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Título

CHRONIC STRESS MEDIATORS IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT: A TRANSVERSAL ANALYSIS OF THE BRAZILIAN MEMORY AND AGING STUDY

Resumo

Introduction: Several studies suggest that chronic stress and persistently high levels of cortisol are related to cognitive dysfunction and neurodegenerative processes. The Brazilian Memory and Aging Study (BRAMS) is a research initiative for the longitudinal follow-up of individuals in a tertiary center specialized memory outpatient clinic. Objectives: to investigate the relationship between markers of chronic stress and cognitive status in BRAMS, making comparisons between the control, subjective cognitive decline (SCD) and mild cognitive impairment (MCI) groups (amnestic, non-amnestic, single domain or multiple domains). Secondarily to correlate the markers with the amyloid status of the participants. Methodology: observational study of the cross-sectional type with a subgroup analysis of the BRAMS cohort, in which individuals aged > 60 years who had access to medical, neuropsychological and amyloid PET assessment. The present analysis seeks to measure the allostatic load index (ALi) through anthropometric, endocrinological, cardiovascular, metabolic and inflammatory markers of chronic stress, correlating the variables with cognitive status and amyloid status. Results: Between the years 2018 and 2021, 77 participants were evaluated in the present protocol, of which 65 met the inclusion criteria. The mean age was 70.2 (+ 6.01) years, with 72% being female with 11 years of schooling (interquartile range 7 – 15). There were 42 subjects classified as MCI, 15 as SCD and 8 as controls. There was a significant difference between HDL measurements (55.6 in the MCI group vs. 66 in the SCD group vs. 69 in the control group, p = 0.04), waist/hip ratio (0.94 in the MCI group vs. 0, 88 in the SCD group, p = 0.03) and also for the measurement of the ALi in percentage value considering the extremes of cortisol (ALi % cortisol p<12.5 or p>87.5) (36.9% in the MCI group vs. 27.2% in the SCD group, p = 0.04). In the multivariate analysis, age, education and economic class played a moderating role. Conclusion: The present work probably represents one of the first research initiatives to address measures of chronic stress beyond cortisol in elderly participants diagnosed with SCD and MCI, with increased markers in the MCI group. Due to the cross-sectional nature of the study, the associations found do not allow inferring causality between the measures, but they can be better explored in the longitudinal follow-up of the participants.

Palavras Chave

mild cognitive impairment; stress; cortisol; perceived-stress scale