Center to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA.
Duke University School of Nursing, Durham, NC, USA.
J Appl Gerontol. 2024 Aug;43(8):1052-1059. doi: 10.1177/07334648241230010. Epub 2024 Feb 1.
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 ( = 3614) experienced was associated with a 47% increase in comorbidity ( < .001), and a 33% increased mortality risk ( < .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.
尽管应激引起的机体适应性负荷（allostatic load，AL）是反映生理损耗的一个关键概念，但老年人在与 AL 相关的研究中代表性不足，尤其是最年长的老年人（≥80 岁）。此外，衰减因素通常未被考虑在内。本研究使用来自美国国家健康老龄化趋势研究的数据进行了纵向分析，通过多层次泊松模型研究了 2017 年 AL 与多波（1）共病累积的关系，以及通过生存分析研究了（2）死亡率风险。到第五年（2022 年），每位老年参与者（n=3614）经历的每一次 AL 递增与共病增加 47%相关（<0.001），且死亡风险增加 33%（<0.001）。这项研究支持通过针对 AL 的干预研究，从被动的疾病治疗模式向更积极主动的健康促进/风险缓解模式转变，而目前针对 AL 的干预研究还很少。确定影响老年人 AL 与健康之间关系的潜在可改变和关键驱动因素，是为干预设计提供信息的重要下一步。
