Division of Psychology, School of Medicine, University of Tasmania, Australia.
Wicking Dementia Research and Education Centre, Tasmania, Australia.
J Alzheimers Dis. 2020;78(1):335-352. doi: 10.3233/JAD-191096.
It has been estimated that one third of dementia cases may be preventable through modifiable lifestyle interventions. Epidemiological evidence suggests a link between stressful life events and aging-related cognitive decline and dementia; however, inherent methodological limitations in examining subjective and biological measures of stress separately leads to interpretive constraints.
The aim of the current study was to conduct a systematic review of the research literature investigating the effect of perceived and biological measures of stress on dementia risk.
A systematic review was conducted of cohort, case-control, longitudinal prospective or retrospective studies examining the association between stress and risk of developing dementia. Studies were identified from a systematic search across major electronic databases from inception to February 2020.
Overall, 22 studies were identified including a total of 496,556 participants, approximately 50% were females, with sample sizes ranging from 62-270,977. There was considerable heterogeneity in the definition and measurement of stress. Most of the identified studies reported a significant positive association between stress and dementia risk.
Evidenced from the current review is that personality traits linked to increased perceived stress and elevated reported perceived stress, are associated with greater statistical risk for dementia. However, this review highlights that caution must be exhibited in interpreting these findings, as methodological issues with confounding adjustment may mediate these results. Future research should focus on the investigation of stress on dementia risk with a full range of confounding adjustment, and on biological measures of stress.
据估计，三分之一的痴呆病例可以通过可改变的生活方式干预来预防。流行病学证据表明，生活应激事件与衰老相关的认知衰退和痴呆之间存在关联；然而，分别检查主观和生物应激测量的内在方法学限制导致解释上的限制。
本研究旨在对研究文献进行系统综述，调查感知和生物应激测量对痴呆风险的影响。
对队列、病例对照、前瞻性或回顾性纵向研究进行了系统综述，这些研究检查了应激与痴呆风险之间的关联。从 2020 年 2 月之前的主要电子数据库系统搜索中确定了研究。
总共确定了 22 项研究，共包括 496556 名参与者，其中约 50%为女性，样本量从 62-270977 不等。应激的定义和测量存在很大的异质性。大多数已确定的研究报告称，应激与痴呆风险之间存在显著的正相关。
从目前的综述来看，与感知到的应激增加和感知到的应激升高相关的人格特质与痴呆的统计风险增加有关。然而，本综述强调，在解释这些发现时必须谨慎，因为混杂调整的方法学问题可能会影响这些结果。未来的研究应侧重于对痴呆风险的应激进行研究，包括进行全面的混杂调整，并对应激的生物测量进行研究。
