Figure 2.

Biobehavioral mechanisms linking interpersonal losses to poorer cognitive outcomes.

A. Spousal caregivers and widow(er)s face caregiving/bereavement-related stressors on top of typical life stressors. B. Chronic stress dysregulates biological stress pathways, whose mediators (i.e., glucocorticoids, cytokines, epinephrine, norepinephrine) feedback to the brain to impact neurobiology, neurocognitive function, mood, affect, and stress appraisal. C. Prolonged dysregulation of biological stress pathways and stress-induced changes in the brain can contribute to abnormal cognitive decline. D. Individual differences in risk exist: caregivers and widow(er)s with multiple Alzheimer’s disease and related dementias (ADRD) risk factors and who adopt maladaptive coping mechanisms may be more likely to develop dementia than individuals with fewer ADRD risk factors and who adopt adaptive coping mechanisms.