Longitudinal Associations Between Aging Trajectories of Perceived Stress and Cognitive Functioning

As the global population ages, understanding and identifying early signs of cognitive decline and dementia has become a central goal of public health and gerontological research as it creates opportunities for early intervention (World Health Organization, 2017). Currently, there is growing interest in the association between perceived stress and subsequent cognitive decline with more stress increasingly recognised as a potential modifiable risk factor for cognitive decline and dementia (Franks et al., 2023; Ramakrishnan et al., 2025). Perceived stress is understood as the extent to which individuals perceive that life demands exceed their coping abilities (Cohen et al., 1983). Feeling stressed is highly prevalent and appears to be increasingly common in the general population (American Psychological Association, 2023). For example, more than half of respondents aged 55 and above of the survey results from a large US survey indicate that they experience moderate to high stress (Morley et al., 2025). However, several limitations of existing literature preclude a full understanding of the association between perceived stress and cognitive performance in older adulthood. For one, existing studies on cognition and stress only assess cognition cross-sectionally, at a single timepoint (Khodami et al., 2026; Korten et al., 2017; Oumohand et al., 2020; Ramakrishnan et al., 2025), or over short follow-up periods (Silwinski et al., 2015), thus they cannot illuminate long-term decline in cognition (or trajectories of perceived stress) over time. Second, while perceived stress as possible predictor for cognitive decline is well-documented, this uni-directional framing overlooks the possibility that declining memory and thinking skills themselves increase stress because everyday tasks become more and more difficult (e.g., Bell et al., 2019; Franks et al., 2023). However, we currently have little understanding of how perceived stress and cognitive decline are intertwined over time or their temporal ordering. Third, existing studies tend to rely on global cognitive composites measures which precludes conclusions about domain-specific associations across cognitive function. A closer look at domain-specific associations could help aid our understanding of which aspects of cognition are most strongly associated with perceived stress (or vice versa) and inform appropriate intervention strategies. The proposed study addresses these limitations by leveraging up to five waves of longitudinal data on perceived stressed and cognitive performance spanning an 11-year period to explore the reciprocal associations between aging trajectories of perceived stress and cognition in adults over the age of 60.