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Cited by 101Dementia and Cognitive Impairment ResearchHealth disparities and outcomesHealth and Well-being Studies

Common psychosocial stressors in middle-aged women related to longstanding distress and increased risk of Alzheimer's disease: a 38-year longitudinal population study

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Johansson, Lena, Guo, Xinxin, Hällström, Tore, Norton, Maria C, Waern, Margda, Östling, Svante, Bengtsson, Calle, Skoog, Ingmar·2013·BMJ Open
DOI 10.1136/bmjopen-2013-003142PMC PMC3787482
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Abstract

Objective: To study the relation among psychosocial stressors, long-standing distress and incidence of dementia, in a sample of women followed from midlife to late life. Design: Prospective longitudinal population study. Setting: The analyses originate from the prospective population study of women in Gothenburg, Sweden, a representative sample of women examined in 1968 (participation rate 90%) and re-examined in 1974, 1980, 1992, 2000 and 2005. Participants: 800 women born in 1914, 1918, 1922 and 1930 who were systematically selected for a psychiatric examination at baseline, in 1968. Primary and secondary outcome measures: 18 psychosocial stressors (eg, divorce, widowhood, work problems and illness in relative) were obtained at baseline. Symptoms of distress were measured according to a standardised question at each study wave. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data, and measured through the whole study period. Results: During the 37 years of follow-up, 153 women developed dementia (104 of those had Alzheimer's disease (AD)). Number of psychosocial stressors in 1968 was associated (HR, 95% CI) with higher incidence of dementia (1.15, 1.04 to 1.27) and AD (1.20, 1.07 to 1.35) between 1968 and 2005, in multivariate Cox regressions. Number of psychosocial stressors in 1968 was also associated (OR, 95% CI) with distress in 1968 (1.48, 1.32 to 1.67), 1974 (1.31, 1.17 to 1.46), 1980 (1.27, 1.11 to 1.45), 2000 (1.39, 1.14 to 1.70) and 2005 (1.35, 1.02 to 1.79), in multivariate logistic regressions. Number of psychosocial stressors (HR 1.17, 95% CI 1.03 to 1.33) and long-standing distress (1968–1974–1980) (HR 1.58, 95% CI 1.03 to 2.45) were independently associated with AD. Conclusions: Our study shows that common psychosocial stressors may have severe and long-standing physiological and psychological consequences. However, more studies are needed to confirm these results and investigate whether more interventions such as stress management and behavioural therapy should be initiated in individuals who have experienced psychosocial stressors.

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  • There is recent evidence that women exposed to serious stressors in middle age have an increased incidence of Alzheimer's disease 20 years later.

    “Notably, there is recent evidence that women exposed to serious stressors in middle age have an increased incidence of Alzheimer’s disease 20 years later43.”

    From Stress weakens prefrontal networks: molecular insults to higher cognition (2015) · cites this paper as [43]

    The Discussion reports that more common psychosocial stressors in midlife were associated with higher Alzheimer’s disease incidence in women. The cited study followed women for 38 years, however, and the Results give a mean time to dementia onset of 29 years; it does not establish the claimed increase specifically 20 years later. It also studied common stressors of varying severity, not exclusively serious ones. (LLM, conf=0.87)

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  • Psychological distress is a risk factor for Alzheimer's degeneration.

    “Although the largest risk factor for Alzheimer’s disease is advanced age, TBI is also an established risk factor140, and new evidence suggests that psychological distress43 and female sex141 are also risk factors for Alzheimer’s degeneration.”

    From Stress weakens prefrontal networks: molecular insults to higher cognition (2015) · cites this paper as [43]

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Authors
Johansson, L., Guo, X., Hällström, T., Norton, M. C., Waern, M., Östling, S., Bengtsson, C., & Skoog, I.
Affiliations
  • University of Gothenburg (SE)
  • Karolinska Institutet (SE)
  • Utah State University (US)
  • Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at Gothenburg University, Mölndal, Sweden
Corresponding author
Johansson, Lena
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2013-08
Volume
3
Issue
9
Pages
e003142
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2013-003142
PMC
PMC3787482
OpenAlex
W2170519037
Cited by
101
References
8
Citations by year
2026: 1 · 2025: 6 · 2024: 8 · 2023: 4 · 2022: 5 · 2021: 8 · 2020: 12 · 2019: 16 · 2018: 10 · 2017: 5 · 2016: 9 · 2015: 11 · 2014: 5 · 2013: 1
FWCI
6.16
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • Forskningsrådet för Arbetsliv och Socialvetenskap
  • Swedish Brain Power
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Psychology › Clinical Psychology › Health and Well-being Studies
Keywords
psychosocial stressors, Alzheimer's disease, dementia incidence, psychological distress, middle-aged women, widowhood, divorce, labor problems, family illness, cumulative stress, women's health, dementia risk factors, loneliness

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