Chronic stress isn’t just uncomfortable—it may be quietly damaging our brains. As research continues to reveal connections between prolonged stress, cardiovascular health, and cognitive decline, stress management is emerging as a potentially powerful tool in Alzheimer’s prevention. Raghid Charara, MD, a Neuropsychiatrist in the department of Psychiatry and Psychology, shares insights on how elevated cortisol levels affect brain health, why stress reduction may be particularly important for those with family histories of Alzheimer’s disease, and which evidence-based interventions offer the most promise for maintaining cognitive resilience throughout life.
Read the interview with Dr. Charara below.
WAM: Research shows that chronic stress keeps cortisol levels elevated. How does prolonged cortisol exposure affect the brain?
Dr. Charara: When cortisol — the body’s main stress hormone — stays elevated for long periods, it can negatively impact brain health. High cortisol levels have been linked to shrinkage in the hippocampus, a region critical for learning and memory. Over time, this can impair cognitive function, increase susceptibility to anxiety and depression, and potentially accelerate age-related brain changes. The brain thrives in a state of balance, and chronic stress disrupts that equilibrium, wearing down our cognitive resilience.
WAM: Given that chronic stress contributes to cardiovascular disease and diabetes—both risk factors for Alzheimer’s—do you see stress management as a potential Alzheimer’s prevention strategy? What does the research tell us about this connection?
Dr. Charara: Absolutely. Chronic stress doesn’t just affect mood — it plays a real biological role in the development of diseases that increase the risk of Alzheimer’s, such as high blood pressure, diabetes, and inflammation. Recent research supports the idea that effective stress management can improve vascular and metabolic health, which are closely tied to brain health. While we can’t eliminate all stress, learning how to manage it may be one of the most accessible and impactful tools we have for protecting our brains as we age.
WAM: For individuals with family histories of Alzheimer’s who are experiencing chronic stress, what specific stress management interventions would you prioritize? Are there particular techniques that might be most neuroprotective?
Dr. Charara: For people at higher genetic risk, I often recommend a combination of mindfulness-based stress reduction, regular physical exercise, and high-quality sleep. These interventions are supported by evidence and accessible to most people. Practices like yoga, meditation, and even nature walks can lower cortisol levels and calm the nervous system. Sleep is especially important, as poor sleep can both increase stress and interfere with the brain’s ability to clear waste — including amyloid proteins associated with Alzheimer’s.
WAM: How does the concept of cognitive reserve relate to stress resilience? Can stress management strategies help build cognitive reserve?
Dr. Charara: Cognitive reserve refers to the brain’s ability to cope with damage and maintain function, often built up over a lifetime of mental stimulation, social engagement, and healthy lifestyle habits. Chronic stress can erode that reserve, while stress management helps preserve and potentially even build it. Engaging in mentally enriching, emotionally calming activities — such as learning something new, practicing mindfulness, or connecting with others — supports brain adaptability. In this way, stress management doesn’t just prevent harm; it strengthens the brain’s ability to bounce back.