Perceived stress and cognitive decline: the moderating role of emotion regulation

Abstract Background and Objectives Perceived stress is associated with poor health outcomes, including accelerated cognitive decline and increased risk for dementia. Prior research suggests that emotion regulation may determine the extent to which stress impairs cognition with age. This study extends this work by examining the moderating role of two emotion regulation strategies (cognitive reappraisal; expressive suppression) on the relationship between perceived stress and cognitive decline over 10 years in a sample of older adults. Research Design and Methods The sample was drawn from the Midlife in the United States Study (MIDUS; N = 468; Mean age at baseline = 60.24), providing measures of perceived stress, emotion regulation, and cognition at baseline and follow-up (episodic memory; executive functioning). Moderation analyses with 5,000 bootstrapped samples were conducted in the PROCESS Macro and statistically adjusted for age, sex, education, household income, medications, and baseline cognition. Results Results revealed that perceived stress interacted with expressive suppression to predict later episodic memory performance. As stress levels increased, only individuals endorsing regular use of expressive suppression exhibited significant memory decline. By contrast, cognitive reappraisal did not significantly moderate relationships between stress and later cognition. Discussion and Implications Findings highlight that habitual suppression of emotional expression may amplify the consequences of perceived stress on memory decline in late life. Promotion of adaptive emotion regulation may play a role in mitigating the effects of stress on cognitive outcomes among older adults.