Perceived Stress is Associated with Alzheimer’s Disease Cerebrospinal Fluid Biomarkers in African Americans with Mild Cognitive Impairment

Article type: Research Article

Authors: Trammell, Antoine R.^{a; *} | McDaniel, Darius J.^b | Obideen, Malik^b | Okafor, Maureen^b | Thomas, Tiffany L.^b | Goldstein, Felicia C.^b | Shaw, Leslie M.^c | Hajjar, Ihab M.^d

Affiliations: [a] Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA | [b] Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA | [c] Department of Pathology and Laboratory Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA | [d] Department of Medicine and Neurology, Emory University School of Medicine, Atlanta, GA, USA

Correspondence: [*] Correspondence to: Antoine R. Trammell, MD, MPH, Assistant Professor of Medicine, Department of Medicine, Emory University School of Medicine, Division of General Medicine & Geriatrics, Emory Brain Health Center, 6 Executive Park Drive NE, Floor: 2, Atlanta, GA 30329, USA. Tel.: +1 404 712 2059; E-mail: antoine.trammell@emory.edu.

Abstract: Background:African Americans (AA) have a higher Alzheimer’s disease (AD) prevalence and report more perceived stress than White Americans. The biological basis of the stress-AD link is unclear. This study investigates the connection between stress and AD biomarkers in a biracial cohort. Objective:Establish biomarker evidence for the observed association between stress and AD, especially in AA. Methods:A cross-sectional study (n = 364, 41.8% AA) administering cognitive tests and the perceived stress scale (PSS) questionnaire. A subset (n = 309) provided cerebrospinal fluid for measurement of Aβ42, Tau, Ptau, Tau/Aβ42 (TAR), and Ptau/Aβ42 (PTAR). Multivariate linear regression, including factors that confound racial differences in AD, was performed. Results:Higher PSS scores were associated with higher Ptau (β= 0.43, p = 0.01) and PTAR (β= 0.005, p = 0.03) in AA with impaired cognition (mild cognitive impairment). Conclusion:Higher PSS scores were associated with Tau-related AD biomarker indices in AA/MCI, suggesting a potential biological connection for stress with AD and its racial disparity.

Keywords: African Americans, Alzheimer’s disease, tauopathy, amyloid-β peptides, cognitive function, mild cognitive impairment, neurocognitive tests, psychological stress

DOI: 10.3233/JAD-200089

Journal: Journal of Alzheimer's Disease, vol. 77, no. 2, pp. 843-853, 2020