Distress proneness and cognitive decline in a population of older persons

The association between distress proneness and cognitive decline was examined in older residents of a biracial community in Chicago. At baseline, participants completed four cognitive tests that yielded a global measure (baseline mean=101.2; standard deviation (SD)=7.8), and a brief measure of the tendency to experience negative emotions (mean=16.5; SD=6.7) based on the Neuroticism scale of the NEO Five-Factor Inventory. Cognitive testing was repeated twice at three-year intervals. In mixed models that controlled age, sex, race, and education, for each point on the distress proneness scale, global cognitive score was 0.12 unit lower at baseline (p<0.001) and annual rate of decline increased by 0.01 unit (p=0.002), or about 2%. Thus, cognitive decline was about 30% faster in a person highly prone to distress (score=24, 90th percentile) compared to the one low in distress proneness (score=9, 10th percentile). This effect was unchanged after controlling for level of cognitive activity or excluding people with cognitive impairment at baseline, but it was reduced to a trend (p=0.059) after controlling for depressive symptoms. The results suggest that the tendency to experience psychological distress is associated with increased cognitive decline in old age.