People 45 and older who have elevated stress levels have been found to be 37% more likely to have cognitive problems, including memory and thinking issues, than those who are not stressed, according to research published in the journal JAMA Network Open.

For more than a decade, the study followed 24,448 people who also are participants in a long-term, ongoing study on brain health. Periodically, the researchers used standardized testing to determine each participant’s cognitive status.

Their stress level – involving feelings or situations beyond their ability to cope – was self-assessed; about 23% of the participants reported high levels of stress.

Stress is considered a natural reaction when a person is under pressure; in the short term, it can provide positive motivation. For instance, it can push you to finish a project or to hit the brakes to avoid an accident.

Chronic stress, however, can lead to various physical and mental health problems, including anxiety, depression, headaches, heart disease, high blood pressure, sleep problems and more.

This study’s findings add cognitive problems to that list, with the researchers determining that risk for cognitive decline – also known as mild cognitive impairment, or MCI – was greater among the most stressed participants, regardless of age, race or sex.

The American Psychological Association notes that reducing stress should not only make you feel better now but also protect your health long term. How to do that varies from person to person, but the APA says it starts with determining the cause of your stress and developing a plan to address it.