Chronic stress linked to differences in cognitive decline across certain demographic groups, study finds

WINSTON-SALEM, N.C., Sept., 24, 2026 - Chronic stress and perceived social support may play a role in how memory and thinking abilities change with age, according to a new study led by researchers at Wake Forest University School of Medicine.

The study, published recently in Alzheimer's & Dementia, followed 3,873 adults age 50 and older enrolled in the Health and Aging Brain Study-Health Disparities, or HABS-HD. Researchers examined whether participants' reported levels of ongoing stress and social support systems at the beginning of the study were associated with changes over time in attention, memory, language and executive function, which includes skills used to plan, organize and solve problems.

While previous studies have examined stress and social support as they relate to cognitive decline, this study looked at both, along with how different demographic groups compare to one another.

Higher social support at the start of the study was associated with less decline in attention over time, regardless of sex or race. Women reporting higher chronic stress experienced greater declines in attention and language compared with men, while Hispanic participants reporting higher chronic stress experienced greater memory decline compared with non-Hispanic participants. The study also showed social support and stress were independent of each other, meaning having strong social support did not offset stress associated with cognitive decline.

"Our findings suggest that chronic stress and social support may be important factors to consider when we think about healthy brain aging," said Michelle M. Mielke, Ph.D., professor of epidemiology and prevention at Wake Forest University School of Medicine and corresponding author of the study. "Findings also show that the relationship between stress and cognitive change may not be the same for everyone, but there is encouraging evidence about the benefits of social support from family, friends and our communities for all."

Study participants were 64.8 years old on average, and none had dementia when they entered the analysis. About 78% had no cognitive impairment and 22% had mild cognitive impairment.

Participants completed questionnaires about long-term stressors, including financial difficulties, work pressures, relationship challenges, health concerns and caregiving responsibilities. They also reported how they perceive their own level of social support. Participants were then scored based on these questionnaires. Cognitive testing throughout the study measured changes in attention, memory, language and executive function, and follow up visits occurred about every two years.

Stress and social support were measured through participant questionnaires at the beginning of the study, and the group reported relatively low stress and high social support overall.

Because the study was observational, it cannot prove that chronic stress causes cognitive decline or that greater social support prevents it. Additional research is needed to understand how these factors may influence cognitive aging and the risk of Alzheimer's disease and related dementias.

"Social connections and stress are parts of everyday life that may be possible to change," Mielke said. "Future research can help determine whether programs that reduce chronic stress or strengthen meaningful support networks can help preserve cognitive function as people age."

Jillian Lee, post-doctoral fellow at Wake Forest University School of Medicine, was the first author on the report.

The study was supported by the National Institute on Aging of the National Institutes of Health under award numbers F31AG087696, 5T32NS115704, R01AG054073, R01AG058533, R01AG070862, P41EB015922 and U19AG078109.

Media Contact

[email protected]

About Wake Forest University School of Medicine

Wake Forest University School of Medicine is the academic core of Charlotte, North Carolina-based Advocate Health and a recognized leader in experiential medical education and groundbreaking research. It directs the education of nearly 1,900 students and fellows, including physicians, basic scientists and allied clinical professionals. The school of medicine also strategically investigates opportunities that will expand basic and clinical research, resulting in nationally and internationally recognized excellence in biomedical research. The school has two campuses, each co-located with leading-edge innovation districts, The Pearl, in Charlotte, and Innovation Quarter, in Winston-Salem, North Carolina. These affiliated life-sciences innovation districts focus on advancing health care through new medical technologies and biomedical discovery.

About Advocate Health

Headquartered in Charlotte, North Carolina, Advocate Health is the third-largest nonprofit, integrated health system in the United States. A preeminent academic health system at the forefront of clinical excellence, innovation and research, it delivers care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin and Michigan, and Wake Forest University School of Medicine is its academic core. Nationally recognized for expertise in heart and vascular, neurosciences, oncology, pediatrics and rehabilitation, Advocate Health is also a pioneer in the delivery of virtual health care. It is accelerating discovery by making research participation part of the standard-of-care through its one-of-a-kind National Center for Clinical Trials, plus two affiliated life-sciences-focused innovation districts and one of the nation's largest graduate medical education programs. With more than 165,000 teammates serving patients at 69 hospitals and over 1,000 care locations across eight states, Advocate Health reinvests over $6 billion each year to improve community health, making it one of the nation's largest providers of community benefit.