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Cited by 21Dementia and Cognitive Impairment ResearchAging, Health, and DisabilityHealth disparities and outcomes

Adverse events in older adults and the risk of dementia and cognitive decline

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Nilaweera, Dinuli, Gurvich, Caroline, Freak-Poli, Rosanne, Woods, Robyn, Owen, Alice, Murray, Anne, Orchard, Suzanne G., Britt, Carlene +3 more·2023·Journal of Affective Disorders Reports
DOI 10.1016/j.jadr.2023.100592PMC PMC10357969
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Abstract

Background: Increasing evidence suggests that stress could be a risk factor for dementia but this might vary by gender. This study investigated whether adverse life events were associated with cognitive decline and dementia in later-life, separately in men and women. Methods: Participants were 12,789 community-dwelling Australians aged ≥ 70 years. Ten common adverse events in later-life were self-reported. Cognitive decline was defined as a 1.5 SD decline from participants' baseline score in tests of global cognition, psychomotor speed, episodic memory, and executive functioning, which were assessed regularly over a maximum of 10.3 years. Dementia was diagnosed according to DSM-IV criteria. Results: An increased risk of dementia was observed in participants who experienced the death of a spouse/partner (HR: 1.72, 95% CI: 1.17 - 2.52) and for individuals who experienced major financial problems (HR: 1.53, 95% CI: 1.05 - 2.23). The latter also increased the risk of cognitive decline in men specifically (HR: 1.43, 95% CI: 1.10 - 1.86). In contrast, some events for women were associated with a reduced risk of dementia (e.g. close family or friends lost their job/retired (HR: 0.62, 95% CI: 0.40-0.95)). Limitations: Events including major money problems may result from prodromal dementia symptoms, thus reverse causation needs to be considered. Conclusions: Adverse life events may influence dementia risk in older adults, but associations vary depending on the nature of the event, and across genders. These findings support the need for early interventions in older people who have experienced adversities, particularly for the death of a loved one.

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  • Stress and trauma are risk factors for cognitive impairment.

    “Stress and trauma are also risk factors for a range of non-communicable diseases, including cardiovascular disease [5,6], diabetes [7], and cognitive impairment [8,9], and can contribute to cancer incidence and survival [10].”

    From Biological Embedding of Early-Life Adversity and a Scoping Review of the Evidence for Intergenerational Epigenetic Transmission of Stress and Trauma in Humans (2023) · cites this paper as [9]

    The Conclusions say adverse events in later life, particularly the death of a spouse or partner, may increase dementia risk in older adults. But the Results report that the observed increase in cognitive decline after a spouse’s death was not significant after adjustment. The citing sentence presents stress and trauma as general risk factors for cognitive impairment, broader and more certain than this paper’s findings. (LLM, conf=0.87)

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Authors
Nilaweera, D., Gurvich, C., Freak-Poli, R., Woods, R., Owen, A., Murray, A., Orchard, S. G., Britt, C., Wu, Z., McNeil, J., & Ryan, J.
Affiliations
  • Monash University (AU)
  • Berman Center for Outcomes and Clinical Research (US)
Corresponding author
Ryan, Joanne
ORCID
Venue
Journal of Affective Disorders Reports
Publisher
Elsevier BV
Published
2023-07
Volume
13
Pages
100592
ISSN
2666-9153 (ISSN-L)
DOI
10.1016/j.jadr.2023.100592
PMC
PMC10357969
OpenAlex
W4367309579
Cited by
21
References
74
Citations by year
2026: 5 · 2025: 6 · 2024: 5 · 2023: 5
FWCI
4.28
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders Reports (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion, cc-by-nc-nd)
  • Cross Connect (Southern Cross University) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institutes of Health
  • National Institute on Aging (U01AG029824, U19AG062682)
  • National Cancer Institute
  • Victorian Cancer Agency
  • National Health and Medical Research Council (1127060, 1135727, 334047)
  • Monash University
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Health › Health disparities and outcomes
Keywords
life events, dementia risk, cognitive decline, older adults, widowhood, financial hardship, gender differences, stress, community-dwelling older adults, episodic memory, executive function, psychomotor speed

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