Reframe your mind to avoid zombie immune cells as you age!
It is now well-established that stress is linked to an increased risk of various diseases, including cardiovascular disease, hypertension, and infectious diseases.Stress has also been found to influence biological processes in the brain and body, thereby accelerating age-related diseases. Image: The Thinker (French: Le Penseur), bronze sculpture by Auguste Rodin
It is now well-established that stress is linked to an increased risk of various diseases, including cardiovascular disease, hypertension, and infectious diseases.

Stress has also been found to influence biological processes in the brain and body, thereby accelerating age-related diseases.

However, the concept of stress is not singular or straightforward. It is an emergent process that involves interactions between individual and environmental factors, historical and current events, allostatic states (chronic deviation from normal), and psychological and physiological reactivity.

The term "stress" is often used to describe a wide range of human experiences and processes, which can sometimes lead to confusion.

For instance, "stress" can refer to actual life events or situations that a person experiences, such as job loss or divorce, which are also known as "stressors" or "stressor exposures". It can also refer to the cognitive, emotional, and biological reactions that these situations evoke, known as "stress responses".

This figure shows that stressor context, cognitive factors, developmental stage, and individual differences including historical stress influence one’s physiological response to an acute stressor. From Reed et al 2023.

Different fields of study tend to focus on different aspects of stress

Economists and social epidemiologists often define stressors in terms of social or economic contexts, such as poverty or neighbourhood deprivation.

Psychologists, on the other hand, tend to focus on individual-level life events like combat exposure, divorce, physical abuse, job loss, and daily hassles.

One crucial factor often overlooked in many models of stress is cumulative stress exposure, which includes historical factors and current stress experiences.

A severe history of stressor exposures, particularly traumatic stress, especially if experienced in childhood, or being under current chronic stress greatly impacts the likelihood of being exposed to more frequent stressors and of developing maladaptive acute stress responses.

Contextual factors and cumulative stress, along with protective factors, shape how people habitually view events and respond to stressors affectively and physiologically.

Protective factors, which are typically malleable social, psychological, and behavioural traits, influence one's resilience to stress. Examples of protective factors include supportive family structures and maintaining a physically active lifestyle that allows one to withstand or bounce back from stress.

Cognitive reappraisal


Cognitive reappraisal, also known as cognitive reframing or cognitive restructuring, is a form of cognitive change that involves using cognitive and linguistic processes to reframe or reinterpret the meaning of a stimulus or situation to regulate the emotions.

Cognitive reappraisal can be an effective strategy for managing stress and has been found to have a protective effect on immune aging induced by life stressors.

Out of life's school of war—what doesn't kill me, makes me stronger.
German philosopher Friedrich Nietzsche, 1888


Stress, ageing and the immune zombie cells

The adverse effects of stress on immune health may be amplified as we age.

The immune system changes with age in ways that can result in greater morbidity and mortality.

Age-related immune changes include immunosenescence where various immune cells become non-active, “sleeping” cells. In other words, they become zombie or inactive cells in distress. The distress signals these cells transmit to other cells are associated with chronic inflammation and disease.

New research has found that cognitive reappraisal has a protective effect on immune ageing induced by life stressors.

The study involved 149 community-dwelling, non-smoking older adults (64–92 years of age).

Participants reported stressful life events, use of cognitive reappraisal, and provided blood for up to 5 years to assess aspects of immune aging.

The study examined the effects of key immune cells including natural killer (NK) cells and inflammatory markers such as interleukin-6 and tumour necrosis factor-alpha (TNF-α).

The study found that experiencing more frequent health related life stressors than usual was associated with some immune cells becoming immune senescent (not maturing properly).

Of particular importance, the study found that older adults who experienced less desirable stressors but also used more reappraisal had significantly lower proportions of these immature, senescent immune cells.

These results suggest that cognitive reappraisal may play a protective role in attenuating the effects of stressful life events on aspects of innate immune aging in older adults.

This means that the ability to reinterpret a situation in a way that changes its emotional impact (cognitive reappraisal) can help reduce the negative effects of stress on the immune system, particularly in older adults.

This means that the ability to reinterpret a situation in a way that changes its emotional impact (cognitive reappraisal) can help reduce the negative effects of stress on the immune system, particularly in older adults.

How to Engage in Cognitive Reappraisal

There are numerous ways to implement cognitive reappraisal, but the most common are listed below.

  1. Assess your automatic appraisals: Pick a challenging situation and identify the thoughts that made it seem difficult. 
  2. Identify maladaptive cognitive distortions or thinking traps. Look for common cognitive distortions such as fortune-telling, all-or-nothing thinking, or catastrophizing.
  3. Investigate your automatic appraisal from different perspectives. List the evidence for and against these appraisals. Do they prove your automatic appraisal? Find alternative explanations. Consider whether other people would interpret this case differently and why. 
  4. Develop a reapprisal. Find a new adaptive way of thinking about the situation that is grounded in facts and helps you feel empowered to face the challenge more confidently.

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References Epel ES, Crosswell AD, Mayer SE, Prather AA, Slavich GM, Puterman E, Mendes WB. More than a feeling: A unified view of stress measurement for population science. Front Neuroendocrinol. 2018 Apr;49:146-169. doi: 10.1016/j.yfrne.2018.03.001. Epub 2018 Mar 15. PMID: 29551356; PMCID: PMC6345505.


Reed, R. G., et al. (2023). "Life stressors and immune aging: Protective effects of cognitive reappraisal." Brain, Behavior, and Immunity 110: 212-22.

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