Psychological Stress Impact on Navigation in Aging

Overseen By Scott Moffat, Ph.D.

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: Georgia Institute of Technology

Must not be taking: Beta-blockers

Disqualifiers: Epilepsy, Dementia, Parkinson's, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 6 months

85 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it excludes those taking medication affecting the cardiovascular system, like beta-blockers. It's best to discuss your specific medications with the trial coordinators.

What data supports the effectiveness of the treatment Anticipatory psychological stress, Stress manipulation, Psychological stress induction on navigation in aging?

Research suggests that stress can impact cognitive functions like working memory, which is important for navigation. Additionally, stress is known to affect psychological adjustment and well-being in older adults, indicating that managing stress could potentially improve navigation abilities in aging individuals. ^{1 2 3 4 5}

Is psychological stress induction safe for humans?

The safety of psychological stress induction in humans is not directly addressed in the provided research articles. However, the importance of evaluating adverse events (unintended negative effects) in psychological interventions is highlighted, suggesting that careful monitoring is necessary to ensure safety. ^{6 7 8 9 10}

How does anticipatory psychological stress treatment differ from other treatments for aging-related navigation issues?

Anticipatory psychological stress treatment is unique because it focuses on inducing stress to study its effects on aging, rather than directly treating symptoms. This approach helps researchers understand how stress impacts cognitive functions like navigation, which is different from traditional treatments that might aim to reduce stress or its effects. ^{1 2 3 4 11}

What is the purpose of this trial?

Two hallmarks of both healthy aging and age-related disease are 1) memory and navigational deficits, particularly in orienting towards goal locations and planning how to navigate to them, and 2) increased susceptibility to stress and altered regulation of the stress response. However, there are marked individual differences in these age-related changes. The investigators' proposal will help characterize factors that contribute to this variability. Participants will be pseudorandomly assigned to stress-manipulated or control groups. The investigators will give both groups a novel immersive navigation task, validated by the PI in healthy young adults. This paradigm gives participants the opportunity to either (a) flexibly draw on spatial memory in order to plan efficient routes to goal locations, or (b) fall back on inefficient, but cognitively less-demanding, stimulus-response associations (i.e., habits). Using neuroimaging and behavioral measures, the investigators' protocol will test whether experimentally-induced stress leads individuals to bring fewer details about future locations to mind when route planning, and whether such restricted prospective thought ultimately biases participants towards relatively inflexible, habitual actions.

Research Team

Thackery I Brown, Ph.D.

Principal Investigator

Georgia Institute of Technology

Eligibility Criteria

This trial is for U.S. citizens or permanent residents aged 65-80 who speak fluent English and can visit Georgia Tech for group sessions. It's not for those with metal/electrical implants, heart issues, certain medications like beta-blockers, epilepsy, dementia, Parkinson's disease, history of stroke/seizure, psychiatric disorders including untreated depression or emotional conditions, ADD/ADHD, MS, uncontrolled blood pressure issues, untreated diabetes or sickle cell anemia.

Inclusion Criteria

I am between 65 and 80 years old.

willing to come to Georgia Tech to participate in group testing sessions

U.S. citizens or permanent residents

Exclusion Criteria

I don't have metal implants, heart issues, or take heart medication.

I do not have any conditions like epilepsy, dementia, or untreated depression that could affect my thinking.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants undergo baseline assessments including neuroimaging and behavioral measures

2 weeks

1 visit (in-person)

Treatment

Participants are assigned to stress-manipulated or control groups and perform virtual navigation tasks

6 months

Multiple visits (in-person)

Follow-up

Participants are monitored for neural and behavioral outcomes post-treatment

4 weeks

1 visit (in-person)

Treatment Details

Interventions

• Anticipatory psychological stress

Trial Overview The study examines how stress affects memory and navigation in aging adults by assigning them to a stressed group or control group during a novel navigation task. Using neuroimaging and behavioral measures under stress-induced conditions versus normal circumstances will reveal the impact on spatial memory and route planning abilities.

Participant Groups

Group I: Stress group Experimental Treatment 1 Intervention

Participants in this group will perform the psychology tasks (virtual navigation) under manipulated psychological stress (anticipatory threat of shock)

Group II: No-stress control group Active Control 1 Intervention

Participants in this group will perform the psychology tasks (virtual navigation) without any manipulation of psychological stress

Who Is Running the Clinical Trial?

Georgia Institute of Technology

Lead Sponsor

Trials

53

Recruited

5,600+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Findings from Research

Research from the Berlin Aging Study, which followed men and women aged 70-100, indicates that chronic health-related stressors significantly impact the daily lives of older adults, leading to a decline in psychological functioning.

The study suggests that prolonged stress can result in a distress syndrome that correlates with decreased well-being and increased mortality in the elderly.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stress and aging: theoretical and empirical challenges for interdisciplinary research. Smith, J.[2019]

In a study of 212 older adults aged 58 to 103, optimism was found to significantly mediate the relationship between perceived stress and psychological health, indicating that a positive outlook can help buffer the effects of stress.

Perceived control over internal states also played a crucial role, mediating the relationships among stress, optimism, and psychological health, suggesting that enhancing these factors could improve psychological adjustment in older adults facing stress.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interrelations of stress, optimism and control in older people's psychological adjustment. Bretherton, SJ., McLean, LA.[2015]

Psychological stress significantly impacts the elderly, leading to anxiety, insecurity, and depression, which can hinder their overall well-being.

The review highlights that the cellular and molecular mechanisms of psychological stress are not well understood, yet they play a crucial role in compromising healthy aging.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Molecular consequences of psychological stress in human aging. Moreno-Villanueva, M., Bürkle, A.[2015]

A study involving 240 adults aged 25-65 found that anticipating stress in the morning negatively impacts spatial working memory performance later that day, regardless of actual stress experienced throughout the day.

This effect of stress anticipation on cognitive function was consistent across all age groups, suggesting that managing stress anticipation could help improve cognitive performance, especially in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Waking Up on the Wrong Side of the Bed: The Effects of Stress Anticipation on Working Memory in Daily Life. Hyun, J., Sliwinski, MJ., Smyth, JM.[2020]

A study involving 94 elderly participants showed that an educational intervention based on the PRECEDE model significantly reduced stress levels, as measured by the DASS 21 questionnaire, after eight weeks of training.

The intervention improved knowledge, attitudes, and practical skills like deep breathing and relaxation techniques, indicating that structured educational programs can effectively help manage stress in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of educational intervention based on PRECEDE model on the level of stress among the elderly at elderly clubs. Sharifirad, G., Ghaffari, M., Zanjani, S., et al.[2021]

In a survey of 874 older adults, 20.3% reported experiencing adverse drug events (ADEs), with stronger concerns about medications and more reported symptoms significantly linked to these events.

Interestingly, the use of inappropriate medications was not significantly associated with self-reported ADEs, suggesting that patients' beliefs and concerns about their medications may play a more critical role in their experiences of side effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Concerns and beliefs about medicines and inappropriate medications: An Internet-based survey on risk factors for self-reported adverse drug events among older adults. Shiyanbola, OO., Farris, KB.[2013]

About 19% of older adults experienced at least one medically serious adverse medical event (AME), with a higher risk among those in poorer health and with more comorbidities, indicating a need for targeted monitoring and prevention strategies.

Experiencing an AME significantly increased Medicare expenditures during and after the event, and was associated with a lower survival rate, as only 55% of those with an AME survived to the end of the study compared to nearly 80% of those without an AME.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Investigating the long-term consequences of adverse medical events among older adults. Carter, MW., Zhu, M., Xiang, J., et al.[2014]

In a study of 838 health professionals in Colombia from 2017 to 2021, 33.8% reported experiencing adverse events, with 21.91% showing medium-high emotional overload and 3.53% experiencing extreme acute stress.

The risk of developing acute stress after an adverse event was found to be significant, with a prevalence ratio of 1.30, indicating that health institutions need to address this issue to improve care capacity and support their staff.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute Stress in Health Workers in Colombia 2017-2021: A Cross-Sectional Study. Gonzalez Delgado, M., Cortes Gil, JD., Rodriguez Araujo, DL., et al.[2023]

The safety of psychological interventions is critical, as adverse events (AEs) can occur and must be carefully evaluated to ensure that these interventions do not cause harm before being deemed beneficial.

There is a pressing need for standardized protocols for assessing and reporting AEs in psychological interventions to improve transparency, consistency, and ultimately enhance clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Editorial: Primum non nocere - are adverse events accurately reported in studies on psychological interventions for children? Purgato, M., Cortese, S.[2023]

In a survey of 2,895 nurses across 115 hospitals in Iran, 29.1% reported experiencing adverse events in the past six months, highlighting a significant issue in patient safety.

The study found that occupational stress and cognitive failure are linked to higher rates of adverse events, with specific stressors like role and interpersonal relations being significant predictors, suggesting a need for interventions to reduce these stressors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Occupational stress and cognitive failure of nurses and associations with self-reported adverse events: A national cross-sectional survey. Kakemam, E., Kalhor, R., Khakdel, Z., et al.[2020]

Psychological stress has a significant and lasting impact on the aging process, potentially accelerating epigenetic aging, which is measured by DNA methylation and serves as a biomarker for aging.

While some evidence suggests that epigenetic aging may be modifiable through interventions, further research is needed to explore the preventability or reversibility of these changes and their clinical implications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Editorial Perspective: Psychological stress and epigenetic aging - what can we learn and how can we prevent? Zannas, AS.[2017]

References

1. United States pubmed.ncbi.nlm.nih.gov

Stress and aging: theoretical and empirical challenges for interdisciplinary research. [2019]

2. Australia pubmed.ncbi.nlm.nih.gov

Interrelations of stress, optimism and control in older people's psychological adjustment. [2015]

3. England pubmed.ncbi.nlm.nih.gov

Molecular consequences of psychological stress in human aging. [2015]

4. United States pubmed.ncbi.nlm.nih.gov

Waking Up on the Wrong Side of the Bed: The Effects of Stress Anticipation on Working Memory in Daily Life. [2020]

5. India pubmed.ncbi.nlm.nih.gov

The effectiveness of educational intervention based on PRECEDE model on the level of stress among the elderly at elderly clubs. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Concerns and beliefs about medicines and inappropriate medications: An Internet-based survey on risk factors for self-reported adverse drug events among older adults. [2013]

7. England pubmed.ncbi.nlm.nih.gov

Investigating the long-term consequences of adverse medical events among older adults. [2014]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Acute Stress in Health Workers in Colombia 2017-2021: A Cross-Sectional Study. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Editorial: Primum non nocere - are adverse events accurately reported in studies on psychological interventions for children? [2023]

10. England pubmed.ncbi.nlm.nih.gov

Occupational stress and cognitive failure of nurses and associations with self-reported adverse events: A national cross-sectional survey. [2020]

11. England pubmed.ncbi.nlm.nih.gov

Editorial Perspective: Psychological stress and epigenetic aging - what can we learn and how can we prevent? [2017]