ArticlePsychosomatic medicine2022
Examination of the Allostatic Load Construct and Its Longitudinal Association With Health Outcomes in the Boston Puerto Rican Health Study.
Article in Psychosomatic medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Association between allostatic load and incident dementia, and race/ethnic disparities in the association in the U.S. health and retirement study.Psychoneuroendocrinology · 2026Article
- CVD Environmental Health Disparities Tool: systematic evidence mapping of psychosocial stressors, environmental exposures, and cardiovascular diseases to inform disparities research and action.Environmental health : a global access science source · 2026Review
- Allostatic load in thyroid cancer is higher than that of other cancers: A secondary analysis using NHANES.PloS one · 2026Article
- Viviendo entre dos culturas: Evaluating the psychometric properties of the Psychological Acculturation Scale among Latinx caregivers.PloS one · 2026Article
- Abnormal Blood Biomarkers and Cumulative Disability Burden in Middle-Aged and Older Adults: Evidence from Two Nationally Representative Surveys in the United States and China.Journal of cardiovascular development and disease · 2025Article
- Association of allostatic load with functional disability in the China Health and Retirement Longitudinal Study.The journal of nutrition, health & aging · 2024Article
- 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).Journal of Alzheimer's disease : JAD · 2024Article
- Comparison of social gradient in cardiometabolic health in Czechia and Venezuela: a cross-sectional study.BMJ open · 2023Article
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Abstract
objectiveDespite evidence on allostatic load (AL) as a model explaining associations between stress and disease, there is no consensus on its operationalization. This study aimed to contrast various AL constructs and their longitudinal associations with disease and disability.
methodsBaseline and 5-year follow-up data from 738 adults participating in the Boston Puerto Rican Health Study were used. Five AL scores were created by summing the presence of 21 dysregulated multisystem physiological parameters using the following: a) z scores, b) population-based quartile cutoffs, c) clinical-based cutoffs, d) 10 preselected clinical-based cutoffs (AL-reduced), and e) 12 clinical-based cutoffs selected a posteriori based on association with disease (AL-select). Adjusted logistic regression models examined associations between each AL score at baseline and 5-year incident type 2 diabetes (T2D), cardiovascular disease (CVD), activities (or instrumental activities) of daily living (ADL; IADL) for physical impairment, and cognitive impairment.
resultsAL-quartile was associated with greater odds of T2D (odds ratio [OR] = 1.20; 95% confidence interval [CI] = 1.07-1.35) and CVD (OR = 1.14; 95% CI = 1.06-1.22). AL-reduced was associated with higher odds of IADL (OR = 1.21; 95% CI = 1.07-1.37) and AL-clinical with CVD (OR = 1.14; 95% CI = 1.07-1.21), IADL (OR = 1.11; 95% CI = 1.04-1.19), and ADL (OR = 1.15; 95% CI = 1.04-1.26). AL-select showed associations with T2D (OR = 1.35; 95% CI = 1.14-1.61), CVD (OR = 1.21; 95% CI = 1.11-1.32), IADL (OR = 1.15; 95% CI = 1.04-1.26), and ADL (OR = 1.24; 95% CI = 1.08-1.41). No associations were found with AL z-score.
conclusionsAL scores computed with clinical-based cutoffs performed robustly in our sample of mainland Puerto Ricans, whereas z scores did not predict disease and disability. AL-select was the most consistent predictor, supporting its use as a disease-predicting model. Future assessment of AL-select in other populations may help operationalize AL.
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