My Alzheimer's Journey
Part 104 - The Connection Between Chronic Stress and Alzheimer's Disease
In October 2023, researchers at the Karolinska Institutet in Sweden published a study addressing the possible link between chronic stress, depression, and Alzheimer’s disease (AD). The study shows how people aged between 18 and 65 with a previous diagnosis of chronic stress and depression were more likely than other people to be diagnosed with mild cognitive impairment or AD.
The Karolinska Institute was founded in 1810 as a school for army surgeons. It is located just outside Stockholm. The school offers degrees solely in the medical and health sciences. Around one-fifth of the Karolinska Institute student body is international. Amazingly, students from European Union and European Economic Area countries as well as Switzerland do not pay tuition; all other students do.
This large scale study involved 44,447 people with a diagnosis of chronic stress and/or depression. The study participants were between the ages of 18 and 65 between 2012 and 2013. The patients were followed for eight years. The study showed that the risk of Alzheimer’s disease was more than twice as high in patients with chronic stress and in patients with depression as it was in patients without either condition. Patients with both chronic stress and depression, the risk of AD was up to four times as high.
The University of Chicago published an article in late 2024, that stated, “Emerging research now suggests a striking new perspective: what if Alzheimer’s isn’t merely a “disease,” but a consequence of prolonged stress—an overload that slowly wears down the brain’s ability to function, leaving behind a tangled mess of memory loss and cognitive decline?” At the center of their argument is prolonged exposure to cortisol appears to shrink the hippocampus of the brain. Under healthy conditions, cortisol helps us deal with stress by sharpening our focus and increasing alertness. Research has shown that if stress doesn’t stop, neither does the cortisol.
The Karolinska Institutet study showed chronic stress ignites inflammation in the brain. This immune response can trigger the release of molecules that break down the blood brain barrier if stress is not managed.
It is easy to follow the logical path that if the blood brain barrier is damaged, then harmful proteins like amyloid-beta and tau, can enter the brain. With an inflamed brain, cognitive decline is accelerated.
Following the Karolinska Institutet study and the University of Chicago article, researchers at the Department of Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, published a study in 2025 that looked at how stress coping strategies could reduce the AD risk. The study group included 99 cognitively unimpaired older adults who completed coping strategy assessments during the COVID-19 pandemic. COVID-19 provided a common stressor that increased psychiatric symptoms among all the study participants.
The participants underwent yearly cognitive assessments over five years, including PET imaging to assess beta-amyloid pathology. According to the study report, “more frequent use of adaptive coping was associated with better cognitive trajectories, even after accounting for beta-amyloid and tau pathology. Further, three-way interactions between tau, adaptive coping, and time indicated that individuals with elevated tau and less adaptive coping showed accelerated cognitive decline.”
The Brigham and Woman’s Hospital study suggests that stress coping strategies could delay cognitive decline in individuals with preclinical AD. Since coping strategies are easily modified, this approach may offer an easy way to preserve cognition.
In summary, it seems rather clear that reducing the stress in our lives will reduce the risk of AD. Certainly, additional studies and trials are needed to absolutely confirm the link between stress, depression, and AD.
The University of Chicago article said it best, “If we continue to glorify constant productivity, competition, and perfection, we are not just creating a stressed generation—we are also creating a generation predestined for cognitive decline. The question now is: will we recognize the danger before it’s too late?”
As I shared before, I certainly lived a stressful life. These studies make me question many of the decisions I made that resulted in my chronic stress.
On a lighter note, Linda and I have been watching Memory of a Killer. This thriller stars Patrick Dempsey as a New York City hitman who develops early-onset Alzheimer’s. If you like thrillers, I highly recommend Memory of a Killer.