Effects of stressful life events on cerebral white matter hyperintensity progression

Abstract

Objective Exposure to stressful events is associated both with occurrence of depression and also vascular disease. The objective of this study was to determine whether higher levels of stress exposure was related to measures of pathological brain aging, specifically white matter hyperintensity volumes, in older adults with and without depression. Methods The sample included 130 depressed and 110 never-depressed older adults aged 60 years or older enrolled in a longitudinal study at an academic medical center. Participants completed clinical assessments, assessment of stressful event exposure and perceived stress, and magnetic resonance imaging at baseline and after two years. Analyses examined both cross-sectional and longitudinal relationships between stress measures and white matter hyperintensity volumes. Results There were no statistically significant relationships observed between cross-sectional baseline stress measures and either baseline hyperintensity volume or two-year change in hyperintensity volume. However, after controlling for demographic variables and baseline measures, change in stressor exposure was associated with change in hyperintensity volumes. In this analysis, increased stressor exposure was associated with greater increases in white matter hyperintensity volume, while reductions in stressor exposure was associated with less increase in hyperintensity volume. This relationship did not significantly differ based on the presence of either depression or medical comorbidities. Conclusions This work adds to a growing literature associating exposure to stressful events in later life with more rapid pathological brain aging. Work is needed to understand the physiological mechanisms by which stress exposure has this effect and examine whether stress reduction techniques may modify these observed outcomes.

Associations of Adverse Childhood Experiences with Past‐Year DSM‐5 Psychiatric and Substance Use Disorders in Older Adults

“…Numerous epidemiological studies have identified risk factors and protective factors for late‐life mental disorders. For example, complex interactions of genetic vulnerabilities (eg, heritability), cognitive dysfunction and coping skills, age‐related neurobiological changes, medical morbidities, and/or other stressful events (eg, bereavement and social isolation) can be risk factors for mental disorders . However, a higher educational level, better socioeconomic status, engagement of other psychosocial activities, and physical activities are often referred to as protective factors …”

“…For example, complex interactions of genetic vulnerabilities (eg, heritability), cognitive dysfunction and coping skills, age-related neurobiological changes, medical morbidities, and/or other stressful events (eg, bereavement and social isolation) can be risk factors for mental disorders. [3][4][5][6] However, a higher educational level, better socioeconomic status, engagement of other psychosocial activities, and physical activities are often referred to as protective factors. [7][8][9] Yet few studies have examined the association of adverse childhood experiences (ACEs) with mental disorders in older adults.…”

Associated factors of white matter hyperintensity volume: a machine-learning approach

“…It can be hypothesised that these predictors might comprise a cluster of mental-health related factors, such as loneliness, anxiety or post-traumatic stress disorder, which were not assessed in this study 38 . The importance of social networks and stressful life events on mental well-being and health in general 51 , 52 , as well as the association of social economic factors with WMH have been established 53 . It was also shown that widowhood accelerates cognitive decline in cognitively normal older adults 54 .…”

MRI of healthy brain aging: A review

“…Probabilistic atlases show that WMHs in normal aging are generally confined to the periventricular space and total WMH volume increases with age 26,84 . Abnormally high body mass index, diabetes, stress, and hypertension are associated with increased WMH burden 84–87 . Underlying systemic vascular risk factors are considered the driver of WMH 88,89 .…”