58. Systemic inflammatory responses to stress and its impact on cognition in subjects with Mild Cognitive Impairment

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Subjects with amnestic Mild Cognitive Impairment (aMCI) do not inevitably show cognitive decline or convert to Alzheimer’s disease supporting the hypothesis that secondary events are crucial in the conversion process. The study purpose is to examine whether stress (psychological and physical) contributes to the worsening of cognitive decline in aMCI subjects due to the prolonged stress-induced production of pro-inflammatory cytokines. This is an observational study assessing the association between cognitive decline and the degree of stress in 140 aMCI subjects and 70 control subjects. The primary hypothesis is that psychological stress, as measured by the RLCQ, is associated with worsened cognitive decline, as measured by the FCSRT-IR, over an 18 month period. Secondary outcomes include difference in change of score in the TMT, Verbal Fluency test, MoCA, DSST, GDS, and the Sickness Behaviour Scale. Other exploratory measures of stress include salivary cortisol levels, the PSS, CSSS, and physical stressors including infections. Biological outcomes include changes in blood levels of inflammatory markers and immunophenotyping of peripheral blood mononuclear cells. To date 62 subjects recruited (27 males vs 35 females; 32 controls vs 30 aMCI). Initial reported prevalence of stressors was high with 89% of subjects reporting 1 or more and 71% reporting 2 or more stressors in the previous 6 months. Life events causing stress appear sufficiently common within this subject group to warrant further investigation.

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