The Psychological Risk Factors for Dementia

06/18/2014

Are cynical people more likely to develop dementia? According to a new study in Neurology, the answer is “yes.” The study, said to be the first to exclusively examine the link between cynicism and dementia, adds to a growing body of evidence on the psychological risk factors for Alzheimer’s and other dementias.

One of the most well-known of these long-term studies comes from David A. Bennett, director of the Rush Alzheimer’s Disease Center at Rush Medical College in Chicago, Illinois.  Bennett’s study, along with a number of subsequent investigations, established that neuroticism, depression, social isolation, and other social traits are all risk factors for Alzheimer’s and other forms of dementia. On the flip side, advanced education, organizational skills, conscientiousness, and other positive traits have been shown to offer protection against dementia and cognitive decline.

How Can You Mitigate Psychological Risk Factors?

A natural predisposition towards cynicism or depression is not a dementia life sentence. There are a number of ways to protect your brain health, regardless of psychological risk factors. Since our brains are constantly changing in response to the environment, a lifetime of social, occupational, and educational engagement can create a "cognitive reserve" that strengthens the brain against future decline. Moreover, individuals suffering from depression can (and should) seek treatment—cognitive impairment associated with depression is potentially reversible if the depression is recognized and treated. 

How Do These Negative Psychological Risk Factors Cause Cognitive Impairment and Dementia?

Many of the negative psychological risk factors linked to dementia are associated with stress—or, more precisely, distress. While stress is always in our environment, distress only occurs when we have a negative psychological response to stress. When this happens, our blood is flooded with stress hormones (e.g., cortisol), which are toxic to the brain cells responsible for memory and learning. We all experience stressful environments, but people who are cynical, neurotic, or depressed are constantly experiencing a distressed response to these environments. 

Another common thread? These negative psychological risk factors are often bundled—for example, a depressed person is more likely to develop a cynical attitude and become socially isolated. 

How Can This Knowledge Inform Drug Discovery to Prevent Cognitive Decline?

We may be able to use this knowledge to develop a drug that blocks the effects of the stress hormone cortisol on the hippocampal region of the brain, where memory and learning happen. Researchers have already identified molecules that can block the cortisol receptor and mitigate the negative effect of cortisol on the brain. The Alzheimer’s Drug Discovery Foundation has funded a number of studies investigating such stress blocking compounds and plans to support their continued development.

Drugs used to treat depression may also hold promise for Alzheimer’s patients. Recent research suggests that the antidepressant citalopram (Celexa™) may inhibit the growth of beta-amyloid plaques. Citalopram belongs to a class of antidepressant drugs known as selective serotonin reuptake inhibitors (SSRIs) that function by increasing serotonin levels in the brain.

As we gain more knowledge about the underlying risk factors for Alzheimer's disease, we will continue to use what we have learned to develop effective drugs to prevent and treat it. 

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