Stress, Hypertension and Inflexible Thinking Patterns: Associations with Mood and Physiological Functioning among Older Adults

Abstract

Older adulthood involves changes in psychological and physical functioning that may affect how individuals respond to stress and health problems. This study investigated the links between perceived stress, cognitive inflexibility, depressive and anxiety symptoms, and cardiovascular indicators among community-dwelling adults aged 60 years and above. Using a cross-sectional correlational design, data were collected from 250 older adults, whose mean age was approximately 67 years. Participants completed standardized measures of perceived stress, cognitive inflexibility, depression, and anxiety. Systolic and diastolic blood pressure and pulse rate were also recorded. The data were examined using descriptive statistics, Pearson correlations, hierarchical multiple regression, and moderation analysis. Higher perceived stress was associated with greater depression (r = .58, p < .01) and anxiety (r = .61, p < .01). Stress was also related to higher systolic (r = .29, p < .01) and diastolic blood pressure (r = .25, p < .01). Cognitive inflexibility showed significant associations with both depression (r = .49, p < .01) and anxiety (r = .43, p < .01). Participants with hypertension reported higher stress, cognitive inflexibility, depression, and anxiety than those with normal blood pressure (all p < .001). Hierarchical regression showed that perceived stress contributed an additional 21% to the explained variance in depression, followed by a further 6% contributed by cognitive inflexibility. The complete model accounted for 36% of the variance in depressive symptoms (adjusted R² = .35, p < .001). A significant interaction between stress and cognitive inflexibility was also observed (B = .09, p = .003). Specifically, the association between perceived stress and depression became stronger as cognitive inflexibility increased. These findings indicate that psychological distress, inflexible patterns of responding, and cardiovascular health are related in later life. Assessment and management of stress and cognitive inflexibility may therefore be useful alongside routine care for hypertension in older adults.