The impact of stress on cognitive functions and quality of life in young and middle-aged
M. I. Strekalova,
O. D. Ostroumova,
A. A. Drozdova,
A. I. Kochetkov,
E. Yu. Ebzeeva,
A. Ya. Starokozheva,
A. A. Tyazhelnikov https://doi.org/10.21518/ms2026-287
Abstract
Introduction. Atrial fibrillation (AF) is increasingly diagnosed in young and middle-aged patients and may impair quality of life not only through physical symptoms but also through psycho-emotional distress, anxiety, sleep disturbances, and potential cognitive decline.
Aim. To assess the impact of stress on cognitive function, nocturnal sleep quality, and quality of life in young and middle-aged patients with AF.
Materials and methods. A cross-sectional cohort study was conducted. Eighty patients with AF aged 18–59 years who were followed at the Central Clinical Hospital RZD-Medicine from September 2025 to April 2026 were included. Patients were divided into two groups: 24 individuals with moderate/high stress levels and 56 individuals with low stress levels according to the Reeder Stress Scale. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Stroop Test. Anxiety was evaluated using the Beck Anxiety Inventory, depression using the Hamilton Depression Rating Scale, perceived stress using the Perceived Stress Scale (PSS-10), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and quality of life using the SF-36 questionnaire.
Results. Patients with moderate/high stress levels demonstrated a statistically significant increase in the completion time of the third part of the Stroop Test and in the T3–T2 difference. No significant differences were observed in MMSE or MoCA scores. The same group exhibited higher levels of anxiety, depressive symptoms, perceived stress, poorer sleep quality, greater daytime dysfunction, and lower scores in several quality-of-life domains.
Conclusions. Moderate/high stress levels in young and middle-aged patients with AF are associated with a less favorable psychophysiological status, poorer sleep quality, reduced quality of life, impaired executive functioning, and greater severity of anxiety and depressive symptoms.
About the Authors
M. I. Strekalova
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Marina I. Strekalova - Clinical Resident, Senior Laboratory Assistant, Departmental Applicant of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
O. D. Ostroumova
Russian Medical Academy of Continuous Professional Education; Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Olga D. Ostroumova - Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, , RMA of Continuous Professional Education; Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov FMSMU (Sechenov University).
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 8, Bldg. 2, Trubetskaya St., Moscow, 119048
A. A. Drozdova
Russian Medical Academy of Continuous Professional Education; City Polyclinic No. 220
Russian Federation
Russian Federation
Anastasia A. Drozdova - Departmental Applicant of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, RMA of Continuous Professional Education; District Therapist of the Budgetary Healthcare Institution City Polyclinic No. 220.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 27, Zamorenova St., Moscow, 123022
A. I. Kochetkov
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Alexey I. Kochetkov - Cand. Sci. (Med.), Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
E. Yu. Ebzeeva
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
Elizaveta Yu. Ebzeeva - Cand. Sci. (Med.), Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
A. Ya. Starokozheva
Russian Medical Academy of Continuous Professional Education; Central Clinical Hospital “RZD-Medicine”
Russian Federation
Russian Federation
Anastasiya Ya. Starokozheva - Cand. Sci. (Med.), Cardiologist, Assistant of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, RMA of Continuous Professional Education; Head of the Department of Cardiology, Central Clinical Hospital “RZD-Medicine”;
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 2, Budayskaya St., Moscow, 129128
A. A. Tyazhelnikov
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Andrey A. Tyazhelnikov - Dr. Sci. (Med.), Professor, Professor of the Department of Public Health and Healthcare named after Yu.P. Lisitsyn.
1, Ostrovityanov St., Moscow, 117513
References
1. Lane DA, Andrade JG, Arbelo E, Boriani G, Hendriks JM, Lee SR et al. Atrial fibrillation. Lancet. 2026;407(10532):1000–1013. https://doi.org/10.1016/S0140-6736(25)02166-X.
2. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2023;147(19):e695–e825. https://doi.org/10.1161/CIR.0000000000001193.
3. Bunova SS, Timakova AYu, Skirdenko YuP, Nikolaev NA, Zhernakova NI, Lebedev DT, Gorbunova EA. Atrial fibrillation and its geriatric aspects: news of the last 5 years (review). Scientific Results in Biomedical Research. 2023;9(1):86–101. (In Russ.) https://doi.org/10.18413/2658-6533-2023-9-1-0-6.
4. Pandey A, Kim S, Moore C, Thomas L. Predictors and prognostic implications of incident heart failure in patients with prevalent atrial fibrillation. JACC Heart Fail. 2017;5:44–52. https://doi.org/10.1016/j.jchf.2016.09.016.
5. Krasnoslobodskaya OV. Medical aspects of quality of life in patients with atrial fibrillation. Fundamental Research. 2011;(7):90–93. (In Russ.) Available at: https://fundamental-research.ru/ru/article/view?id=26732.
6. Ladwig KH, Goette A, Atasoy S, Johar H. Psychological aspects of atrial fibrillation: A systematic narrative review: Impact on incidence, cognition, prognosis, and symptom perception. Curr Cardiol Rep. 2020;22(11):137. https://doi.org/10.1007/s11886-020-01396-w.
7. D’Elia NW, Kistler PM, Voskoboinik A. Atrial fibrillation in the young: Pathogenesis and clinical implications. Heart Lung Circ. 2018;27(10):1153–1160. https://doi.org/10.1016/j.hlc.2018.05.138.
8. Rafaqat S, Rafaqat S, Rafaqat S. The role of major biomarkers of stress in atrial fibrillation: A literature review. J Innov Card Rhythm Manag. 2023;14(2):5355–5364. https://doi.org/10.19102/icrm.2023.14025.
9. Fu Y, He W, Ma J, Wei B. Relationship between psychological factors and atrial fibrillation: A meta-analysis and systematic review. Medicine. 2020;99(16):e19615. https://doi.org/10.1097/MD.0000000000019615.
10. Whang W, Davidson KW, Conen D, Albert CM, Manson JE, Chae CU. Global psychological distress and risk of atrial fibrillation among women: The Women’s Health Study. J Am Heart Assoc. 2012;1:e001107. https://doi.org/10.1161/jAHA.112.001107.
11. Kisch AI, Reeder LG. Client evaluation of physician performance. J Health Soc Behav. 1969;10(1):51–58. https://pubmed.ncbi.nlm.nih.gov/5776948.
12. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198. https://doi.org/10.1016/0022-3956(75)90026-6.
13. MacLeod CM. Half a century of research on the Stroop effect: An integrative review. Psychol Bull. 1991;109(2):163–203. https://doi.org/10.1037/0033-2909.109.2.163.
14. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x.
15. Beck AT, Epstein N, Brown GK, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893–897. https://doi.org/10.1037/0022-006X.56.6.893.
16. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56–62. https://doi.org/10.1136/jnnp.23.1.56.
17. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–396. https://doi.org/10.2307/2136404.
18. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–483. Available at: https://www.jstor.org/stable/3765916.
19. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):192–213. https://doi.org/10.1016/0165-1781(89)90047-4.
20. Vrinceanu T, Khairy P, Roy D, Payer M, Gagnon C, Kaushal N et al. Pattern of atrial fibrillation and cognitive function in young patients with atrial fibrillation and low CHADS₂ score: Insights from the BRAIN-AF trial. Circ Arrhythm Electrophysiol. 2022;15(2):e010462. https://doi.org/10.1161/CIRCEP.121.010462.
21. Sadlonova M, Senges J, Nagel J, Celano C, Klasen-Max C, Borggrefe M et al. Symptom severity and health-related quality of life in patients with atrial fibrillation: Findings from the observational ARENA study. J Clin Med. 2022;11(4):1140. https://doi.org/10.3390/jcm11041140.
22. Thrall G, Lip GY, Carroll D, Lane D. Depression, anxiety, and quality of life in patients with atrial fibrillation. Chest. 2007;132(4):1259–1264. https://doi.org/0.1378/chest.07-0036.
23. Szymanski FM, Filipiak KJ, Karpinski G, Platek AE, Opolski G. Occurrence of poor sleep quality in atrial fibrillation patients according to the EHRA score. Acta Cardiol. 2014;69(3):291–296.https://doi.org/10.1080/ac.69.3.3027832.
24. Chokesuwattanaskul R, Thongprayoon C, Sharma K, Congrete S, Tanawuttiwat T, Cheungpasitporn W. Associations of sleep quality with incident atrial fibrillation: A meta-analysis. Intern Med J. 2018;48(8):964–972. https//doi.org/10.1111/imj.13764.
25. Ahn HJ, Lee SR, Choi EK, Bae NY, Ahn HJ, Kwon S et al. Increased risk of incident atrial fibrillation in young adults with mental disorders: A nationwide population-based study. Heart Rhythm. 2023;20(3):365–373. https://doi.org/10.1016/j.hrthm.2022.12.019.
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For citations:
Strekalova MI, Ostroumova OD, Drozdova AA, Kochetkov AI, Ebzeeva EY, Starokozheva AY, Tyazhelnikov AA. The impact of stress on cognitive functions and quality of life in young and middle-aged. Meditsinskiy sovet = Medical Council. 2026;(12):54-62. (In Russ.) https://doi.org/10.21518/ms2026-287
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