Allostatic Load Score Research Articles

Association between allostatic load and accelerated white matter brain aging: findings from the UK biobank.

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 0.29years in association analysis and by 0.33years in Mendelian analysis. The age- and sex-stratified analysis showed consistent results among participants 45-54 and 55-64years 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.

Combined Effects of Environmental Metals and Physiological Stress on Lipid Dysregulation.

Cardiovascular diseases (CVD) are a leading cause of mortality worldwide, influenced by genetic, environmental, and behavioral factors. This study examines the relationship between heavy metal exposure, chronic physiological stress (allostatic load), and lipid profiles, which are markers of CVD risk, using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. We utilized structural equation modeling (SEM) to explore the associations between blood levels of lead, cadmium, allostatic load (AL), and lipid measures (low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides). The AL index was derived from cardiovascular, inflammatory, and metabolic biomarkers and categorized into quartiles to identify high-risk individuals, with an index out of 10 subsequently developed. The SEM analysis revealed that both heavy metal exposure and allostatic load are significantly associated with lipid profiles. Higher levels of lead and cadmium were associated with increased LDL and triglycerides, while higher AL scores were linked to increased LDL and triglycerides and decreased HDL levels. Age was also a significant factor, showing positive correlations with LDL and triglycerides, and a negative correlation with HDL. This study underscores the multifactorial nature of CVD, highlighting the combined impact of environmental pollutants and physiological stress on lipid dysregulation. These findings suggest the need for integrated public health strategies that address both environmental exposures and chronic stress to mitigate cardiovascular risk. Further research is warranted to explore the underlying mechanisms and develop targeted interventions.

Clinical and allostatic load scores across bmi categories and fat mass strata: Insights from the adult lead cohort

Clinical and allostatic load scores across bmi categories and fat mass strata: Insights from the adult lead cohort

Abstract A088: Examining associations between objective and perceived stress and allostatic load in African American prostate cancer survivors

Abstract Background. Racial disparities in prostate cancer survivorship persist despite clinical advancements. Stress has been implicated as a potential driver of these disparities, with both chronic and perceived stress found to be associated with adverse cancer survivorship. Allostatic load (AL), one such marker of chronic stress, has been associated with decreased survivorship and worse quality of life (QoL) in cancer survivors. Perceived stress has also been associated with outcomes in cancer survivorship including increased symptom burden and worse quality of life. Despite this, few studies incorporate direct measures of stress or examine how these measures contribute to AL This study examines the relationship between AL, objective stress (as measured by occurrence of stressful life events), and self-reported perceived stress in a subset of African American prostate cancer survivors (N=59) enrolled in Men Moving Forward, a randomized trial to improve body composition through lifestyle change. Methods. At baseline, participants completed an adapted version of the Crisis in the Family Systems (CRISYS) survey, an instrument designed to measure recent (past 4 months) contemporary life stressors. The survey was tailored for AAPCS via feedback from the community advisory board. 41 items reflective of 11 domains were included. Overall CRISYS scores and scores by domain were calculated. Feelings of perceived stress in the past month were measured via the 10-item perceived stress scale, with higher scores reflecting higher perceived stress. AL scores used 15 criterion reflecting neuroendocrine, cardiovascular, immune, and metabolic systems. Each criterion was assigned a score of 0 or 1: 1 if in the high-risk range based on clinical guidelines. An index score was generated by summing high-risk indicators. Pearson correlations were used to explore the relationship between stress measures. Logistic regression comparing the those with highest quartile AL to lower AL was also performed. Results. The mean AL score was 5.6 (SD ± 2.4) of a maximum score of 15. The mean summative score for CRISYS was 4.8 (SD ± 3.3). The most common domains of stress experienced were safety in the community (67%), relationships (66%), and medical issues of loved ones (44%). The Mean PSS was 11.5 (SD ± 6.0), with 64% of men reporting low stress and 36% moderate stress levels. Significant correlations were found between CRISYS and PSS, however no correlations with AL were detected. No significant findings were identified in the regression analysis. Conclusions. Objective and perceived stress measures were correlated, but no associations were found between the perceived or objective stress measure and AL in this sample.. Given AL is meant to reflect the physiological impact of cumulative and chronic stress burdens, it is possible that the shorter-term context of the objective (past 4 months) and perceived stress (past month) measures were not sufficiently aligned with the longer-term context of AL. Citation Format: Iwalola Awoyinka, Deepak Kilari, Kathryn Bylow, Jennifer Knight, Alexis Visotcky, Anjishnu Banerjee, Patricia Sheean, Paula Papanek, Melinda Stolley. Examining associations between objective and perceived stress and allostatic load in African American prostate cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A088.

Abstract PR011: Investigating the interplay among allostatic load, social determinants of health, and treatment outcomes in chronic myeloid leukemia patients

Abstract Introduction. The advent of tyrosine kinase inhibitors (TKIs) has transformed chronic myeloid leukemia (CML) into a chronic condition, allowing many patients (pts) to achieve survival rates comparable to the general population. Yet, most pts patients require lifelong therapy, regular follow-up, and management of TKI side effects, posing challenges within the healthcare system alongside structural and financial barriers. We have previously found that CML pts with an allostatic load (AL) burden indicating cumulative stress, experience worse treatment outcomes. In light of this, we investigated whether AL is a biological indicator of social determinants of health (SDH) and its correlation with CML treatment outcomes. Methods. We conducted a single-institution retrospective study, enrolling CML pts and assessing 23 biomarkers across four domains (cardiovascular, metabolic, immunologic, and neuroendocrine) required to calculate the AL score at the time of the first visit. Pts were sorted into low and high AL groups using the cohort's median score of 5 as the threshold. SDH was evaluated at both individual and population levels by integrating data from medical records with the SDH database from the Agency for Healthcare Research and Quality. Statistical analyses, including chi-square and Fisher’s exact tests, were conducted with significance set at p<0.05. Results. Between 2003 and 2023, data from 108 CML pts undergoing first-line treatment were retrieved. Pts with high AL were more likely to be older (mean age 53.8 vs. 47.2 years, p=0.03), and a greater proportion were identified as Black compared to those in the low AL cohort (25.5% vs. 12.3%, p=0.01). We identified an association between high AL and overall mortality (13.7% vs. 1.8%, p=0.02), with effects trending towards a higher risk of CML-specific death (6.4% vs. 0, p=0.05). Higher AL was correlated with adverse SDH, such as reliance on public health insurance (32% vs. 52.2%, p=0.04), living alone (67.7% vs. 86.8%, p=0.05), and lack of regular exercise (38.9% vs. 7.4%, p=0.01). Geographic inequality was identified, as patients with high AL were more likely to reside in Georgia (GA) compared to South Carolina and other states (66.7% vs. 27.5% vs. 5.9%, p=0.01). Indeed, pts in GA who traveled shorter distances to the treatment facility and resided in areas with higher particulate matter levels, as an indicator of air pollution, were less likely to achieve major molecular response (p=0.011 and p=0.008, respectively). SDH such as regular exercise, home environment, and health insurance were associated with overall and CML-specific survival. However, birth country, language, household income, and education, were not associated with either AL or treatment outcomes. Conclusion. Adverse SDH significantly amplifies the burden of AL, serving as a comprehensive indicator of chronic stress, health behaviors, and environmental conditions. Our findings highlight the intricate interplay between social, economic, and environmental factors in shaping treatment outcomes among CML patients. Citation Format: Marisol Miranda-Galvis, Muhannad Sharara, Kellen C. Tjioe, McKenzie Maloney Maloney, Vamsi Kota, Anand Jillella, Locke Bryan, Amany R. Keruakous, Jorge E. Cortes. Investigating the interplay among allostatic load, social determinants of health, and treatment outcomes in chronic myeloid leukemia patients [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr PR011.

Accelerated Phenotypic Aging Associated With Hepatitis C Infection: Results From the U.S. National Health and Nutrition Examination Surveys 2015-2018.

Chronic hepatitis C virus (HCV) infection is associated with early onset of chronic diseases and increased risk of chronic disorders. Chronic viral infections have been linked to accelerated biological aging based on epigenetic clocks. In this study, we aimed to investigate the association between HCV infection and clinical measures of biological aging among 8 306 adults participating in the 2015-2018 waves of the National Health and Nutrition Examination Survey (NHANES). NHANES 2015-2018 participants aged 20 years and older who had complete data on clinical blood markers and HCV-related tests were included in the current study. We estimated biological age using 2 approaches including phenotypic age (PhenoAge) and allostatic load (AL) score based on 9 clinical biomarkers. After adjusting for demographic and other confounding factors, HCV antibody-positivity was associated with advanced PhenoAge (β = 2.43, 95% confidence interval: 1.51-3.35), compared with HCV antibody-negativity. Additionally, both active HCV infection (HCV RNA (+)) and resolved infection were associated with greater PhenoAge acceleration. The positive association with the AL score was not statistically significant. We did not observe any significant interactions of potential effect modifiers, including smoking and use of drug/needle injection, with HCV infection on measures of biological aging. Our findings suggest that HCV infection is independently associated with biological aging measured by phenotypic age in the U.S. general population. Further studies are warranted to confirm the findings.

Allostatic load and cognitive recall among young adults: Racial, ethnic, and sex-specific variations

Abstract Introduction: While factors such as age and education have been associated with persistent differences in functional cognitive decline, they do not fully explain observed variations particularly those between different racial/ethnic and sex groups. The aim of this study was to explore the association between allostatic load (AL) and cognition in a racially diverse cohort of young adults. Methods: Utilizing Wave V of the National Longitudinal Study of Adolescent to Adult Health – a nationally representative, longitudinal survey of adults aged 34–44, this study utilized primary data from 10 immune, cardiovascular, and metabolic biomarkers to derive an AL Index. Cognition was previously recorded through word and number recall scores. Regression analysis evaluated the association between cognitive recall, AL, age, sex, and race/ethnicity. Results: Regression results indicated statistically higher AL scores among Blacks (IRR = 1.09, CI = 1.01, 1.19) compared to Whites and lower AL score among females compared to males (IRR = 0.76, CI = 0.72, 0.81). At zero AL, Blacks (IRR = 1.2399, CI = 1.2398, 1.24) and Other races (IRR = 1.4523, CI = 1.452, 1.4525) had higher recall while Hispanics (IRR = 0.808, CI = 0.8079, 0.8081) had lower recall compared to Whites. Relative to males, females had higher number recall (IRR = 1.1976, CI = 1.1976, 1.1977). However, at higher, positive levels of AL, Blacks (IRR = 0.9554, CI = 0.9553, 0.9554), Other races (IRR = 0.9479, CI = 0.9479, 0.9479) and females (IRR = 0.9655, CI = 0.9655, 0.9655) had significantly lower number recall than Whites and males respectively. Conclusions: Race and sex differences were observed in recall at different levels of AL. Findings demonstrate the need for further exploration of cognition in young adults across diverse populations that includes examination of AL.

Allostatic Load, Genetic Susceptibility, Incidence Risk, and All-cause Mortality of Colorectal Cancer.

Allostatic load (AL) reflects the cumulative burden of chronic stress throughout life, potentially influencing the onset and prognosis of cancer. However, the associations between AL, colorectal cancer (CRC) risk and all-cause mortality in patients with CRC remain unclear. We analyzed the association between AL and CRC risk in 304,959 adults and all-cause mortality in 1,794 patients with CRC from the UK Biobank, using Cox proportional hazards regression models. Compared to the AL level in the first quartile, individuals in the second to fourth quartiles had a respective 20%, 29%, and 43% increased risk of CRC; 15%, 24%, and 42% increased risk for colon cancer; and 30%, 38%, and 45% increased risk for rectal cancer. We identified a positive dose-gradient association of AL score with CRC risk, including colon and rectal cancer. Additionally, the association between AL and increased risk of CRC was observed across different strata of genetic susceptibility for CRC. Eliminating AL exposures could prevent nearly 39.24% (95% CI: 36.16-42.32) of CRC incident cases. Meanwhile, a significant association between the AL and all-cause mortality in patients with CRC was found, with a HR of 1.71 (95% CI: 1.16-2.50) for the fourth quartile compared to the AL score in the first quartile, demonstrating a positive dose-response relationship. High AL was associated with increased CRC risk and all-cause mortality in CRC patients. Future research should prioritize the development of cognitive or behavioral intervention strategies to mitigate the adverse effects of AL on CRC incidence and prognosis.

Relationship Between Glaucoma and Chronic Stress Quantified by Allostatic Load Score in the All of Us Research Program

PurposeTo assess the relationship between glaucoma and allostatic load (AL), an established framework for quantifying the physiologic effects of chronic stress through measurements of systemic biomarkers. DesignRetrospective case-control study. MethodsParticipants of the National Institutes of Health All of Us (AoU) Research Program with complete AL biomarker data between December 1984 to June 2022 and with (cases) or without (controls) primary glaucoma were identified. AL scores were calculated using the adapted Seeman AL scale consisting of 10 systemic biomarkers: body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, glomerular filtration rate, albumin, C-reactive protein, and homocysteine. AL score was defined as the number of biomarkers with measurements in the highest risk quartiles. Age was calculated as the median age at time of biomarker measurements. Logistic regression analysis was performed to assess the association between the earliest possible AL score and glaucoma adjusted for race/ethnicity. Mediation analysis was performed to estimate the relationship between race/ethnicity and glaucoma mediated by AL score. ResultsThe study cohort consisted of 349 (16.1%) cases and 1,819 (83.9%) controls with 52.7% females, 2.2% Asians, 10.7% Blacks, 10.0% Hispanics, and 72.5% non-Hispanic Whites. At the earliest timepoint (median [IQR] = 6.4 [1.9-12.2] years prior to diagnosis), cases had higher AL score than controls (3 [1-4] versus 2 [1-3], respectively; p<0.001). On multivariable analysis, higher AL score (OR=1.09 per point), Black race (OR=2.58), and Hispanic ethnicity (OR=2.12) conferred higher risk of glaucoma (p≤0.02). AL score partially mediated higher glaucoma risk among Blacks (7.5%) and Hispanics (5.0%) compared to non-Hispanic Whites. On subgroup analysis, higher AL score was significantly associated with primary open angle glaucoma (POAG; OR=1.11; p=0.01) but not primary angle closure glaucoma (PACG; p=0.87). ConclusionAoU participants with glaucoma had greater AL 6.4 years prior to diagnosis, and AL score partially mediated racial/ethnic differences in glaucoma risk. These findings suggest chronic stress may increase risk for glaucoma and contribute to racial disparities in glaucoma burden.

Allostatic load in rat model: An efficient tool for evaluating and understanding aging.

Aging and age-related diseases are an ever-increasing social and public health problem. Allostatic load (AL) shows great potential as an interdisciplinary tool for assessing the aging of human beings but as yet lacks investigation in animal models which is our study focus at. Here a continuous study of AL was conducted on naturally aging rats. Blood samples were collected from the rats at ages of 5, 8, 14, 18, and 21 months. Dozens of blood biochemical indicators, including serum corticosterone, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, interleukin-6, 25-hydroxyvitamin D, free fatty acid, CD3+ T cell count, CD4+/CD3+ T cell ratio, CD8+/CD3+ T cell ratio, and CD3/4/8+ T cell apoptosis, were determined. AL was scored from those indicators, and we found that AL score gradually increased with age. AL can reliably reveal the cumulative and systemic changes in aging. Geriatr Gerontol Int 2024; 24: 1077-1084.

Association Between Uveal Melanoma and Allostatic Load.

Allostatic load (AL) is a measure of chronic stress that is associated with worse cancer outcomes. The purpose of this retrospective cohort study was to investigate the relationship between AL and uveal melanoma (UM) clinical features. AL score was calculated as a composite of ten biomarkers in 111 patients with UM from the University of Illinois Hospital. One point was assigned to an AL score for each biomarker based on predetermined cutoff values. Linear and logistic regression analyses evaluated the relationship between AL score and several tumor clinical characteristics. High AL score had a significant relationship with extraocular extension (p=0.015). There was also a significant difference in mean blood glucose levels between the different tumor size groups (p=0.029). Higher AL scores also had a trend of being associated with a smaller tumor size (p=0.069). AL score was significantly associated with the presence of extraocular extension for uveal melanoma, while the smallest tumor size group was associated with the highest blood glucose level. No other significant correlations were found between AL and other clinical features of UM. The relationship between AL score and extraocular extension warrants further investigation. Additional research is needed to evaluate socioeconomic factors and their effect on the relationship between chronic stress and the clinical features of UM.

Cognitive performance in young adult women with a history of premature adrenarche.

Girls with premature adrenarche (PA) mature earlier than peers and have been found to have greater symptom accounts reflecting anxiety compared to peers. It is not known, however, whether PA effects cognitive development. This longitudinal case-control cohort study aimed: (1) To investigate whether a history of PA leads to measurable changes in adulthood cognitive performance, and (2) to assess whether findings characteristic of PA girls predict adulthood cognitive performance. Twenty-seven girls with PA and 27 age-matched control girls were examined and followed from mid-childhood (mean age 7.2 years) until early adult age (18.5 years). Wechsler Adult Intelligence Scale, Fourth Edition scores were used as main outcome measure. Allostatic load (AL) scores, which compile multisystem variables to reflect the overall wear and tear of the body from increased and prolonged stress, were higher in the PA group in both prepuberty and adulthood, but there were no differences in WAIS-IV results between the groups (full-scale IQ 92.7 vs. 97.5, p 0.376; no differences in separate indexes). Childhood androgen levels, glucose metabolism biomarkers, and AL scores failed to predict adulthood cognitive performance outcomes. The study suggests that PA does not predispose to adverse adulthood outcomes of cognitive development. The study suggests that a history of premature adrenarche (PA) does not affect cognitive performance in adult age. Childhood androgen levels and biomarkers of glucose metabolism failed to predict adulthood cognitive outcomes in this study. Allostatic load scores were elevated in the PA group both in childhood and adulthood but did not predict adulthood cognitive outcomes.

Association between Neighborhood Stressors and Allostatic Load in Breast Cancer Survivors: The Pathways Study.

Allostatic load (AL) is an intermediary outcome through which neighborhood drivers of health may impact cancer survivorship outcomes. We examined associations of neighborhood stressors and AL in 2,553 women with breast cancer recruited into the Pathways Study in 2006-2013. AL score was derived from biomarkers in the cardiovascular, metabolic, and immune domains of physiological stress measured within 3 years after baseline. Neighborhood data were appended to participants' geocoded baseline addresses. Odds ratios (OR) and 95% confidence intervals (CI) were used to estimate associations between neighborhood stressors and risk of higher AL score. Adjusting for age and stage, high AL was positively associated with low versus high neighborhood socioeconomic status (nSES; OR=2.24, 95% CI=1.61-3.12) and green space (OR=1.55, 95% CI=1.18-2.03); high versus low traffic (OR=1.32, 95% CI=1.01-1.72), crime (OR=1.32, 95% CI=1.05-1.67), and household crowding (OR=1.57, 95% CI=1.22-2.01); and more versus no fast-food restaurants (OR=1.50, 95% CI=1.21-1.84). Associations remained for nSES and fast-food restaurants after co-adjustment with other neighborhood stressors, and for fast-food restaurants after additional adjustment with individual sociodemographic and lifestyle factors. Our preliminary findings can inform further studies of the physiological effects of neighborhood stressors, which collectively may help improve survivorship outcomes for the growing population of breast cancer survivors.

Associations between allostatic load and hepatic steatosis and liver fibrosis: evidence from NHANES 2017–2020

BackgroundAllostatic load, the cumulative strain resulting from chronic stress responses, has been linked to disease occurrence and progression, yet research quantifying this relationship is limited. This study aimed to explore the relationship between allostatic load score (ALS) levels and the degree of hepatic steatosis and fibrosis.MethodsData from the National Health and Nutrition Examination Survey 2017–2020 were analyzed. The ALS was based on the statistical distribution, assigning one point for each biomarker if it was in the highest risk quartile, and then summing them to generate the ALS score (range, 0–8). The multivariate linear regression was employed to analyze the association between the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) with ALS. Additionally, multinomial logistic regression was used to investigate the association between ALS and the degree of hepatic steatosis and fibrosis.ResultsParticipants had a weighted mean age of 52.69 years and 56.14% were female. In the multivariate linear regression analysis, ALS showed a significant positive correlation with CAP (β = 15.56, 95% CI: 14.50–16.62) and LSM (β = 0.58, 95% CI: 0.48–0.67). Age, healthy dietary level, and PIR had significant interactions with this positive correlation. In the multinomial logistic regression analysis, ALS exhibited a significant positive correlation with different degrees of hepatic steatosis and fibrosis. Consistency of the results was observed in sensitivity analyses using clinical thresholds of ALS.ConclusionsComprehensive clinical assessment targeting load adaptation may enhance the effectiveness of risk assessment in patients with hepatic steatosis and fibrosis.

Association of social determinants of health (SDH), allostatic load (AL) and incident cancers in the multi-ethnic study of atherosclerosis (MESA).

10562 Background: AL may represent accumulated physiologic stress from adverse SDH. We assess the relationship of AL and incident cancer risk in MESA, a cohort free of cardiovascular disease (CVD) at baseline. Methods: MESA participants at Exam 1 (July 2000-August 2002) were included, except those with prevalent cancers other than non-melanoma skin, median follow-up, 16.5 years. We assigned the composite AL measure 1 point for each individual biomarker in the worst quartile for total cholesterol, high density lipoprotein cholesterol, C-reactive protein, and IL-6. One point each was assigned for BMI&gt;25 or &lt;18kg/m2; creatinine&gt;1.2mg/dL (women) or &gt;1.4mg/dL(men), systolic (≥140mmHg), diastolic (≥90mmHg) blood pressure; heart rate&gt;100bpm; coronary artery calcium score&gt;0 and history of diabetes. AL score (mean=3.09, SD=1.76) ranged 0-12. Other covariates included sociodemographic variables. Where missing, data for individual biomarkers were imputed using Multivariate Imputation by Chained Equations in R prior to calculating AL score. Cox regression models assessed AL in the whole population and stratified by race/ethnicity. Results: 6808 participants comprised the analytic sample; 1022 (15%) were diagnosed with new cancer during follow-up. Chinese (adjusted hazard ratio [aHR], 95% confidence interval [95%CI], 0.46,0.36-0.60) and Hispanic/Latino (aHR,95%CI 0.60,0.50-0.72) participants were less likely to develop new cancers compared with White participants. Each AL point increase was associated with increased new cancer risk (aHR,95%CI 1.07,1.03-1.11). In models stratified by race/ethnicity, AL association with new cancer risk persisted only for Black (aHR,95%CI 1.07, 1.00-1.14, p=0.04) and Hispanic/Latino (aHR,95%CI 1.17, 1.07-1.28, p=0.001) participants. Conclusions: AL as a composite measure of physiologic stress and self-reported Chinese and Hispanic/Latino race/ethnicity independently correlated with incident cancer risk in a cohort free of CVD at baseline. Race/ethnicity may moderate the effects of AL. [Table: see text]

Associations of Allostatic Load with Level of and Change in Cognitive Function Among Middle-Aged and Older Hispanic/Latino Adults: The Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA).

Higher allostatic load (AL), a multi-system measure of physiological dysregulation considered a proxy for chronic stress exposure, is associated with poorer global cognition (GC) in older non-Hispanic white adults. However, evidence of these associations in middle-aged and older US-based Hispanic/Latino adults is limited. To examine associations of AL with level of cognition, performance in cognition 7 years later, and change in cognition over 7 years among middle-aged and older US-based Hispanic/Latino adults. We used data (n = 5,799, 45-74 years at baseline) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL-Investigation of Neurocognitive Aging (SOL-INCA). The AL score comprised 16 biomarkers representing cardiometabolic, glucose, cardiopulmonary, parasympathetic, and inflammatory systems (higher scores = greater dysregulation). Cognitive outcomes included GC and individual tests of verbal learning and memory, world fluency (WF), Digit Symbol Substitution (DSS), and Trail Making (Parts A & B). Survey-linear regressions assessed associations of AL with performance in cognition at baseline, 7 years later, and via 7-year cognitive change scores adjusting for sociodemographic characteristics, lifestyle factors, and depressive symptoms. Higher AL was associated with lower baseline performance in GC and WF; and lower 7-year follow-up performance in these same measures plus DSS and Trail Making Parts A & B. Higher AL was associated with more pronounced 7-year change (reduction) in GC and on WF and DSS tests. Findings extend previous evidence in predominantly older non-Hispanic white cohorts to show that AL is related to level of and change in GC (as well as WF and DSS) among middle-aged and older US-based Hispanic/Latino adults.

Harmonizing the assessment of allostatic load across cycles of the Canadian Health Measures Survey: Variable selection and calculation method.

The availability of measures to operationalize allostatic load - the cumulative toll on the body of responding to stressor demands - in population health surveys may differ across years or surveys, hampering analyses on the entire sampled population. Here, impacts of variable selection and calculation method were evaluated to generate an allostatic load index applicable across all cycles of the Canadian Health Measures Survey (CHMS). Data from CHMS cycles 1 to 4 were used to compare allostatic load scores when replacing the most prevalent risk factor, waist-to-hip ratio - available in cycles 1 to 4 but not 5 and 6 - with body mass index (BMI), waist circumference, waist circumference within BMI groups (classified as normal, overweight, or obese), or waist-to-height ratio. Indexes were generated using clinical or sex-specific empirically defined risk thresholds and as count-based or continuous scores. Logistic regression models that included age and sex were used to relate each potential index to socioeconomic indicators (educational attainment, household income). Of the variables assessed, waist-to-height ratio and waist circumference were closest to waist-to-hip ratio according to an individual's percentile ranking and in classifying "at risk" using either clinical or empirically defined cut-offs. Allostatic load profiles generated using waist-to-height ratios most closely resembled profiles constructed using waist-to-hip ratios. Sex-dependent associations with educational attainment and household income were maintained across constructs whether indexes were count-based or continuous. Allostatic load profiles and associations with socioeconomic indicators were robust to variable substitution and method of calculation, supporting the use of a harmonized index across survey cycles to assess the cumulative toll on health of stressor exposure.

Income Inequality, Gender Disparities, and Ethnic Differences: Investigating Allostatic Load in American Adults.

To estimate the association between income inequality and allostatic load score (AL) in adults ages 20 years and older, with a particular focus on the differential impacts across racial and gender groups. By examining this association, the study seeks to inform targeted policy interventions to mitigate health disparities exacerbated by economic inequality. Utilizing data from the 1999-2016 National Health and Nutrition Examination Survey (NHANES), we assessed AL through eight biomarkers: systolic blood pressure (mm Hg), diastolic blood pressure (mm Hg), pulse rate (beats/min), body mass index (kg/m2), glycohemoglobin (%), direct HDL cholesterol (mg/dL), total cholesterol (mg/dL), and serum albumin (g/dL). Employing negative binomial regression (NBRG), we estimated incidence rate ratios (IRR) for a sample comprising 7367 men and 7814 women, adjusting for age, race/ethnicity, marital status, education, health insurance, comorbidity, and mental health professional utilization. Gini coefficients (GC) were calculated to assess income inequality among men and women. Findings revealed that men exhibited a higher poverty-to-income ratio (PIR) compared to women (3.12 vs. 2.86, p < 0.01). Yet, women experienced higher rates of elevated AL (AL > 4) (31.8% vs. 29.0%) and were more adversely affected by income inequality (GC: 0.280 vs. 0.333). NBRG results indicated that high PIR individuals had a lower IRR (0.96; CI:0.92-0.95) compared to their low PIR counterparts, a trend observed in women but not men. High PIR was notably protective among White non-Hispanic (WNH) men and women. Additionally, vigorous and moderate physical activity engagement was associated with lower AL (IRR: 0.89, CI: 0.85-0.93). The study emphasizes the importance of implementing policies that target AL in low-income populations across all racial groups, with a specific focus on Black non-Hispanic (BNH) and Hispanic communities. By prioritizing these groups, policies can more effectively target the nexus of income inequality, health disparities, and allostatic load, contributing to the reduction of health inequities.

The physiological toll of arrests: An examination of arrest history on midlife allostatic load

PurposeTo understand how allostatic load – cumulative physiologic burden of stress – varies by amount and timing of arrests stratified by race/ethnicity and by sex. MethodsUsing The National Longitudinal Study of Adolescent to Adult Health, we calculated descriptive statistics and mean differences in bio-marker measured allostatic load by arrest history stratified by race/ethnicity and sex. ResultsOne-third of participants experienced at least one arrest, and most experienced arrests only as adults. Allostatic load scores were higher for those that had ever experienced an arrest compared to never (mean difference: 0.58 (0.33, 0.84)). Similar results held for men and women and across race/ethnicity, but Black non-Hispanic individuals had higher allostatic load at all levels compared to other individuals. ConclusionsExperiencing both any arrest and multiple arrests were associated with higher allostatic load. The stress of arrests may contribute to physiological maladaptations and poor health. The public health and law enforcement fields must recognize the detrimental consequences of arrests on physiological stress and search for non-carceral solutions.

Allostatic load and frailty do not covary significantly among older residents of Greater Poland

BackgroundPhysiological 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.MethodsTo 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.ResultsALS 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.ConclusionIn 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.