The Stress-Alzheimer’s Connection: Is Your Brain at Risk?

Did you know there’s a thing called “stress-induced Alzheimer’s disease”?

That’s right, a high-stress lifestyle could set off biological changes linked to Alzheimer’s disease, according to a new paper from researchers in India.1

The reason: Cortisol—a stress hormone your body releases to help you respond to threats—isn’t meant to stay elevated long-term. In fact, that leads to all kinds of trouble.

Chronically high cortisol levels can actually harm critical brain regions like your hippocampus—which handles memory—and your prefrontal cortex, which is essential for decision-making and mood.?

Elevated cortisol may also contribute to plaque buildup in your brain, a key feature of Alzheimer’s disease.

Only it’s not just a problem with cortisol. It’s actually due to a dysfunction that occurs when your stress response system “breaks.”?

Are you at risk??

I created a simple quiz to help you find out. Plus, I’ll give you practical, science-backed strategies to help you reduce stress and protect your brain from these damaging effects.?

Why Cortisol Is Actually Vital for Your Health

Before we dive into the quiz, let’s take a closer look at why your stress response system can sometimes “break”—and how it all starts with cortisol.

Cortisol gets a lot of flak as the “stress hormone,” but let’s set the record straight—it’s one of your body’s best allies. It plays a key role in managing your body’s stress response while also helping to regulate energy levels, mood, immune function, digestion, and even reproductive health.?

This essential hormone supports vital processes like metabolism, inflammation, and your sleep-wake cycle, while also helping maintain stable blood sugar levels. In the right amounts, cortisol helps you wake up, keeps your immune system in check, and helps you rise to life’s challenges.

The trick is balance. Too much—or too little—cortisol can throw your body into chaos. So how does your body maintain this balance? Meet the HPA axis.

Your Brain-Body Stress Connection

Think of your HPA axis—short for hypothalamic-pituitary-adrenal axis—as your body’s stress management system. It’s the command center that connects your brain and body to keep you steady under pressure.

The process starts in the brain, where the hypothalamus and pituitary gland send signals to your adrenal glands, which sit atop your kidneys. When you encounter stress, this system releases cortisol to help you prepare for action. In other words, the classic “fight or flight” response.

In a healthy stress response, your HPA axis uses a built-in feedback loop to stay in control.?

Specialized receptors (called “glucocorticoid receptors”) in your brain can actually sense how much cortisol is around. When levels rise—like during a stressful event—your brain signals your adrenal glands to dial back production of cortisol.?

Once the stress passes, your cortisol levels return to baseline, and your body shifts into recovery mode.

What Happens When Stress Doesn’t Let Up?

Chronic stress can keep cortisol levels stuck in overdrive, overwhelming your HPA axis and throwing it out of balance. The feedback system that normally keeps cortisol levels in check can start to break down.

Here’s how it works: The glucocorticoid receptors in your brain that sense cortisol levels can become less responsive, almost like they’ve “gone numb.” Without this signal to slow down, your body keeps pumping out cortisol, leaving you stuck in a constant “fight or flight” state. This might feel like being on edge all the time, with a racing heart and tense muscles.

Over time, your HPA axis can burn out, and your cortisol levels may drop too low. When that happens, you’re left feeling drained, foggy, and unable to handle stress.?

Whether your system is running on overdrive or running on empty, recovery gets harder, and the toll on your health can ripple through every part of your life. Here’s What Stress Can Do to Your Brain

Beyond its toll on your body, chronic stress can also impact your brain health in ways that may pave the road to cognitive decline and even Alzheimer’s disease.2?Here's what the research reveals:?

? Chronic stress can drive cognitive decline in aging. A study of older adults found that chronic stress can speed up the shift from mild memory issues to dementia.3

It’s important to note that cortisol levels alone didn’t predict progression to dementia. This suggests that different mechanisms are at play to drive cognitive changes.?

? Chronic stress and depression amplify dementia risk. A study of over 1.3 million adults found that chronic stress raised the risk of memory problems by 87% and Alzheimer’s by 145%. Depression also doubled the risk of Alzheimer’s and tripled the risk of memory issues.?

And together, stress and depression nearly quadrupled the chances of developing these conditions.?

? Stress linked to cognitive impairment in older adults. Another study published in JAMA followed over 24,000 adults aged 45 and older. The findings? Feeling stressed wasn’t just linked to current cognitive problems—it also predicted future cognitive decline.??And this held true even when researchers accounted for factors like age, race, and depression.?

All these findings highlight the need for regular stress screening and stress-management practices that work.

Which leads me to my next point.

Are You at Risk for HPA-Axis Dysfunction?

Answer the following questions honestly. For each question, give yourself:

• 0 points: Low risk
• 1 point: Moderate risk
• 2 points: High risk

1. I feel overwhelmed or stressed most days.
2. I have trouble falling or staying asleep, even when I’m tired.
3. I feel fatigued during the day, no matter how much rest I get.
4. I often feel tired but wired.
5. I struggle with memory or find it hard to concentrate.
6. I’ve noticed changes in my weight or appetite without explanation.
7. I frequently experience mood swings or feel anxious without a clear reason.
8. I have been more prone to catching colds or other illnesses lately.
9. I crave salty or sugary foods, especially during stressful times.
10. I’ve felt a lack of motivation or enjoyment in activities I usually love.
11. I’ve been diagnosed with or suspect I might have chronic conditions like depression, anxiety, or high blood pressure.
12. I have panic attacks or am easily startled.

Take a moment to tally up your points and see where you fall on the spectrum.

Scoring Guide:

• 0-6 Points: Low risk: balanced stress response
• 7-14 Points: Moderate risk: reactive stress response
• 15-24 Points: High risk: overloaded stress response

What Does Your Score Mean?

0-6 Points: Low Risk Your responses suggest that you’re managing your stress fairly well, but it’s always a good idea to maintain healthy habits to support your resilience.

7-14 Points: Moderate Risk You may be experiencing moderate levels of stress, which could impact your well-being over time. Building supportive routines can help keep stress in check.

15-24 Points: High Risk Your responses indicate that high levels of stress may be affecting various areas of your life and potentially impacting your health.

What You Can Control to Protect Your Brain

While you can’t always control the stressors in your life, you can take steps to manage how your body responds—and these simple science-backed strategies are a great place to start.

Take a moment to ask yourself: ‘What’s on this list that you’re not doing—but could start doing today?’?

Maybe you could prioritize sleep by setting a bedtime routine or limiting screen time before bed. Or perhaps you could take a small step, like eliminating caffeine in the afternoon to improve sleep quality.

If you’re ready to take your nutrition up a notch, my 10-Day Detox program is a great way to reset your body and start feeling better fast.

Supplements can also support your stress response. Specifically, adaptogens may help your body handle stress more effectively.

Healing Your Stress Response with Adaptogens

If stress has been running (or ruining) your life, adaptogens could be another tool you can leverage to help your body recover. These unique herbs, like rhodiola, ashwagandha, or holy basil work with your body to restore balance and rebuild resilience.

One way adaptogens help is by resensitizing your glucocorticoid receptors—those “off switches” for stress hormones like cortisol. As I noted earlier, chronic stress can desensitize these receptors, leaving your cortisol levels stuck on high.?

Adaptogens essentially reboot these receptors and help bring your cortisol back to healthy levels.??So your body can calm down and recover.

Adaptogens also have a powerful impact on your cells. They stimulate molecules like heat shock proteins (Hsp70), which repair stress-damaged cells, reduce inflammation, and support energy production. Think of it as giving your body a much-needed tune-up to bounce back.

If you’re ready to give adaptogens a try, remember that they’re not a one-size-fits-all solution. And finding the right adaptogen for you might take some trial and error. If you’re not sure where to start, working with your Functional Medicine doctor can help personalize your treatment. Otherwise, here’s an adaptogen blend you can try.?

References

1. P S, Vellapandian C. Hypothalamic-Pituitary-Adrenal (HPA) Axis: Unveiling the Potential Mechanisms Involved in Stress-Induced Alzheimer’s Disease and Depression. Cureus. 2024 Aug 23;16(8):e67595. doi: 10.7759/cureus.67595. PMID: 39310640; PMCID: PMC11416836.
2. ávila-Villanueva M, Gómez-Ramírez J, Maestú F, Venero C, ávila J, Fernández-Blázquez MA. The Role of Chronic Stress as a Trigger for the Alzheimer Disease Continuum. Front Aging Neurosci. 2020 Oct 22;12:561504. doi: 10.3389/fnagi.2020.561504. PMID: 33192456; PMCID: PMC7642953.
3. Peavy GM, Jacobson MW, Salmon DP, Gamst AC, Patterson TL, Goldman S, Mills PJ, Khandrika S, Galasko D. The influence of chronic stress on dementia-related diagnostic change in older adults. Alzheimer Dis Assoc Disord. 2012 Jul-Sep;26(3):260-6. doi: 10.1097/WAD.0b013e3182389a9c. PMID: 22037597; PMCID: PMC3290680.?
4. Wallensten, J., Ljunggren, G., Nager, A. et al. Stress, depression, and risk of dementia – a cohort study in the total population between 18 and 65 years old in Region Stockholm. Alz Res Therapy 15, 161 (2023). https://doi.org/10.1186/s13195-023-01308-4.?
5. Kulshreshtha A, Alonso A, McClure LA, Hajjar I, Manly JJ, Judd S. Association of Stress With Cognitive Function Among Older Black and White US Adults. JAMA Netw Open. 2023;6(3):e231860. doi:10.1001/jamanetworkopen.2023.1860.?
6. Panossian A, Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity. Pharmaceuticals (Basel). 2010 Jan 19;3(1):188-224. doi: 10.3390/ph3010188. PMID: 27713248; PMCID: PMC3991026.