Dementia IMonday, June 11, 2012, 11:30 - 12:30
Development of Alzheimer's disease and recent stress eventsE. Reich, C. Torres, E. Arias, M. Carlino, E. Halac (Buenos Aires, AR)
Background: The sporadic nature and late onset of most AD cases could suggest that aside from biological determinants, environmental factors such as stress may play a role in the development and progression of the disease.
Recent data implicated stress as a potential risk factor in development of AD. The present study aims to analize the relationship between recent stressful life events and the development of AD.
Methods: We studied 107 patients with clinical diagnosis of probable AD, according validated criteria, in mild to moderate stages. The medium age was 72 years and the educational level was 8.1 years. The meantime elapsed from the diagnosis or the initial symptoms was 2.5 years. A control group of 76 healthy individuals, paired by age, gender and educational level was studied. A standardized questionnaire looking for significant stressful life events in the 3 years before the diagnosis of AD was performed to patients, family caregivers and control individuals.
Results: In the AD group, 78 patients (73%) presented a history of significant stressful life events, 2.1 years (SD 1.3 y) before the onset of the symptoms. The most common findings in the AD group were: couple death (21 cases), child death (14 cases), history of assault or violent theft (20 cases), history of car accident without severe injuries (10 cases). Other stressful situations were marked financial problems, bereavement, retirement, adaptative changes due to migrations and diagnosis of severe somatic disease in the family. In the control group, only 18 individuals (24%) recognized a similar stress factor in the previous 3 years.
Conclusions: In our study, we observed an association between stressful life events preceding the onset of dementia symptomatology in a high percentage of our patients. Different authors hypothesized that stress could trigger the degenerative process in AD and growing evidences suggest a dysfunction in the neuroendocrine and immune system. According our results, we can establish a relationship between several stressful life events and the onset of the initial symptoms of dementia. It is an observational finding and does not imply direct causality. Futures studies are required to examine this association in more detail and to explain the possible mechanisms of this relationship.