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Better stress coping associated with lower tau in amyloid-positive cognitively unimpaired older adults
Arenaza-Urquijo EM, Przybelski SA, Machulda MM, Knopman DS, Lowe VJ, Mielke MM, Reddy AL, Geda YE et al.. Neurology, 2020-01-21
Topic: Amyloid, tau and blood-test diagnosis
Objective Research in animals has shown that chronic stress exacerbates tau pathology. In humans, psychological stress has been associated with higher risk of Alzheimer disease clinical syndrome. The objective of this cross-sectional study was to assess the hypothesis that stress coping ability (assessed via the Brief Resilience Scale [BRS]) is associated with tau burden and to evaluate whether these associations differed by sex and amyloid status (A+/A-) in cognitively unimpaired (CU) older adults. Methods We included 225 CU participants (mean age 70.4 ± 10.2 years, 48% female) enrolled in the population-based Mayo Clinic Study of Aging who completed the BRS and underwent amyloid-PET (Pittsburgh compound B-PET) and tau-PET (AV1451-PET). We fitted multiple regression and analysis of covariance models to assess the associations between BRS and tau-PET and the interaction with amyloid status and sex. We focused on entorhinal cortex (ERC) tau burden and also performed voxel-wise analyses. Age, sex, education, depression, and anxiety were considered as covariates. Results Higher stress coping ability was associated with lower tau burden in the medial temporal lobe (including ERC) and occipito-temporal and cuneal/precuneal cortices. The association was present in both A+ and A- but weaker in A- CU older adults. There was an interaction between amyloid status and stress coping ability that was restricted to the medial temporal lobe tau such that A+ CU older adults with lower stress coping abilities showed higher tau. There were no significant interactions between stress coping and sex. Conclusions A faster termination of the stress response (higher coping ability) may limit the negative effects of stress on tau deposition. Conversely, lower stress coping ability may be an early sign of accumulating tau pathology. Longitudinal studies are warranted to clarify whether stress mechanisms act to exacerbate tau pathology or tau influences stress-related brain mechanisms and lowers the ability to cope with stress.
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APA 7th
Arenaza-Urquijo, E. M., Przybelski, S. A., Machulda, M. M., Knopman, D. S., Lowe, V. J., Mielke, M. M., et al. (2020). Better stress coping associated with lower tau in amyloid-positive cognitively unimpaired older adults. Neurology. https://doi.org/10.1212/wnl.0000000000008979
Vancouver
Arenaza-Urquijo EM, Przybelski SA, Machulda MM, Knopman DS, Lowe VJ, Mielke MM, et al. Better stress coping associated with lower tau in amyloid-positive cognitively unimpaired older adults. Neurology. 2020. doi:10.1212/wnl.0000000000008979. PMID: 31964689.
BibTeX
@article{arenazaurquijo2020-31964689,
author = {Arenaza-Urquijo, E. M. and Przybelski, S. A. and Machulda, M. M. and Knopman, D. S. and Lowe, V. J. and Mielke, M. M. and Reddy, A. L. and Geda, Y. E. and others},
title = {{Better stress coping associated with lower tau in amyloid-positive cognitively unimpaired older adults}},
journal = {Neurology},
year = {2020},
doi = {10.1212/wnl.0000000000008979},
pmid = {31964689},
url = {https://doi.org/10.1212/wnl.0000000000008979}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Objective Research in animals has shown that chronic stress exacerbates tau pathology.
- In humans, psychological stress has been associated with higher risk of Alzheimer disease clinical syndrome.
- The objective of this cross-sectional study was to assess the hypothesis that stress coping ability (assessed via the Brief Resilience Scale [BRS]) is associated with tau burden and to evaluate whether these associations differed by sex and amyloid status (A+/A-) in cognitively unimpaired (CU) older adults.
- Results Higher stress coping ability was associated with lower tau burden in the medial temporal lobe (including ERC) and occipito-temporal and cuneal/precuneal cortices.
- There were no significant interactions between stress coping and sex.
Why it matters
Among 225 cognitively unimpaired older adults, better stress coping ability was associated with lower tau burden in several brain regions, with the link present in both amyloid-positive and amyloid-negative people but weaker in the latter. This is a cross-sectional association and does not show that improving coping treats, cures or prevents Alzheimer's disease.
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Study details
- Study designcross-sectional
- Participants225
- Evidence strengthModerate
How this study scored 58/100
Published in a leading specialty journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 225 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 34 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.2 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 3 / 6 | Cited 3.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Prashanthi Vemuri: h-index 106 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Mayo Clinic: institution h-index 1,606 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 31964689) |
| Free to read | 2 / 2 | Free to read |
| Total | 58 / 100 | — |
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