If you want to know if you face an extra risk of developing cognitive impairment or dementia when you get older, you can take a couple of quick—and free—online tests. There’s a short one here with only four questions, one here with 10, and a long one here with 30.
They’re called the Cohen Perceived Stress Scale and they supposedly measure—you guessed it—how stressed we feel in our everyday lives.
You’re actually supposed to take them quickly, without thinking about the answers too much, so they only take a couple of minutes.
And that’s critical because a new study has found that older people who have higher levels of stress are more likely to develop dementia. An astonishing 37% more likely, just within an 11-year period.
“Elevated levels of perceived stress…were associated with 1.37 times higher odds of poor cognition after adjustment for socio-demographic variables, cardiovascular risk factors, and depression,” write Ambar Kulshreshtha, a medical doctor and professor of epidemiology at Emory University, and co-authors in a new paper in the Journal of the American Medical Association. (The article is available, for free, here.)
Technically they can only prove the two are “associated.” Definitive proof of causation is notoriously hard to get.
This was based on a study of nearly 24,500 subjects over the age of 45 over an 11-year period, involving in-home interviews, phone interviews and questionnaires that they filled out themselves. The in-home interviews included blood tests and physical exams, so the whole thing was in depth.
The study was especially remarkable for several reasons: The size and the ethnic diversity.
The median age was 64, and women and Black Americans were oversampled: The group studied was 60% female and 42% Black. A disproportionate number also lived in the southeast, where average health scores are lower than in the rest of the country.
The findings show the importance of looking at statistics closely. For example, across the entire group, those who had high stress levels were more likely to be younger, female, Black, have lower incomes, not have a college degree, and live in the southeast. Those with high levels or stress were also more likely to have cardiovascular disease, such as high blood pressure and diabetes. But the connection between stress and risk of dementia was independent of that: So even though it is, for example, true that someone poor is more likely to have high stress and that raises their risk of developing dementia, someone well off who has high stress is just as likely to develop dementia.
The thing that surprised me was how low the bar is for “elevated stress.” The researchers counted anyone scoring 5 or above on the 4-question version, out of a maximum of 16 (with 16 equaling maximum stress). In other words, just scoring 32% or higher on the stress scale is enough to put you at risk.
The authors say that “perceived stress is defined as a consequence of events or demands that exceed an individual’s professed ability to cope.”
According to this survey—reported here by psychology professor Sheldon Cohen of Carnegie Mellon University, who first developed the scale—the average was about 35% for those in their 20s, declining to about 30% for those 55 and over. The survey was conducted in the 1990s, and used the 10-point scale.
I confess myself amazed at how calm everyone is.
I better not report my score, in case I ever want to buy life insurance. But based on my reading, the effort I am putting in to ensure I have enough money for a long and healthy old age is almost certainly wasted. I probably didn’t need to quit smoking either.
Admittedly, these “averages” were from before the rise of the internet, smartphones, “social” media, and all the other things that are supposed to be making our lives—ahem—“better.”
If you think they are, ask yourself if Twitter, Facebook, and the need to check your email 16 hours a day is raising, or lowering, the overall stress in your life.
The latest study adds to growing evidence that high levels of stress are really bad for our health. These smaller previous studies—here and here — linked them to dementia. Research conducted by Cohen found that overall stress makes us more susceptible to diseases generally.
And this study found that work-related stress over the long term makes you more susceptible to cancer. Naturally enough stress also makes you more susceptible to depression.
The question is what we can do about it? Researchers refer to stress as a “modifiable” factor, because in theory we can control it or influence it. The Mayo Clinic lists all sorts of positive things we can do that might lower our stress. A 20 minute walk in the park (or in nature generally) can help. Mindful meditation and chanting can too.
(I confess I’ve let my chanting slide.)
And, of course, playing with a pet can be a great stress-buster. Pretty much any pet.
Meanwhile those with an analytical mind may find the PSS scale itself useful, as it breaks down general “stress” into a handful of specific questions about our lives that we could tackle individually.
And if you were looking for a final inspiration to dump that smartphone and “social” media, this is it.