Association between psychological resilience and cognitive function in older adults: effect modification by inflammatory status

Abstract

To examine the association between psychological resilience and cognitive function and investigate the role of acute inflammation as an effect modifier. Total 7535 people from the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC), aged ≥ 50 years and residing in areas near Seoul, South Korea, were included in this cross-sectional analysis. Stressful life events in the past 6 months were gauged by the Life Experience Survey, and current depression symptoms were analyzed with the Beck Depression Inventory-II. Participants were categorized into the following four groups according to their past experience and depression status: reference, resilient, reactive depression, and vulnerable depression. Cognitive function was evaluated using the mini-mental state examination (MMSE). The level of high-sensitivity C-reactive protein (hsCRP) was measured from blood samples. A generalized linear model was used. Upon adjusting for socio-demographic factors, comorbidity, and lifestyle factors, the final model was stratified with the highest quartile of the hsCRP level by sex. Compared to the reference group, the resilient group showed higher MMSE, which was also significant in women (adj-β = 0.280, p-value < 0.001). Vulnerable depression group showed a significantly lower MMSE (adj-β = − -0.997, p-value 0.002), especially in men. This pattern seemed to be limited to the low hsCRP subgroup. We provided evidence from the largest Korean population used to evaluate the association between psychological resilience and cognition, which was more prominent in low inflammatory status. Psychological resilience was associated with a lower likelihood of cognitive deficit in women. This pattern was modulated by inflammatory status.

Interaction of Depressive Status and Cognitive Ability Predicts Psychological Resilience of Young Adults in Taiwan

“…For example, some studies have shown that resilience is positively associated with general cognitive ability 13,46 or speci c cognitive components 17 , but Bemath,et al 18 found no association between cognitive ability and resilience. The inconsistent ndings may result from these studies de ning an individual's resilience by using single index (e.g., participant's education attainments 13 , participants showed no depression when experiencing the negative events 14,15 and focusing on adults who experienced adverse events in their childhood where their cognitive abilities may be in uenced. In the current study a self-report measurement tool (RSA) was used to de ne an individual's resilience, and adults were recruited without experiencing adverse events.…”

“…Wolf, et al 13 conducted a longitudinal study of cognitively healthy elderly individuals in Germany and found that individuals with lower resilience capacities (measured by educational attainments, which is the highest level of education that an individual has completed) exhibited stronger amyloid-related cognitive decline. In South Korea, researchers differentiated the degree of cognitive abilities between resilient individuals and non-resilient individuals in cross-sectional and longitudinal settings 14,15 . They de ned the "resilient group" as the participants who had at least one negative experience without any depressive syndromes in the past two weeks, and those who did not report any negative experience and had no depression were designated as the "reference group".…”

“…There are several factors that could explain the inconsistent ndings. First, studies vary in how they de ne and measure an individual's resilience, such as a participant's education attainments 13 , and participants experienced negative events without depression 14,15 . Second, some studies focused on adults (ages 30 to 64) in adverse circumstances 14,15 , and ndings from these studies may not be generalized to young adults (age of 20 to 30).…”

“…First, studies vary in how they de ne and measure an individual's resilience, such as a participant's education attainments 13 , and participants experienced negative events without depression 14,15 . Second, some studies focused on adults (ages 30 to 64) in adverse circumstances 14,15 , and ndings from these studies may not be generalized to young adults (age of 20 to 30). Finally, the relationship between resilience and general cognitive function has been found to be contingent upon individuals' depressive status 15 measured by the Beck's Depression Inventory II BDI-II, an index of one's depressive status; 19 .…”

Nutrition Strategies Promoting Healthy Aging: From Improvement of Cardiovascular and Brain Health to Prevention of Age-Associated Diseases

“…Development of aging phenotypes and the pathogenesis of age-related diseases are also influenced by a heightened state of low-grade sterile systemic inflammation (“inflamm-aging”) [ 105 ]. Recent findings highlight the association between inflammation and deleterious frailty status in older adults [ 106 , 107 ]. Inadequate diets (e.g., a high fat diet [ 95 , 96 , 97 , 98 , 99 ], diabetogenic diets, high methionine diets [ 108 , 109 , 110 ]) are an important contributing factor to this low-grade systemic inflammation, but it is also one of the easiest modifiable interventions for elderly individuals to intervene on the process of aging [ 105 ].…”