Hostility, Stress Levels Linked to Cognitive Deficits

Hostility, Stress Levels Linked to Cognitive Deficits



Young adults who battle life’s stresses or who have a hostile attitude go on to have cognitive deficits in middle-age, a new study suggests.

“There are many aspects to a patient, including personality, that in one way or another contribute to whatever brings them to the doctor,” said lead author Lenore J. Launer, PhD, senior investigator, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland.

The results were published online March 2 in Neurology.

The analysis included 3126 participants from the Coronary Artery Risk Development In Young Adults (CARDIA) study. CARDIA is a large, prospective, population-based cohort of white and black women and men followed since 1985–1986.

Suspicious Attitudes

Investigators used the Cook-Medley scale to assess hostility. This scale, which ranges from 0 to 50, measures hostility and suspicious attitudes towards others. An example of a true-or-false question included in the questionnaire: “When someone does me wrong, I feel I should pay him back if I can just because of the principle of the thing.”

For both hostility and effortful coping, researchers separated participants into categories of low, mid-low, mid-high, and high.

The study showed that compared to those with the lowest level, participants with the highest effortful coping at baseline had lower cognitive function in midlife after adjustment for sociodemographic characteristics, negative life events, and cumulative exposure to cardiovascular risk factors (CVRF), depressive symptoms, feeling discriminated against, and cognitive ability at baseline.

As for hostility, the study found that the highest level at baseline was also associated with lower cognitive function in midlife, independent of demographic characteristics, educational level, and depression and that these levels were not confounded by lifelong depression and feeling discriminated against.

The “underlying hypothesis” is that both hostility and effortful coping lead to stress, which in turn could cause cardiovascular disease (eg, hypertension) but could also work directly on the brain, said Dr Launer. “So in that context, these personality traits could be said to increase the risk for cognitive impairment.”

Million-Dollar Question

How young adults might better manage stress “is the million-dollar question,” said Dr Launer. But if neurologists notice that a patient is under a lot of stress, “they should have something in their files, such as a yoga program, to refer that patient to,” she said.

“I think neurologists have to know a little bit more beyond what they’re immediately dealing with, in order to really improve health care.”

Indeed, the results “raise the possibility that behavioral interventions designed to reduce hostility and improve effortful coping could reduce the risk of cognitive decline,” added Dr Lipton.

Controlling for such risk factors as well as for demographic features, depression, negative life events, smoking, and alcohol was one of the strengths of the study, he said. Other strengths included its large sample size, the 25-year follow-up, and use of a robust cognitive battery, he added.

Cite this article: Hostility, Stress Levels Linked to Cognitive Deficits. Medscape. Mar 02, 2016.

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