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Polick CS, Harris-Gersten ML, Dennis PA, Noonan D, Hastings SN, Calhoun PS, Rosemberg MA, Stoddard SA. Allostatic Load, Morbidity, and Mortality Among Older Adults: A Multi-Wave Analysis From the National Health and Aging Trends Study. J Appl Gerontol 2024; 43:1052-1059. [PMID: 38299792 PMCID: PMC11291700 DOI: 10.1177/07334648241230010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
Although allostatic load (AL) is a key concept to reflect physiologic wear and tear from stress, older adults are underrepresented in AL-related research, especially the oldest old (≥80). Further, attenuative factors are often unaccounted for. This longitudinal analysis using data from National Health and Aging Trends Study investigated relationships of AL in 2017 and multi-wave (1) comorbidity accumulation using multilevel Poisson modeling and (2) mortality risk using survival analysis. By year five (2022), each incremental AL increase that older adults (n = 3614) experienced was associated with a 47% increase in comorbidity (p < .001), and a 33% increased mortality risk (p < .001). This research supports a shift to a more proactive, health promotion/risk mitigation paradigm through informing intervention research targeting AL, which is currently scarce. Identifying potentially modifiable and key driving factors influencing the relationship between AL and health among older adults is an important next step to inform intervention design.
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Affiliation(s)
- Carri S. Polick
- Center to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Duke University School of Nursing, Durham, NC, USA
| | - Melissa L. Harris-Gersten
- Center to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Duke University School of Nursing, Durham, NC, USA
| | - Paul A. Dennis
- Center to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Devon Noonan
- Duke University School of Nursing, Durham, NC, USA
| | - Susan N. Hastings
- Center to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Patrick S. Calhoun
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Whitley E, Benzeval M, Kelly-Irving M, Kumari M. When in the lifecourse? Socioeconomic position across the lifecourse and biological health score. Ann Epidemiol 2024; 96:73-79. [PMID: 38945315 DOI: 10.1016/j.annepidem.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/14/2024] [Accepted: 06/25/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Educational attainment is associated with multiphysiological wear and tear. However, associations with measures of socioeconomic position (SEP) across different life-stages are not established. METHODS Using regression models and data from 8105 participants from the UK Household Longitudinal Study (Understanding Society), we examined associations of lifecourse SEP with an overall biological health score (BHS). BHS is broader than usual measures of biological 'wear and tear' and is based on six physiological subsystems (endocrine, metabolic, cardiovascular, inflammatory/immune, liver, and kidney), with higher scores indicating worse health. Lifecourse SEP was based on respondents' parental, first, and most recent occupations. RESULTS Associations with SEP at all life-stages demonstrated higher BHS with increasing disadvantage (e.g. slope index of inequality (SII) (95 % CI) for most recent SEP: 0.04 (0.02, 0.06)). There was little difference in the magnitude of associations for SEP measured at each life-stage. Cumulative disadvantage across the lifecourse showed a stepped association with increasing BHS (SII (95 % CI): 0.05 (0.04, 0.07)). Associations were largely driven by metabolic, cardiovascular, and inflammatory systems. CONCLUSION Our results suggest that disadvantaged SEP across the lifecourse contributes cumulatively to poorer biological health, highlighting that every life-stage should be a target for public health policies and intervention.
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Affiliation(s)
- Elise Whitley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, G3 7HR Glasgow, UK.
| | - Michaela Benzeval
- Institute for Social and Economic Research, University of Essex, Colchester CO4 3SQ, UK; School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | | | - Meena Kumari
- Institute for Social and Economic Research, University of Essex, Colchester CO4 3SQ, UK
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Beese S, Abshire DA, DeJong TL, Carbone JT. An evaluation of the All of Us Research Program database to examine cumulative stress. J Am Med Inform Assoc 2024:ocae201. [PMID: 39058629 DOI: 10.1093/jamia/ocae201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/08/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVES To evaluate the NIH All of Us Research Program database as a potential data source for studying allostatic load and stress among adults in the United States (US). MATERIALS AND METHODS We evaluated the All of Us database to determine sample size significance for original-10 allostatic load biomarkers, Allostatic Load Index-5 (ALI-5), Allostatic Load Five, and Cohen's Perceived Stress Scale (PSS). We conducted a priori, post hoc, and sensitivity power analyses to determine sample sizes for conducting null hypothesis significance tests. RESULTS The maximum number of responses available for each measure is 21 participants for the original-10 allostatic load biomarkers, 150 for the ALI-5, 22 476 for Allostatic Load Five, and n = 90 583 for the PSS. DISCUSSION The NIH All of Us Research Program is well-suited for studying allostatic load using the Allostatic Load Five and psychological stress using PSS. CONCLUSION Improving biomarker data collection in All of Us will facilitate more nuanced examinations of allostatic load among US adults.
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Affiliation(s)
- Shawna Beese
- College of Agricultural, Human, and Natural Resources Sciences, Extension, Washington State University, Pullman, WA 99164, United States
- Department of Nursing and Systems Science, College of Nursing, Washington State University, Spokane, WA 99202, United States
| | - Demetrius A Abshire
- Department of Biobehavioral Health and Nursing Science, College of Nursing, University of South Carolina, Columbia, SC 29208, United States
| | - Trey L DeJong
- Center of Interdisciplinary Statistical Education and Research (CISER), Washington State University, Pullman, WA 99164, United States
| | - Jason T Carbone
- School of Social Work, Wayne State University, Detroit, MI 48202, United States
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Migeot J, Panesso C, Duran-Aniotz C, Ávila-Rincón C, Ochoa C, Huepe D, Santamaría-García H, Miranda JJ, Escobar MJ, Pina-Escudero S, Romero-Ortuno R, Lawlor B, Ibáñez A, Lipina S. Allostasis, health, and development in Latin America. Neurosci Biobehav Rev 2024; 162:105697. [PMID: 38710422 PMCID: PMC11162912 DOI: 10.1016/j.neubiorev.2024.105697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/05/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
The lifespan is influenced by adverse childhood experiences that create predispositions to poor health outcomes. Here we propose an allostatic framework of childhood experiences and their impact on health across the lifespan, focusing on Latin American and Caribbean countries. This region is marked by significant social and health inequalities nested in environmental and social stressors, such as exposure to pollution, violence, and nutritional deficiencies, which critically influence current and later-life health outcomes. We review several manifestations across cognition, behavior, and the body, observed at the psychological (e.g., cognitive, socioemotional, and behavioral dysfunctions), brain (e.g., alteration of the development, structure, and function of the brain), and physiological levels (e.g., dysregulation of the body systems and damage to organs). To address the complexity of the interactions between environmental and health-related factors, we present an allostatic framework regarding the cumulative burden of environmental stressors on physiological systems (e.g., cardiovascular, metabolic, immune, and neuroendocrine) related to health across the life course. Lastly, we explore the relevance of this allostatic integrative approach in informing regional interventions and public policy recommendations. We also propose a research agenda, potentially providing detailed profiling and personalized care by assessing the social and environmental conditions. This framework could facilitate the delivery of evidence-based interventions and informed childhood-centered policy-making.
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Affiliation(s)
- Joaquín Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Carolina Panesso
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Cristian Ávila-Rincón
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia
| | - Carolina Ochoa
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Hernando Santamaría-García
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio Bogotá, San Ignacio, Colombia
| | - J Jaime Miranda
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - María Josefina Escobar
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Stefanie Pina-Escudero
- Global Brain Health Institute, Memory and Aging Center, University of California, San Francisco, USA
| | - Roman Romero-Ortuno
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
| | - Sebastián Lipina
- Unidad de Neurobiología Aplicada (UNA, CEMIC-CONICET), Buenos Aires, Argentina.
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Lee JH, Meyer EJ, Nenke MA, Lightman SL, Torpy DJ. Cortisol, Stress, and Disease-Bidirectional Associations; Role for Corticosteroid-Binding Globulin? J Clin Endocrinol Metab 2024:dgae412. [PMID: 38941154 DOI: 10.1210/clinem/dgae412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Indexed: 06/30/2024]
Abstract
Selye described stress as a unified neurohormonal mechanism maintaining homeostasis. Acute stress system activation is adaptive through neurocognitive, catecholaminergic, and immunomodulation mechanisms, followed by a reset via cortisol. Stress system components, the sympathoadrenomedullary system, hypothalamic-pituitary-adrenal axis, and limbic structures are implicated in many chronic diseases by establishing an altered homeostatic state, allostasis. Consequent "primary stress system disorders" were popularly accepted, with phenotypes based on conditions such as Cushing syndrome, pheochromocytoma, and adrenal insufficiency. Cardiometabolic and major depressive disorders are candidates for hypercortisolemic etiology, contrasting the "hypocortisolemic symptom triad" of stress sensitivity, chronic fatigue, and pain. However, acceptance of chronic stress etiology requires cause-and-effect associations, and practical utility such as therapeutics altering stress system function. Inherent predispositions to stress system perturbations may be relevant. Glucocorticoid receptor (GR) variants have been associated with metabolic/neuropsychological states. The SERPINA6 gene encoding corticosteroid-binding globulin (CBG), was the sole genetic factor in a single-nucleotide variation-genome-wide association study linkage study of morning plasma cortisol, a risk factor for cardiovascular disease, with alterations in tissue-specific GR-related gene expression. Studies showed genetically predicted high cortisol concentrations are associated with hypertension and anxiety, and low CBG concentrations/binding affinity, with the hypocortisolemic triad. Acquired CBG deficiency in septic shock results in 3-fold higher mortality when hydrocortisone administration produces equivocal results, consistent with CBG's role in spatiotemporal cortisol delivery. We propose some stress system disorders result from constitutional stress system variants rather than stressors themselves. Altered CBG:cortisol buffering may influence interstitial cortisol ultradian surges leading to pathological tissue effects, an example of stress system variants contributing to stress-related disorders.
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Affiliation(s)
- Jessica H Lee
- Department of Medicine, Adelaide University, Adelaide, SA 5000, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
| | - Emily Jane Meyer
- Department of Medicine, Adelaide University, Adelaide, SA 5000, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
- Endocrine and Diabetes Services, The Queen Elizabeth Hospital, Woodville South, SA 5011, Australia
| | - Marni Anne Nenke
- Department of Medicine, Adelaide University, Adelaide, SA 5000, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
- Endocrine and Diabetes Services, The Queen Elizabeth Hospital, Woodville South, SA 5011, Australia
| | - Stafford L Lightman
- Systems Neuroendocrinology Research Group, University of Bristol, Bristol, BS1 3NY, UK
| | - David J Torpy
- Department of Medicine, Adelaide University, Adelaide, SA 5000, Australia
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
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Cranshaw O, Haworth S. Neighborhood Access to the Built Environment and Allostatic Load: A Systematic Review of the Use of Geographic Information Systems. Public Health Rev 2024; 45:1606624. [PMID: 38846333 PMCID: PMC11153763 DOI: 10.3389/phrs.2024.1606624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
Objectives: This paper systematically reviews how spatial analysis has been used to measure relationships between access to the built environment and Allostatic Load (AL) or biomarkers relevant to the stress pathway. Geographic Information Systems (GIS) facilitate objective measurement of built environment access that may explain unequal health outcomes linked to living in stressful environments. Methods: Systematic review, search date 13 July 2022 with methods published a priori. Included studies that quantitatively assessed associations between GIS measures of neighborhood attributes and biomarkers of stress. Results: 23 studies from 14 countries were included having used GIS measures to assess relationships between access to the built environment and biomarkers relevant to AL, with 17 being cross-sectional and 6 longitudinal. Just 2 studies explicitly assessed associations between GIS measures and AL, but 21 explored biomarkers relevant to the stress pathway. GIS was used to calculate density (how much of x within y) and proximity (how far from a to b) measures. Conclusion: GIS measures of greenspace, the food environment, area-level demographics, and land-use measures were found to influence biomarkers relevant to the stress pathway, highlighting the utility of this approach. GIS use is extremely limited when measuring the built environment and its influence on AL but has been widely used to consider effects on individual biomarkers of stress. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=348355], identifier [CRD42022348355].
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Affiliation(s)
- Owen Cranshaw
- Institute for Social and Economic Research (ISER), University of Essex, Colchester, United Kingdom
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Feng L, Ye Z, Du Z, Pan Y, Canida T, Ke H, Liu S, Chen S, Hong LE, Kochunov P, Chen J, Lei DK, Shenassa E, Ma T. Association between allostatic load and accelerated white matter brain aging: findings from the UK Biobank. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.26.24301793. [PMID: 38343822 PMCID: PMC10854327 DOI: 10.1101/2024.01.26.24301793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
White matter (WM) brain age, a neuroimaging-derived biomarker indicating WM microstructural changes, helps predict dementia and neurodegenerative disorder risks. The cumulative effect of chronic stress on WM brain aging remains unknown. In this study, we assessed cumulative stress using a multi-system composite allostatic load (AL) index based on inflammatory, anthropometric, respiratory, lipidemia, and glucose metabolism measures, and investigated its association with WM brain age gap (BAG), computed from diffusion tensor imaging data using a machine learning model, among 22 951 European ancestries aged 40 to 69 (51.40% women) from UK Biobank. Linear regression, Mendelian randomization, along with inverse probability weighting and doubly robust methods, were used to evaluate the impact of AL on WM BAG adjusting for age, sex, socioeconomic, and lifestyle behaviors. We found increasing one AL score unit significantly increased WM BAG by 0.29 years in association analysis and by 0.33 years in Mendelian analysis. The age- and sex-stratified analysis showed consistent results among participants 45-54 and 55-64 years old, with no significant sex difference. This study demonstrated that higher chronic stress was significantly associated with accelerated brain aging, highlighting the importance of stress management in reducing dementia and neurodegenerative disease risks.
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Affiliation(s)
- Li Feng
- Department of Nutrition and Food Science, College of Agriculture & Natural Resources, University of Maryland, College Park, Maryland, United States of America
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Zhenyao Ye
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Zewen Du
- Department of Biostatistics, School of Global Public Health, New York University, New York, New York, United States of America
| | - Yezhi Pan
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Travis Canida
- Department of Mathematics, The college of Computer, Mathematical, and Natural Sciences, University of Maryland, College Park, Maryland, United States of America
| | - Hongjie Ke
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Song Liu
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, China
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - L. Elliot Hong
- Louis A. Faillace Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Peter Kochunov
- Louis A. Faillace Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Jie Chen
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - David K.Y. Lei
- Department of Nutrition and Food Science, College of Agriculture & Natural Resources, University of Maryland, College Park, Maryland, United States of America
| | - Edmond Shenassa
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
- Maternal & Child Health Program, School of Public Health, University of Maryland, College Park, Maryland, United States of America
- Department of Epidemiology, School of Public Health, Brown University, Rhode Island, United States of America
- Department of Epidemiology & Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Tianzhou Ma
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
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Jeszka J, Hummel D, Woźniewicz M, Morinaka T, Sone Y, Crews DE. Allostatic load and frailty do not covary significantly among older residents of Greater Poland. J Physiol Anthropol 2024; 43:12. [PMID: 38643177 PMCID: PMC11031922 DOI: 10.1186/s40101-024-00359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 03/28/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Physiological dysregulation/allostatic load and the geriatric syndrome frailty increase with age. As a neurophysiological response system, allostasis supports survival by limiting stressor-related damage. Frailty reflects decreased strength, endurance, and physical abilities secondary to losses of muscle and bone with age. One suggestion, based on large cohort studies of person's ages 70 + years, is that frailty contributes to allostatic load at older ages. However, small community-based research has not confirmed this specific association. METHODS To further explore possible associations between allostatic load and frailty, we enrolled 211 residents of Greater Poland aged 55-91 years living in a small village (Nekla, N = 104) and an urban center and capital of Greater Poland (Poznan, N = 107). For each, we recorded age, self-reported sex, and residence and estimated a 10-biomarker allostatic load score (ALS) and an 8-biomarker frailty index. We anticipated the following: higher ALS and frailty among men and rural residents; for frailty but not ALS to be higher at older ages; significant associations of ALS with sex and place of residence, but not with age or frailty. The significance of observed associations was evaluated by t-tests and multivariate regression. RESULTS ALS did not vary significantly between men and women nor between Nekla and Poznan residents overall. However, women showed significantly higher frailty than men. Nekla men showed significantly higher ALS but not frailty, while Nekla women showed nonsignificantly higher ALS and lower frailty than Poznan. In multivariate analyses, neither age, nor sex, nor residence was associated with ALS. Conversely, age, sex, and residence, but not ALS, are associated significantly with frailty. In Nekla, both age and sex, but in Poznan only age, are associated with ALS. Among women, both age and residence, but among men, neither associated with ALS. In no case did ALS associate significantly with frailty. CONCLUSION In this sample, lifestyle factors associated with residence, age, and sex influence stress-related physiology, less so in women, while ALS and frailty do not covary, suggesting their underlying promoters are distinct. Similar complex associations of physiological dysregulation with frailty, age, sex, and residence likely exist within many local settings. Knowledge of this variation likely will aid in supporting health and healthcare services among seniors.
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Affiliation(s)
- Jan Jeszka
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, Poznan, Poland
| | - Darian Hummel
- Department of Anthropology, The Ohio State University, Columbus, OH, USA
| | - Malgorzata Woźniewicz
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, Poznan, Poland
| | - Tomoko Morinaka
- Graduate School of Human Life Science, Osaka City University, Osaka, Japan
| | - Yoshiaki Sone
- Graduate School of Human Life Science, Osaka City University, Osaka, Japan
- Mimasaka University, Tsuyama, Okayama, Japan
| | - Douglas E Crews
- Department of Anthropology and School of Public Health, Smith Laboratory, The Ohio State University, 174 W. 18Th Avenue, Columbus, OH, 43210-1106, USA.
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Honkalampi K, Kraav SL, Kerr P, Juster RP, Virtanen M, Hintsa T, Partonen T, Lehto SM. Associations of allostatic load with sociodemographic factors, depressive symptoms, lifestyle, and health characteristics in a large general population-based sample. J Affect Disord 2024; 350:784-791. [PMID: 38266933 DOI: 10.1016/j.jad.2024.01.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE We examined the associations between allostatic load (AL) and sociodemographic factors, depressive symptoms, lifestyle and health characteristics in a population-based sample of 4993 adults in Finland. METHODS Thirteen biomarkers were used to construct AL. High AL was defined as scoring highly in ≥4 items. RESULTS AL scores of 4 and above were exceeded in the age group of 45-54 years in men and 65-74 years in women. Age was the strongest predictor for belonging to the high AL score group. In addition, elevated depressive symptoms (BDI-6 ≥ 4), male sex, not engaging in physical exercise, high alcohol use and a low level of education were associated with an increased likelihood of belonging to the high AL group. CONCLUSION The older the participants were, the greater their AL burden was. However, AL burden increased more steeply as a function of age in men. In addition to lifestyle interventions, effective prevention strategies for depression at the population level could have a major public health impact in reducing the accumulation of AL burden.
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Affiliation(s)
- Kirsi Honkalampi
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
| | - Siiri-Liisi Kraav
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Philippe Kerr
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Canada
| | - Robert-Paul Juster
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Canada
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Taina Hintsa
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; R&D Department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway; Department of Psychiatry, University of Helsinki, Helsinki, Finland
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10
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Bruun-Rasmussen NE, Napolitano G, Bojesen SE, Ellervik C, Holmager TLF, Rasmussen K, Lynge E. Correlation between allostatic load index and cumulative mortality: a register-based study of Danish municipalities. BMJ Open 2024; 14:e075697. [PMID: 38346879 PMCID: PMC10862330 DOI: 10.1136/bmjopen-2023-075697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES The aim of this study was to examine population-based allostatic load (AL) indices as an indicator of community health across 14 municipalities in Denmark. DESIGN Register-based study. SETTING Data derived from: the Lolland-Falster Health Study, the Copenhagen General Population Study and the Danish General Suburban Population Study. Nine biomarkers (systolic blood pressure, diastolic blood pressure, pulse rate, total serum cholesterol, high-density lipoprotein cholesterol, waist-to-hip ratio, triglycerides, C-reactive protein and serum albumin) were divided into high-risk and low-risk values based on clinically accepted criteria, and the AL index was defined as the average between the nine values. All-cause mortality data were obtained from Statistics Denmark. PARTICIPANTS We examined a total of 106 808 individuals aged 40-79 years. PRIMARY OUTCOME MEASURE Linear regression models were performed to investigate the association between mean AL index and cumulative mortality risk. RESULTS Mean AL index was higher in men (range 2.3-3.3) than in women (range 1.7-2.6). We found AL index to be strongly correlated with the cumulative mortality rate, correlation coefficient of 0.82. A unit increase in mean AL index corresponded to an increase in the cumulative mortality rate of 19% (95% CI 13% to 25%) for men, and 16% (95% CI 8% to 23%) for women but this difference was not statistically significant. The overall mean increase in cumulative mortality rate for both men and women was 17% (95% CI 14% to 20%). CONCLUSIONS Our findings indicate the population-based AL index to be a strong indicator of community health, and suggest identification of targets for reducing AL.
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Affiliation(s)
| | - George Napolitano
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Stig E Bojesen
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christina Ellervik
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Laboratory Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Data and Data Support, Region Zealand, Sorø, Denmark
| | | | - Knud Rasmussen
- Department of Data and Data Support, Region Zealand, Sorø, Denmark
| | - Elsebeth Lynge
- Center for Epidemiological Research, Nykøbing Falster Sygehus, Nykøbing Falster, Denmark
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11
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Neufcourt L, Castagné R, Wilsgaard T, Grimsgaard S, Chadeau-Hyam M, Vuckovic D, Ugarteche-Perez A, Farbu EH, Sandanger TM, Delpierre C, Kelly-Irving M. Educational patterning in biological health seven years apart: Findings from the Tromsø Study. Psychoneuroendocrinology 2024; 160:106670. [PMID: 37992555 DOI: 10.1016/j.psyneuen.2023.106670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Social-to-biological processes is one set of mechanisms underlying the relationship between social position and health. However, very few studies have focused on the relationship between social factors and biology at multiple time points. This work investigates the relationship between education and the dynamic changes in a composite Biological Health Score (BHS) using two time points seven years apart in a Norwegian adult population. METHODS We used data from individuals aged 30 years and above who participated in Tromsø6 (2007-2008) and Tromsø7 (2015-2016) (n = 8117). BHS was defined using ten biomarkers measured from blood samples and representing three physiological systems (cardiovascular, metabolic, inflammatory). The higher the BHS, the poorer the health status. FINDINGS Linear regression models carried out on BHS revealed a strong educational gradient at two distinct time points but also over time. People with lower educational attainment were at higher risk of poor biological health at a given time point (βlow education Tromsø6=0.30 [95 %-CI=0.18-0.43] and βlow education Tromsø7=0.30 [95 %-CI=0.17-0.42]). They also presented higher longitudinal BHS compared to people with higher education (βlow education = 0.89 [95 %-CI=0.56-1.23]). Certain biomarkers related to the cardiovascular system and the metabolic system were strongly socially distributed, even after adjustment for sex, age, health behaviours and body mass index. CONCLUSION This longitudinal analysis highlights that participants with lower education had their biological health deteriorated to a greater extent over time compared to people with higher education. Our findings provide added evidence of the biological embodiment of social position, particularly with respect to dynamic aspects for which little evidence exists.
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Affiliation(s)
- Lola Neufcourt
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France.
| | - Raphaële Castagné
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Dragana Vuckovic
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Ainhoa Ugarteche-Perez
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Erlend Hoftun Farbu
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Cyrille Delpierre
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Michelle Kelly-Irving
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
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12
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Navyte G, Gillmeister H, Kumari M. Interpersonal touch and the importance of romantic partners for older adults' neuroendocrine health. Psychoneuroendocrinology 2024; 159:106414. [PMID: 37866125 DOI: 10.1016/j.psyneuen.2023.106414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/03/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
Interpersonal touch is an essential aspect of human interaction that has the ability to regulate physiological stress responses. Prolonged exposure to stress can have cumulative multiphysiological effects; for example, allostatic load. Despite the increased susceptibility of social isolation for older adults, there is a paucity of research on the efficacy of touch in regulating stress responses among this population. It is also unknown whether touch confers benefits regardless of the person with whom it is shared. This study investigates the difference in physiological stress based on the frequency of touch (hugs, holding, or other close physical contact) shared with romantic partners as compared to other close adults (family, friends, and neighbours) in an older adult population. Data were analysed from 1419 respondents (aged 57-85 years) of the National Social Life, Health, and Aging Project (NSHAP) in 2005-2006. Principal components analysis determined whether the eight markers of allostatic load measured in the NSHAP function as a singular system or as distinct components. Analyses revealed three components of allostatic load: metabolic, cardiovascular, and neuroendocrine health. The results of multiple regression revealed that a higher frequency of interpersonal touch shared with romantic partners was associated with better neuroendocrine health (β = 0.13, p = 0.004) following adjustment for a variety of covariates (but not with better metabolic or cardiovascular health), with no associations apparent for touch from other close adults. These findings highlight the importance of promoting interpersonal touch with romantic partners for older adults' neuroendocrine health.
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Affiliation(s)
- Gabriele Navyte
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, United Kingdom; Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, United Kingdom.
| | - Helge Gillmeister
- Department of Psychology, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, United Kingdom
| | - Meena Kumari
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, United Kingdom
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13
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Hoffman KW, Tran KT, Moore TM, Gataviņš MM, Visoki E, DiDomenico GE, Schultz LM, Almasy L, Hayes MR, Daskalakis NP, Barzilay R. Allostatic load in early adolescence: gene / environment contributions and relevance for mental health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.27.23297674. [PMID: 37961462 PMCID: PMC10635214 DOI: 10.1101/2023.10.27.23297674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Allostatic load is the cumulative "wear and tear" on the body due to chronic adversity. We aimed to test poly-environmental (exposomic) and polygenic contributions to allostatic load and their combined contribution to early adolescent mental health. Methods We analyzed data on N = 5,035 diverse youth (mean age 12) from the Adolescent Brain Cognitive Development Study (ABCD). Using dimensionality reduction method, we calculated and overall allostatic load score (AL) using body mass index [BMI], waist circumference, blood pressure, blood glycemia, blood cholesterol, and salivary DHEA. Childhood exposomic risk was quantified using multi-level environmental exposures before age 11. Genetic risk was quantified using polygenic risk scores (PRS) for metabolic system susceptibility (type 2 diabetes [T2D]) and stress-related psychiatric disease (major depressive disorder [MDD]). We used linear mixed effects models to test main, additive, and interactive effects of exposomic and polygenic risk (independent variables) on AL (dependent variable). Mediation models tested the mediating role of AL on the pathway from exposomic and polygenic risk to youth mental health. Models adjusted for demographics and genetic principal components. Results We observed disparities in AL with non-Hispanic White youth having significantly lower AL compared to Hispanic and Non-Hispanic Black youth. In the diverse sample, childhood exposomic burden was associated with AL in adolescence (beta=0.25, 95%CI 0.22-0.29, P<.001). In European ancestry participants (n=2,928), polygenic risk of both T2D and depression was associated with AL (T2D-PRS beta=0.11, 95%CI 0.07-0.14, P<.001; MDD-PRS beta=0.05, 95%CI 0.02-0.09, P=.003). Both polygenic scores showed significant interaction with exposomic risk such that, with greater polygenic risk, the association between exposome and AL was stronger. AL partly mediated the pathway to youth mental health from exposomic risk and from MDD-PRS, and fully mediated the pathway from T2D-PRS. Conclusions AL can be quantified in youth using anthropometric and biological measures and is mapped to exposomic and polygenic risk. Main and interactive environmental and genetic effects support a diathesis-stress model. Findings suggest that both environmental and genetic risk be considered when modeling stress-related health conditions.
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Affiliation(s)
- Kevin W. Hoffman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, US
| | - Kate T. Tran
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Tyler M. Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Mārtiņš M. Gataviņš
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Elina Visoki
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Grace E. DiDomenico
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
| | - Laura M. Schultz
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, US
| | - Laura Almasy
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, US
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
| | - Matthew R. Hayes
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
| | - Nikolaos P. Daskalakis
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ran Barzilay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, US
- Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, Philadelphia, US
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