s disease. Current Alzheimer Research, 10(9), 907-930.
Uhlaner, J. E., & Bolanovich, D. J. (1952). Development of Armed Forces Qualification Test and Predecessor Army Screening Tests, 1946-1950. ADJUTANT GENERAL'S OFFICE (ARMY) WASHINGTON DC.
Van der Kolk, B. A. (2003). Psychobiology of posttraumatic stress disorder. Textbook of biological psychiatry, 319-344.
Wang, T. Y., Wei, H. T., Liou, Y. J., Su, T. P., Bai, Y. M., Tsai, S. J., Yang, A. C., Chen, T. J., Tsai, C. F., & Chen, M. H. (2018). Risk for developing dementia among patients with posttraumatic stress disorder: A nationwide longitudinal study. Journal of Affective Disorders, 205, 306–310. https://doi.org/10.1016/j.jad.2016.08.013
Weiner, M. W., Harvey, D., Hayes, J., Landau, S. M., Aisen, P. S., Petersen, R. C., Tosun, D., Veitch, D. P., Jack, C. R., Decarli, C., Saykin, A. J., Grafman, J., & Neylan, T. C. (2017). Effects of traumatic brain injury and posttraumatic stress disorder on development of Alzheimer’s disease in Vietnam Veterans using the Alzheimer’s Disease Neuroimaging Initiative: Preliminary report. Clinical Interventions, 3, 177–188. https://doi.org/10.1016/j.trci.2017.02.005
Yaffe, K., Vittinghoff, E., Lindquist, K., Barnes, D., Covinsky, K. E., Neylan, T., Kluse, M., & Marmar, C. (n.d.). Posttraumatic Stress Disorder and Risk of Dementia Among US Veterans.
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Keywords:
veterans, mild cognitive impairment, psychosocial stress, traumatic stress
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How to Cite
Goulden, K. (2024). The Effects of Psychosocial and Traumatic Stressors on MCI Diagnosis. Graduate Student Journal of Psychology, 22(1). https://doi.org/10.52214/gsjp.v22i1.11974