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Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging
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Allostatic load (AL) has been proposed as a new conceptualization of cumulative biological burden exacted on the body through attempts to adapt to life's demands. Using a multisystem summary measure of AL, we evaluated its capacity to predict four categories of health outcomes, 7 years after a baseline survey of 1,189 men and women age 70–79. Higher baseline AL scores were associated with significantly increased risk for 7-year mortality as well as declines in cognitive and physical functioning and were marginally associated with incident cardiovascular disease events, independent of standard socio-demographic characteristics and baseline health status. The summary AL measure was based on 10 parameters of biological functioning, four of which are primary mediators in the cascade from perceived challenges to downstream health outcomes. Six of the components are secondary mediators reflecting primarily components of the metabolic syndrome (syndrome X). AL was a better predictor of mortality and decline in physical functioning than either the syndrome X or primary mediator components alone. The findings support the concept of AL as a measure of cumulative biological burden.
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“Fortunately, although diagnosable disease does not occur until later in life, there are several reliable indices of early damage to regulatory systems, allostatic load (Hwang et al., 2014; Robertson et al., 2017; Seeman et al., 2001), and cellular aging such as inflammation, telomere length, and epigenetic clock (Chen et al., 2016; Codd et al., 2013; Emerging Risk Factors Collaboration et al., 201”
From More than a feeling: A unified view of stress measurement for population science (2018) · cites this paper as Seeman et al., 2001
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“There is also wealth of evidence establishing direct pathways between the SNS and physical health (Danese and McEwen, 2012; McLaughlin et al., 2014a; Seeman et al., 2001).”
From Developmental psychoneuroendocrine and psychoneuroimmune pathways from childhood adversity to disease (2017) · cites this paper as Seeman et al., 2001
In the citing paper
“the effects were found to result from the contributions of multiple regulatory systems represented in the index, 164”
From Socio‐economic differentials in peripheral biology: Cumulative allostatic load (2010) · cites this paper as [164]
In the citing paper
“These associations were found both with respect to an initial 2.5 year follow-up period 176 as well as a longer 7-year period, 164”
From Socio‐economic differentials in peripheral biology: Cumulative allostatic load (2010) · cites this paper as [164]
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“Though early studies focused on age-related changes in physiologic function (Crimmins et al., 2003; Karlamangla et al., 2002; Seeman et al., 2001; Seeman et al., 1997), more recent studies have demonstrated associations with explicit forms of social stress that appear to be Allen et al.”
ResultKira, I. A., Ashby, J. S., Lewandowski, L., Alawneh, A. W. N., Mohanesh, J., & Odenat, L. (2013) · Psychology · doi:10.4236/psych.2013.44057 · Cited by 115
“Elevated continuous or prolonged, chronic coping demands sets in motion a cascade of physiological changes that contribute to the development of chronic illnesses, including hypertension, cardiac disease, diabetes, stroke, and psychiatric disorders (Seeman et al., 2001).”
Backgroundthe Community Child Health Network, Ramey, S. L., Schafer, P., DeClerque, J. L., Lanzi, R. G., Hobel, C. J., Shalowitz, M. U., Chinchilli, V. M., & Raju, T. N. K. (2014) · Maternal and Child Health Journal · doi:10.1007/s10995-014-1581-1 · Cited by 125
Social relationships and allostatic load in the MIDUS study.
Brooks, K. P., Gruenewald, T. L., Karlamangla, A. S., Hu, P., Koretz, B. K., & Seeman, T. E. (2014) · Health Psychology · doi:10.1037/a0034528 · Cited by 113
“Consistent with previous work, the measure of allostatic load was designed to summarize dysregulation across multiple physiological systems (Seeman et al., 2001; Gruenewald et al., 2012) Biomarkers were selected based on two major criteria.”
MethodSelf-citationDo biomarkers of stress mediate the relation between socioeconomic status and health?
Dowd, J. B., & Goldman, N. (2006) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2005.040816 · Cited by 112
“[21] [ 27 ] [28] Three sub-scales will also be used to look at the separate effects of SNS and HPA”
MethodThe Alzheimer's Disease Exposome
Finch, C. E., & Kulminski, A. M. (2019) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2019.06.3914 · Cited by 114
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BackgroundMethodInfluentialGetting strategic about the environment and health
Morris, G. P., Beck, S. A., Hanlon, P., & Robertson, R. (2006) · Public Health · doi:10.1016/j.puhe.2006.05.022 · Cited by 110
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“The original operationalisation of AL comprised ten physiologic indicators, including four primary and six secondary mediators (Seeman et al., 1997, 2001).”
BackgroundMethodAssessment of Epigenetic Clocks as Biomarkers of Aging in Basic and Population Research
Levine, M. E. (2020) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glaa021 · Cited by 99
“(15) sought to link three clocks—Horvath, Hannum, and Levine (also commonly referred to as the PhenoAge clock) (17)—to another biomarker often used in epidemiolocal and sociological studies to model aging, Allostatic Load (AL)(18,19).”
BackgroundPsychobiological Mechanisms of Resilience and Vulnerability
Charney, D. S. (2004) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.2.3.368 · Cited by 127
“Thus, these data are consistent with the hypothesis that although modest abnormalities in a single physiological system may not be predictive of poor health outcome, the cumulative effect of multiple abnormalities in the physiological system is prognostic of poor physical health (11, 138).”
BackgroundResultLinking Perceived Unfairness to Physical Health: The Perceived Unfairness Model
Jackson, B. M., Kubzansky, L. D., & Wright, R. J. (2006) · Review of General Psychology · doi:10.1037/1089-2680.10.1.21 · Cited by 108
“As suggested by allostatic load theory, there may be a cumulative cost of adaptation (Seeman et al., 2001).”
BackgroundGustafsson, P. E., Janlert, U., Theorell, T., Westerlund, H., & Hammarström, A. (2010) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2010.108332 · Cited by 109
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Biopsychosocial Challenges of the New Millennium
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Self-citationCumulative Risk Assessment for Combined Health Effects From Chemical and Nonchemical Stressors
Sexton, K., & Linder, S. H. (2011) · American Journal of Public Health · doi:10.2105/ajph.2011.300118 · Cited by 106
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A systematic review and meta-analysis of the Everyday Discrimination Scale and biomarker outcomes
Lawrence, J. A., Kawachi, I. I., White, K., Bassett, M. T., Priest, N., Masunga, J. G., Cory, H. J., Mita, C., & Williams, D. R. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105772 · Cited by 118
“, the neuroendocrine system (HPA axis, sympathetic-adreno-medullar axis), the autonomic nervous system, immune and inflammatory processes, and metabolism (McEwen, 2000; McEwen and Stellar, 1993; Seeman et al., 2001).”
Perceived stress and physiological dysregulation in older adults
Goldman, N., Glei, D. A., Seplaki, C., Liu, I.-W., & Weinstein, M. (2005) · Stress · doi:10.1080/10253890500141905 · Cited by 80
“The conventional measure of cumulative physiological dysregulation, typically referred to as an index of allostatic load, is a count based on a single tail of risk for each of 10 biomarkers (Seeman et al. 1997, 2001).”
BackgroundGleason, C. E., Zuelsdorff, M., Gooding, D. C., Kind, A. J. H., Johnson, A. L., James, T. T., Lambrou, N. H., Wyman, M. F., Ketchum, F. B., Gee, A., et al. (2022) · Alzheimer's & Dementia · doi:10.1002/alz.12511 · Cited by 104
Evans, G. W., & Fuller‐Rowell, T. E. (2013) · Developmental Science · doi:10.1111/desc.12082 · Cited by 122
Worthman, C. M., & Panter‐Brick, C. (2008) · Development and Psychopathology · doi:10.1017/s0954579408000114 · Cited by 109
“Following previous reports (Seeman et al., 1997, 2001), we constructed a measure of allostatic load that summarizes status on biomarkers that index multiple systems related to child developmental risk and well-being.”
MethodResultTracking biocultural pathways in population health: The value of biomarkers
Worthman, C. M., & Costello, E. J. (2009) · Annals of Human Biology · doi:10.1080/03014460902832934 · Cited by 106
“The widespread effects of stress have prompted the search for an aggregate measure of the physical burdens of coping with stress by creating an index representing key functions or systems affected by stress, termed allostatic load (Seeman et al. 2001; McEwen and Wingfield 2003).”
BackgroundChronic stress and endothelial dysfunction: mechanisms, experimental challenges, and the way ahead
Sher, L. D., Geddie, H., Olivier, L., Cairns, M., Truter, N., Beselaar, L., & Essop, M. F. (2020) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00244.2020 · Cited by 111
Allostatic Load in Cancer: A Systematic Review and Mini Meta-Analysis
Mathew, A. E., Doorenbos, A. Z., Li, H., Jang, M. K., Park, C. G., & Bronas, U. G. (2020) · Biological Research For Nursing · doi:10.1177/1099800420969898 · Cited by 106
“Thus, health-related effects of stress can be quantified using a cumulative multisystem measure, termed as the allostatic load index (ALI), which may have greater value in stress assessment and the associated biological burden than individual biomarkers (McEwen, 2007; Seeman et al., 2001).”
BackgroundMethodInfluentialRobertson, T., Beveridge, G., & Bromley, C. (2017) · PLoS ONE · doi:10.1371/journal.pone.0183297 · Cited by 102
“Seeman et al (2001) investigated the association between AL and all-cause mortality over 7 years using a sub-sample of 720 people (153 who had died within the follow-up period).”
MethodEveryday unfair treatment and multisystem biological dysregulation in African American adults.
Ong, A. D., Williams, D. R., Nwizu, U., & Gruenewald, T. L. (2017) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/cdp0000087 · Cited by 133
The geroscience agenda: Toxic stress, hormetic stress, and the rate of aging
Epel, E. S. (2020) · Ageing Research Reviews · doi:10.1016/j.arr.2020.101167 · Cited by 110
“Selye described the continuum from acute stress to chronic stress (Selye, 1956).”
BackgroundIntegrating DNA Methylation Measures of Biological Aging into Social Determinants of Health Research
Raffington, L., & Belsky, D. W. (2022) · Current Environmental Health Reports · doi:10.1007/s40572-022-00338-8 · Cited by 97
“One type consists of counts of deficits in physiological parameters, including blood chemistry analytes and organ function tests, such as allostatic load indices [66, 67].”
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McCrory, C., McLoughlin, S., Layte, R., Cheallaigh, C. N., O’Halloran, A. M., Barros, H., Berkman, L. F., Bochud, M., Crimmins, E. M., Farrell, M. T., et al. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106117 · Cited by 108
“4 INTRODUCTION It has been proposed that lifetime exposure to psychosocial stressors increases the risk of diseases in later life by disrupting the physiological regulatory systems that are involved with initiating, maintaining, and inhibiting the stress response leading to greater ‘wear and tear’ on the body, and inc…”
Self-citationGrundy, E. M. D., & Read, S. (2015) · Demographic Research · doi:10.4054/demres.2015.32.4 · Cited by 102
“Consequent wear and tear across multiple physiological systems is a significant contributor to overall health risk (Seeman et al. 1997, 2001).”
BackgroundGaab, J., Sonderegger, L., Scherrer, S., & Ehlert, U. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.10.005 · Cited by 101
Assessment of acculturation in minority health research
Fox, M. M., Thayer, Z. M., & Wadhwa, P. D. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.01.029 · Cited by 120
“…of the sympatheticeadrenalemedullary and hypothalamicepituitaryeadrenal (HPA) axes (Juster et al., 2010), and the chronic stimulation of these stress pathways may damage one or more of many interconnected physiological systems, eventually leading to chronic disease (Seeman et al., 2001).”
BackgroundSocial status, immune response and parasitism in males: a meta-analysis
Habig, B., & Archie, E. A. (2015) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2014.0109 · Cited by 100
Neighborhood Poverty and Allostatic Load in African American Youth
Brody, G. H., Lei, M., Chen, E., & Miller, G. E. (2014) · PEDIATRICS · doi:10.1542/peds.2014-1395 · Cited by 98
Race, again: how face recognition technology reinforces racial discrimination
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Resilience to adversity and the early origins of disease
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“, allostatic load) that manifest as vulnerability to disease and death [18,19].”
BackgroundThe Detrimental Effects of Allostasis: Allostatic Load as a Measure of Cumulative Stress
Stewart, J. A. (2006) · Journal of PHYSIOLOGICAL ANTHROPOLOGY · doi:10.2114/jpa2.25.133 · Cited by 100
Juster, R., Marin, M., Sindi, S., Nair, N. P. V., Ng, Y. K., Pruessner, J. C., & LUPIEN, S. J. (2011) · Physiology & Behavior · doi:10.1016/j.physbeh.2011.02.027 · Cited by 94
“AL indices were then constructed using the original one-tailed formulation [28,29] calculated by summing the number of values falling at or past the upper 75th percentile for every biomarker, except HDL-cholesterol, whereby the lowest 25th percentile denoted high risk.”
MethodYe, Z. J., Qiu, H. Z., Liang, M. Z., Liu, M. L., Li, P. F., Chen, P., Sun, Z., Yu, Y. L., Wang, S. N., Zhang, Z., et al. (2017) · British Journal of Cancer · doi:10.1038/bjc.2017.325 · Cited by 99
Zaslavsky, O., Cochrane, B. B., Thompson, H. J., Woods, N. F., Herting, J. R., & LaCroix, A. Z. (2012) · Biological Research For Nursing · doi:10.1177/1099800412462866 · Cited by 94
Ashiabi, G. S., & O’Neal, K. K. (2008) · Child Development Perspectives · doi:10.1111/j.1750-8606.2008.00049.x · Cited by 93
Measuring Recent Apparent Declines In Longevity: The Role Of Increasing Educational Attainment
Bound, J., Geronimus, A. T., Rodríguez, J. M., & Waidmann, T. (2015) · Health Affairs · doi:10.1377/hlthaff.2015.0481 · Cited by 98
Ethnicity, Nativity, and the Health of American Blacks
Griffith, D. M., Johnson, J. L., Zhang, R., Neighbors, H. W., & Jackson, J. S. (2011) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2011.0011 · Cited by 96
Salivary cortisol, brain volumes, and cognition in community-dwelling elderly without dementia
Geerlings, M. I., Sigurdsson, S. O., Eiríksdóttir, G., Garcia, M. E., Harris, T. B., Gudnason, V. G., & Launer, L. J. (2015) · Neurology · doi:10.1212/wnl.0000000000001931 · Cited by 96
“Indirect evidence for this originates from studies that found that cumulative physiologic wear and tear or allostatic load increases risk of cognitive decline.(33,34) It is also possible that HPA axis dysregulation resulted from repeated depressive episodes earlier in life(10) which, in turn, led to brain volume reduc…”
BackgroundAllostatic Load in Women With and Without PTSD Symptoms
Glover, D. A., Stuber, M. L., & Poland, R. E. (2006) · Psychiatry · doi:10.1521/psyc.2006.69.3.191 · Cited by 93
“These findings extend use of the composite AL score used in previous geriatric (Karlamangla et al., 2002; McEwen and Seeman, 1999; Seeman et al., 1997, 2001, 2002) and adolescent (Goodman et al., 2005) research to an adult sample of women.”
A comparison of methods for assessing mortality risk
Levine, M. E., & Crimmins, E. M. (2014) · American Journal of Human Biology · doi:10.1002/ajhb.22595 · Cited by 92
“…systems that are chronically challenged—typically as a result of stressful environments—will lose their ability to function properly and eventually become dysregulated making them unable to appropriately respond and/or adjust to environmental stimuli (McEwan and Stellar, 1993; Seeman et al., 2001).”
BackgroundChen, E., Miller, G. E., Brody, G. H., & Lei, M. (2014) · Clinical Psychological Science · doi:10.1177/2167702614546639 · Cited by 103
“This internal toll is indicated by elevations in catecholamines, cortisol, blood pressure, and obesity—the composite of allostatic load that when taken together, predicts risk for cardiovascular diseases and all-cause mortality later in life (Seeman et al., 1997; Seeman et al., 2001).”
BackgroundLife course social roles and women’s health in mid-life: causation or selection?
McMunn, A., Bartley, M., Hardy, R., & Kuh, D. J. (2006) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2005.042473 · Cited by 91
Kern, M. L., Hampson, S. E., Goldberg, L. R., & Friedman, H. S. (2012) · Developmental Psychology · doi:10.1037/a0030874 · Cited by 90
Chalmers, T., Hickey, B. A., Newton, P. J., Lin, C., Sibbritt, D. W., McLachlan, C. S., Clifton-Bligh, R. J., Morley, J. W., & Lal, S. (2021) · Sensors · doi:10.3390/s22010151 · Cited by 106
“It is of importance as it supports the aforementioned theory that immersion in frequent stressful scenarios associated with certain careers may result in an individual becoming more capable of responding to stress; however, allostatic load (the concept of ongoing failed adaptation to stress) can present in individuals…”
BackgroundErickson, A. C., & Arbour, L. (2014) · Journal of Environmental and Public Health · doi:10.1155/2014/901017 · Cited by 90
“Evidence shows that chronic life stressors associated with low SES at multiple levels of organization (individual, household, and community) result in a cumulative biological toll on the body affecting multiple systems and increasing susceptibility to numerous ailments [21, 157–160] including APOs [15, 26, 161, 162].”
BackgroundQuantitative measures of healthy aging and biological age
Kim, S., & Jazwinski, S. M. (2015) · Healthy Aging Research · doi:10.12715/har.2015.4.26 · Cited by 93
“A concept that developed concurrently with frailty is ‘allostatic load’ [24], which attempts to characterize the effect of cumulative biological burden as the body adapts to life stress.”
BackgroundParker, S. K., Ward, M. K., & Fisher, G. G. (2021) · Academy of Management Annals · doi:10.5465/annals.2019.0057 · Cited by 106
Association of allostatic load with brain structure and cognitive ability in later life
Booth, T., Royle, N. A., Corley, J., Gow, A. J., Valdés Hernández, M. D. C., Muñoz Maniega, S., Ritchie, S. J., Bastin, M. E., Starr, J. M., Wardlaw, J. M., et al. (2015) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2014.12.020 · Cited by 88
Castro‐Diehl, C., Roux, A. V. D., Seeman, T. E., Shea, S., Shrager, S., & Tadros, S. S. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.12.013 · Cited by 88
“Urinary measurements of both cortisol and epinephrine and norepinephrine have previously been used to assess the activity of the HPA axis and the SNS in laboratory and population studies (Lundberg and Frankenhaeuser, 1980; Seeman et al., 1994, 2001; JanickiDeverts et al., 2007).”
Self-citationLavretsky, H., & Irwin, M. R. (2007) · Johns Hopkins University Press eBooks · doi:10.1353/book.34895 · Cited by 91
Forgiveness in personal relationships: Its malleability and powerful consequences
Karremans, J. C., & Lange, P. A. M. V. (2008) · European Review of Social Psychology · doi:10.1080/10463280802402609 · Cited by 97
Depressive symptoms are associated with allostatic load among community-dwelling older adults
Kobrosly, R. W., van Wijngaarden, E., Seplaki, C. L., Cory‐Slechta, D. A., & Moynihan, J. A. (2013) · Physiology & Behavior · doi:10.1016/j.physbeh.2013.10.014 · Cited by 94
“We employed a summary score method is that frequently used in epidemiology studies of physiological dysfunction [12, 60, 61].”
MethodWeiss, T., Skelton, K., Phifer, J., Jovanovic, T., Gillespie, C. F., Smith, A., Umpierrez, G., Bradley, B., & Ressler, K. J. (2011) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2011.01.002 · Cited by 87
“Previous studies have demonstrated that comprehensive measures of physiological function can be more predictive of cumulative biological risk than approaches that assess biological risk factors as individual parameters [30].”
Measuring allostatic load: Approaches and limitations to algorithm creation
Carbone, J. T., Clift, J., & Alexander, N. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111050 · Cited by 89
Midlife Work-Related Stress Increases Dementia Risk in Later Life: The CAIDE 30-Year Study
Sindi, S., Hagman, G., Håkansson, K., Kulmala, J., Nilsen, C., Kåreholt, I., Soininen, H. S., Solomon, A., & Kivipelto, M. (2016) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbw043 · Cited by 92
Gallo, L. C., Jiménez, J. A., Shivpuri, S., Monteros, K. E. D. L., & Mills, P. J. (2010) · Annals of Behavioral Medicine · doi:10.1007/s12160-010-9233-1 · Cited by 91
“We adopted the MacArthur Studies of Successful Aging algorithm [10, 11], such that each of the 12 biological parameters was divided into quartiles based on the distribution of scores in the sample, and AL was measured by summing the number of parameters for which the subject fell into the highest risk quartile.”
MethodRepeated stressors in adulthood increase the rate of biological ageing
Hau, M., Haussmann, M. F., Greives, T. J., Matlack, C., Costantini, D., Quetting, M., Adelman, J. S., Miranda, A. C., & Partecke, J. (2015) · Frontiers in Zoology · doi:10.1186/s12983-015-0095-z · Cited by 85
“Understanding the causes and consequences of individual variation in behaviour and physiology has long been a subject of intensive research [2], and it has also permeated into the demographic and medical fields [3,4].”
Gijzel, S. M. W., van de Leemput, I. A., Scheffer, M., Roppolo, M., Rikkert, M. G. M. O., & Melis, R. J. F. (2017) · The Journals of Gerontology Series A · doi:10.1093/gerona/glx065 · Cited by 90
Effects of Alzheimer Caregiving on Allostatic Load
Roepke, S. K., Mausbach, B. T., Patterson, T. L., von Känel, R., Ancoli‐Israel, S., Harmell, A. L., Dimsdale, J. E., Aschbacher, K., Mills, P. J., Ziegler, M. G., et al. (2010) · Journal of Health Psychology · doi:10.1177/1359105310369188 · Cited by 84
Felitti, V. J., & Anda, R. F. (2009) · Cited by 85
Benefit Finding and Physical Health: Positive Psychological Changes and Enhanced Allostasis
Bower, J. E., Low, C. A., Moskowitz, J. T., Sepah, S., & Epel, E. S. (2007) · Social and Personality Psychology Compass · doi:10.1111/j.1751-9004.2007.00038.x · Cited by 93
“There is growing evidence that biological profiles indicative of allostatic load are associated with negative health outcomes (e.g., Seeman et al., 2001), and that individuals who show more pronounced and persistent physiological reactivity to stress are at greater risk for disease, particularly…”
BackgroundMeasurement of cumulative physiological dysregulation in an older population
Seplaki, C. L., Goldman, N., Weinstein, M., & Lin, Y.-H. (2006) · Demography · doi:10.1353/dem.2006.0009 · Cited by 84
“…dysregulation are associated with diverse health outcomes (e.g., mortality, cognitive and physical function, and cardiovascular disease; Karlamangla et al. 2002; Seeman et al. 2001; Seeman et al. 1997) and various dimensions of the social environment (Schnorpfeil et al. 2003; Seeman et al. 2002).”
Cellular allostatic load is linked to increased energy expenditure and accelerated biological aging
Bobba‐Alves, N., Sturm, G., Lin, J., Ware, S. A., Karan, K. R., Monzel, A. S., Bris, C., Procaccio, V., Lenaers, G., Higgins‐Chen, A., et al. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106322 · Cited by 88
“…epidemiological studies also show that allostatic load, quantified by the abnormal levels of stress hormones, metabolites, and cardiovascular risk parameters, predicts physical and cognitive decline, as well as earlier mortality (Gruenewald et al., 2006; Juster et al., 2010; Seeman et al., 2001).”
Allostatic Load and Frailty in the Women's Health and Aging Studies
Szanton, S. L., Allen, J. K., Seplaki, C. L., Bandeen‐Roche, K., & Fried, L. P. (2008) · Biological Research For Nursing · doi:10.1177/1099800408323452 · Cited by 84
“Measures included in prior studies (Seeman, Singer, Rowe, Horwitz, & McEwen, 1997; Seeman et al., 2001; Seeman et al., 2004; Szanton et al., 2005) that were absent from the WHAS included primary indicators of the HPA-axis and sympathetic nervous system, specifically cortisol, norepinephrine, and…”
BackgroundMethodAlmeida, D. M., Piazza, J. R., Stawski, R. S., & Klein, L. C. (2010) · Elsevier eBooks · doi:10.1016/b978-0-12-380882-0.00012-7 · Cited by 87
Disparities in Breast Cancer Associated With African American Identity
Stringer-Reasor, E. M., Elkhanany, A. M., Khoury, K. E., Simon, M. A., & Newman, L. A. (2021) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_319929 · Cited by 85
Misiak, B., Stańczykiewicz, B., Pawlak, A., Szewczuk-Bogusławska, M., Samochowiec, J., Samochowiec, A., Tyburski, E. M., & Juster, R. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105602 · Cited by 83
“2017), cardiovascular diseases (Gillespie et al., 2019; Seeman et al., 2001) and all-cause mortality”
Kendall, J., & Hatton, D. C. (2002) · Advances in Nursing Science · doi:10.1097/00012272-200212000-00003 · Cited by 88
Liu, Z., Chen, B. H., Assimes, T. L., Ferrucci, L., Horvath, S., & Levine, M. E. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.01.028 · Cited by 81
Stochastic model for analysis of longitudinal data on aging and mortality
Yashin, A. I., Arbeev, K. G., Akushevich, I., Kulminski, A., Akushevich, L., & Ukraintseva, S. V. (2007) · Mathematical Biosciences · doi:10.1016/j.mbs.2006.11.006 · Cited by 82
“They are related to the notion of allostatic load [6], the decline in adaptive capacity (homeostenosis) [7,8], the decline in resistance to stresses [9], the aging-related physiological norms, and heterogeneity in longitudinal data.”
BackgroundPerry, S. L. (2013) · NEW SOLUTIONS A Journal of Environmental and Occupational Health Policy · doi:10.2190/ns.23.1.d · Cited by 85
“Allostatic load has been implicated in poor health outcomes when social and environmental factors create chronic stress that elevates cortisol levels, which then work to biologically impact the body [67, 68].”
BackgroundChoroid Plexus Enlargement and Allostatic Load in Schizophrenia
Zhou, Y., Huang, J., Zhang, P., Fan, F., Chen, S., Fan, H., Cui, Y., Luο, X., Tan, S., Wang, Z., et al. (2019) · Schizophrenia Bulletin · doi:10.1093/schbul/sbz100 · Cited by 83
Allostatic load in an environmental riskscape: The role of stressors and gender
Mair, C. A., Cutchin, M. P., & Peek, M. K. (2011) · Health & Place · doi:10.1016/j.healthplace.2011.03.009 · Cited by 82
Factor Structure Underlying Components of Allostatic Load
McCaffery, J. M., Marsland, A. L., Strohacker, K. A., Muldoon, M. F., & Manuck, S. B. (2012) · PLoS ONE · doi:10.1371/journal.pone.0047246 · Cited by 89
“Such summary scores have been shown to predict cognitive and physical functioning [21,22], incident cardiovascular disease [20,21] and all-cause mortality [20,23]_ENREF_16.”
BackgroundAntiglucocorticoid drugs in the treatment of depression
Reus, V. I., & Wolkowitz, O. M. (2001) · Expert Opinion on Investigational Drugs · doi:10.1517/13543784.10.10.1789 · Cited by 82
“Such a nosology has proven useful in understanding the cost to the organism of constant and recurrent attempts to elicit a stress response, or ‘allostatic load’ [20].”
BackgroundSchmitz, N., Gariépy, G., Smith, K. J., Clyde, M. J., MALLA, A. K., Boyer, R., Strychar, I. M., LESAGE, A. D., & Wang, J. (2013) · Diabetes Care · doi:10.2337/dc13-1832 · Cited by 86
“Recurrent (moderate) depressive symptoms may produce an allostatic load (14), which increases the probability of developing worse health outcomes (15).”
BackgroundPhysiological dysregulation and changes in health in an older population
Goldman, N., Turra, C. M., Glei, D. A., Lin, Y., & Weinstein, M. (2006) · Experimental Gerontology · doi:10.1016/j.exger.2006.06.050 · Cited by 81
Special Report: The Biology of Inequalities in Health: The Lifepath Consortium
Vineis, P., Avendano-Pabon, M., Barros, H., Bartley, M., Carmeli, C., Carra, L., Chadeau-Hyam, M., Costa, G., Delpierre, C., D'Errico, A., et al. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.00118 · Cited by 80
“These scores of AL have been shown to be a better predictor of mortality and functional limitations than the metabolic syndrome or any of the individual components used to measure AL when analyzed separately (59).”
Psychophysiological risk markers of cardiovascular disease
Hamer, M., & Malan, L. (2009) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2009.11.004 · Cited by 81
Kim, P., Evans, G. W., Chen, E., Miller, G. E., & Seeman, T. E. (2017) · Springer eBooks · doi:10.1007/978-3-319-47143-3_19 · Cited by 92
“Adults exposed to SED have higher rates of cancer, cardiovascular disease, and diabetes (Seeman et al. 2001).”
BackgroundSelf-citationSong, X., Mitnitski, A., MacKnight, C., & Rockwood, K. J. (2004) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2004.52319.x · Cited by 79
Barber, S., Hickson, D. A., Kawachi, I. I., Subramanian, S. V., & Earls, F. J. (2015) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-015-0157-0 · Cited by 81
“[21] found that higher CBR was associated with an increased risk of incident cardiovascular disease (CVD) and was also associated with cognitive decline, physical functioning, and all-cause mortality [21, 22].”
Allostatic Load and Birth Outcomes Among White and Black Women in New Orleans
Wallace, M. E., & Harville, E. W. (2012) · Maternal and Child Health Journal · doi:10.1007/s10995-012-1083-y · Cited by 83
Worked to Death: The Relationships of Job Demands and Job Control with Mortality
Gonzalez-Mule, E. N., & Cockburn, B. S. (2016) · Personnel Psychology · doi:10.1111/peps.12206 · Cited by 87
“This time lag is consistent with studies conducted in epidemiology that examine the link between more proximal strain indicators and distal outcomes (e.g., Seeman et al., 2001).”
BackgroundResultNeighborhood effects on health: concentrated advantage and disadvantage
Finch, B. K., Phuong Do, D., Heron, M., Bird, C., Seeman, T., & Lurie, N. (2010) · Health & Place · doi:10.1016/j.healthplace.2010.05.009 · Cited by 78
Forgiveness as a moderator of the association between anger expression and suicidal behaviour
Hirsch, J. K., Webb, J. R., & Jeglic, E. L. (2011) · Mental Health Religion & Culture · doi:10.1080/13674676.2011.571666 · Cited by 78
Hampson, S. E., Edmonds, G. W., Goldberg, L. R., Dubanoski, J. P., & Hillier, T. A. (2013) · Health Psychology · doi:10.1037/a0031655 · Cited by 77
Age trajectories of physiological indices in relation to healthy life course
Arbeev, K. G., Ukraintseva, S. V., Akushevich, I. V., Kulminski, A. M., Arbeeva, L. S., Akushevich, L., Culminskaya, I. V., & Yashin, A. I. (2011) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2011.01.001 · Cited by 77
“…reflecting functioning of the hypothalamic–pituitary–adrenal axis, sympathetic nervous system, cardiovascular system, and metabolic processes allows for calculation of cumulative physiological wear and tear measure of allostatic load and its effect on health outcomes (Seeman et al., 1997, 2001).”
InfluentialHealth and Aging: Unifying Concepts, Scores, Biomarkers and Pathways
Fuellen, G., Jansen, L., Cohen, A. A., Luyten, W. H. M. L., Gogol, M., Simm, A., Saul, N., Cirulli, F., Berry, A., Antal, P., et al. (2018) · Aging and Disease · doi:10.14336/ad.2018.1030 · Cited by 81
Allostatic Load as a Biological Substrate to Intrinsic Capacity: A Secondary Analysis of CRELES
Gutiérrez‐Robledo, L. M., García-Chanes, R. E., & Pérez‐Zepeda, M. U. (2019) · The journal of nutrition health & aging · doi:10.1007/s12603-019-1251-5 · Cited by 84
Childhood poverty and psychological well-being: The mediating role of cumulative risk exposure
Evans, G. W., & France, K. D. (2021) · Development and Psychopathology · doi:10.1017/s0954579420001947 · Cited by 77
Metadata
- Authors
- Seeman, T. E., McEwen, B. S., Rowe, J. W., & Singer, B. H.
- Affiliations
- Aetna (United States) (US)
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2001-04-03
- Volume
- 98
- Issue
- 8
- Pages
- 4770-4775
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC31909
- OpenAlex
- W2015252215
- Cited by
- 1,385
- References
- 24
- Citations by year
- 2026: 68 · 2025: 68 · 2024: 52 · 2023: 51 · 2022: 73 · 2021: 86 · 2020: 86 · 2019: 91 · 2018: 66 · 2017: 67 · 2016: 79 · 2015: 63 · 2014: 79 · 2013: 49 · 2012: 50
- FWCI
- 30.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ag017056-03)
- National Institute on Aging (AG00586, AG 17056)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Developmental and Educational Psychology › Aging and Gerontology Research
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Keywords
- allostatic load, successful aging, older adults, mortality, cognitive decline, cardiovascular disease, metabolic syndrome, biological mediators, aging
- MeSH terms
- Aged, Aging, Female, Humans, Male, Regression Analysis, Stress, Physiological, Microvascular Angina
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