Perceived stress does not have a direct effect on cognitive change over time in Black Americans, but systolic and diastolic blood pressure moderated the stress-inductive reasoning relationship in a counterintuitive direction, such that high stress combined with high BP was associated with higher inductive reasoning scores.
Key Findings
Results
Perceived stress showed no direct effect on domain-specific cognitive changes over time in Black Americans.
Study used the Baltimore Study of Black Aging-Patterns of Cognitive Aging (BSBA-PCA)
Linear regression models assessed whether perceived stress is associated with domain-specific cognitive changes over time
No direct stress effect was found across any of the five cognitive domains examined: working memory, processing speed, verbal memory, vocabulary, and inductive reasoning
The absence of direct effects was consistent across all cognitive domains at follow-up
Results
Systolic blood pressure significantly moderated the relationship between perceived stress and inductive reasoning.
F (3, 346) = 3.00, p = 0.031
Systolic BP moderation was specific to inductive reasoning and did not extend to working memory, processing speed, verbal memory, or vocabulary
The sample was drawn from the Baltimore Study of Black Aging-Patterns of Cognitive Aging
Results
Diastolic blood pressure also significantly moderated the relationship between perceived stress and inductive reasoning.
F (3, 346) = 2.63, p = 0.050
Like systolic BP, diastolic BP moderation was limited to inductive reasoning and not related to other cognitive domains
Both systolic and diastolic BP moderation effects were identified using linear regression models
Results
The interaction between stress and blood pressure on inductive reasoning was counterintuitive, with high stress and high BP associated with higher inductive reasoning scores.
Participants with high stress and high BP had high inductive reasoning scores
Participants with low stress and high BP had low inductive reasoning scores
Authors described this as a 'fragile interaction' and noted 'high stress may not be beneficial for people with high BP'
Authors concluded this counterintuitive finding 'requires further examination'
Conclusions
The study examined whether stressors may have an unforeseen protective effect on domain-specific cognitive decline specifically in Black Americans.
The study exclusively used data from Black Americans via the Baltimore Study of Black Aging-Patterns of Cognitive Aging
Authors called for 'additional research that documents whether stressors have an unforeseen protective effect on domain-specific cognitive decline in Black Americans'
The focus on domain-specific cognition rather than global cognition was identified as a methodological distinction from prior research
Few prior studies have examined BP as a moderator of the stress-cognition relationship
What This Means
This research suggests that simply feeling stressed does not directly cause cognitive decline across multiple thinking and memory skills in Black Americans. The study followed participants from the Baltimore Study of Black Aging and tested whether perceived stress was linked to changes in five areas of cognition — working memory, processing speed, verbal memory, vocabulary, and inductive reasoning (problem-solving). No straightforward connection between stress levels and cognitive decline was found in any of these areas.
However, the study found that blood pressure played a surprising role in how stress relates to one specific cognitive skill: inductive reasoning, which is the ability to identify patterns and solve problems. People who reported high stress AND had high blood pressure actually scored better on inductive reasoning tests, while those with low stress and high blood pressure scored worse. This unexpected pattern held for both the upper (systolic) and lower (diastolic) numbers in a blood pressure reading. The researchers describe this as a 'counterintuitive' and 'fragile' finding that needs more investigation.
This research matters because it highlights that the relationship between stress, blood pressure, and brain health may be more complex than previously understood — and that these relationships may look different in Black Americans, a population that has been historically underrepresented in cognitive aging research. The findings raise the possibility that certain stressors might have an unexpected protective effect on some aspects of thinking ability in this group, though the authors caution that high stress is not generally considered beneficial for people with high blood pressure and that further research is needed before drawing firm conclusions.
Byrd D, Maxfield M, Zuelsdorff M, Coon D, Thorpe R, Whitfield K. (2026). Linking perceived stress and cognitive aging: The influence of blood pressure in Black Americans.. Journal of Alzheimer's disease : JAD. https://doi.org/10.1177/13872877261440135