P50: Development of Alzheimer´s Disease (AD) and Recent Stressful Life Events

Abstract

Background: The sporadic nature of AD suggest that aside from biological determinants, environmental factors such as stress may play a role in the development, progression and outcome of disease. Recent data implicated stress as a potential risk factor in development of AD. This study aims to analyze the possible relationship between recent stressful life events and AD.

Methods: We studied 132 patients with diagnosis of probable AD, according validated criteria, in mild to moderate stages. Medium age was 72.4 years. Meantime elapsed from the initial symptoms was 2.4 years. A control group of 89 healthy individuals paired for age, sex and education was studied. A questionnaire looking for stressful life events in the 3 years before diagnosis of AD was performed to patients, caregivers and controls.

Results: In the AD group, 97 patients (73.5%) presented a history of significant stressful life events, 2.3 years (SD .4 years) before the onset of symptoms. The most common findings in the AD group were: couple death (28 cases), son’s death (17 cases), history of assault or violent theft (25 cases), and history of car accident without severe injuries (13 cases). Other stressful situations were marked financial problems, bereavement, retirement, adaptive changes due to migrations and diagnosis of severe somatic disease in the family. In the control group, only 24 individuals (27%) recognized similar previous stress factors in the previous 3 years

Conclusions: We observed an association between stressful life events preceding the onset of dementia in a high percentage of our patients. Stress could trigger the degenerative process in AD and growing evidences suggest a dysfunction in neuroendocrine and immune system. According our results, we can establish a relationship between several stressful life events and the onset of dementia. It is an observational finding and does not imply direct causality. Future studies are required to examine this association in more detail in order to explain the possible mechanisms of this relationship.