Stress, Alzheimer’s and Memory Loss

Are you or a loved one at increased risk for Alzheimer’s, a fatal disease for which there is no cure?  More and more people complain of problems remembering familiar names, phone number, or where they put their glasses, keys, etc.  Loss of memory, especially for recent events, is quite common in the elderly, but surveys show that these same symptoms are increasingly being seen in middle-aged and younger individuals. Many are understandably concerned about whether they will go on to develop Alzheimer’s disease (AD). or have mild cognitive impairment (MCI) that does not significantly impair normal function and may not progress. Making a definitive diagnosis is difficult, since it requires demonstrating the presence of both amyloid plaque and neurofibrillary tangles of tau protein in the brain, which can only be done at autopsy.

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As illustrated in the above PET scans, changes in brain glucose metabolism (shown in yellow and red) can be present in MCI, although they are more pronounced in AD as indicated by the larger amount of central, blue, brain tissue with diminished metabolic activity. This is of no value in predicting whether MCI will worsen but a new fluorescent dye that binds to amyloid plaque on PET scans may be able to provide this information.

 

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This is important, since if patients with MCI do not show amyloid plaque, they will not progress to AD. MCI is reversible in many individuals if its cause can be treated or eradicated. Some culprits include depression, insomnia, sleep apnea, hypothyroidism, B12 or folate deficiency, certain medications and brain tumors.

 

 

 

 

Stress is the major cause of MCI, particularly in those younger than 50 according to a national survey.  Stress is also an important contributor to Alzheimer’s based on animal studies an accumulation of tau protein tangles after 14 days of low grade chronic stress, as shown below.1

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  Electron micrograph illustrating an accumulation of insoluble phosphorylated tau protein aggregates in brain cells after exposing mice to only 14 days of repeated stress.

This effect was most notable in the hippocampus, which is responsible for the formation, organization and storage of memories. In AD, the hippocampus is usually the first region of the brain showing tau pathology and it suffers the most cell death and atrophy.  Hippocampal atrophy is also seen to a lesser degree in depressed and PTSD patients who complain of memory loss. They also have higher levels of cortisol, suggesting they have been subjected to increased chronic stress. Acute but brief periods of stress not only don’t produce debilitating tau protein accumulations in experimental animals, but actually appear to facilitate learning and memory. These differences may be due to effects on two key corticotropin-releasing factor receptors, suggesting a target for potential therapies. Beta-blocker drugs that block stress hormones significantly reduced or delayed the onset of Alzheimer’s, whereas other antihypertensive medications did not in the ongoing Honolulu Asia Aging Study.

Death of a spouse, the most stressful life change event, has been reported to be a risk factor for AD, and a study of 800 nuns, priests and brothers found that those who reported more stress due to anxiety and depression were twice as likely to develop Alzheimer’s as controls who did not perceive they were under increased stress. In addition, stress reduction with meditation and yoga have been shown to slow the progression of Alzheimer’s and other dementias.

Paul J. Rosch, MD, FACP

12/16/13

1. Robert A. Rissman, Michael A. Staup, Allyson Roe Lee, et al. Corticotropin-releasing factor receptor-dependent effects of repeated stress on tau phosphorylation, solubility, and aggregation. Proceedings of the National Academy of Sciences, March 26, 2012

 
Dr. Paul J. Rosch is current Chairman of the Board of The American Institute of Stress, Clinical Professor of Medicine and Psychiatry at New York Medical College, Honorary Vice President of the International Stress Management Association and has served as Chair of its U.S. branch. You can follow AIS on Twitter, watch AIS videos on You Tube, become a fan of AIS on Facebook and subscribe to one or both free AIS magazines to receive the latest stress information and research from around the globe directly to your inbox.

By | 2016-03-23T12:54:31+00:00 January 16th, 2014|Chairman's Blog|

About the Author:

Kellie Marksberry

One Comment

  1. whatisdementiablog October 22, 2016 at 12:27 pm

    Do You Want to know What Is Dementia?
    Dementia is an umbrella term for mental conditions in which a person suffers from mental decline, memory loss, muscles impairment, behavioral instability and difficulty in conducting daily chores. This is not it. There are plenty of other signs of dementia I am going to explain a bit later, below.
    But before that, let me briefly tell you that there are multiple forms of dementia – alzheimer’s disease being the most common one that accounts for 40 to 75% of dementia cases and is the sixth leading cause of death in United States. Additionally, dementia and its types have common signs with some variations.

    Most Common Symptoms:
    The earliest symptom of Alzheimer’s is poor memory or short term memory loss. As the disease advances, it begins to manifest itself as:

    Problems in communication
    Confusion and disorientation
    Forgetfulness
    Repetitiveness
    Inability to manage routine chores
    Mood swings
    Behavioral issues
    A complete loss of touch with reality
    Social withdrawal
    Doctors do not know the exact cause of Alzheimer’s. Genetics and heredity are said to play the major role in the development of the condition. Other risk factors include:

    Depression
    Hypertension
    A history of head injuries

    Normal Memory Change Vs Dementia/Alzheimer’s:

    Forgetfulness is a common complaint among people, particularly the older adults. We all misplace keys, mobile phone, spectacles, and sometimes forget to recall names of the acquaintances. This is all normal.

    Age-related memory forgetfulness is not disabling; dementia is. The age-related memory lapses have little impact on your ability to carry out routine activities, while dementia-related memory loss is related to persistent, disabling decline in two or more intellectual abilities such as thinking, memory, language, and judgment.

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