Association of allostatic load with functional disability in the China Health and Retirement Longitudinal Study

IF 4.3 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging Pub Date : 2024-09-27 DOI:10.1016/j.jnha.2024.100367

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引用次数: 0

Abstract

Objectives

Allostatic load (AL) is an index that manifests as cumulative wear and tear on multiple physiological systems resulting from repeated adaptation to stressors throughout the life course. Higher AL was found to be associated with increased risk of adverse health outcomes, but studies on functional disability among large Chinese older population were limited. We aimed to investigate the associations of AL with functional disability among Chinese older adults.

Research design and methods

This prospective cohort study included 5880 older adults who were at least 50 years old and participated in the CHARLS at baseline (2011 wave), with 3 follow-ups (2013, 2015 and 2018 waves). We selected 11 biomarkers from 4 physiological systems to construct AL. AL score was classified into three categories based on tertiles: 0–1 (low burden), 2–3 (medium burden) and 4–11 (high burden). Functional disability was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Multivariable logistic regression models examined the association between baseline AL, transitions of AL burden and incidence of functional disability.

Results

In cross-sectional analyses, medium and high AL burden were associated with an increased prevalence of ADL disability, while association was only significant between high AL burden and IADL disability. During the 7-year follow-up, 1102 and 1777 participants incident ADL disability and IADL disability, respectively. Those with medium and high AL burden had an increased risk of new-onset ADL disability than those with low AL burden (“medium”: OR = 1.25, 95%CI = 1.01, 1.55; “high”: OR = 1.69, 95%CI = 1.32, 2.18). As for IADL disability, association was only significant in “high” group (OR = 1.50, 95% CI = 1.24, 1.83). We also found keep medium/high AL burden in 2011 and 2015 was associated with new-onset ADL (OR = 2.27, 95%CI = 1.50, 3.44) and IADL disability (OR = 1.51, 95%CI = 1.11, 2.05) in 2018.

Conclusion

These results show that higher AL predicts functional disability among Chinese older adults. Monitoring AL and paying close attention to those with medium/high AL burden may aid prevention of adverse health outcomes, thus giving a healthier ageing experience to a large proportion of the population.

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中国健康与退休纵向研究中异位负荷与功能障碍的关系

目的静力负荷（Allostatic load，AL）是一个指数，表现为在整个生命过程中因反复适应压力因素而对多个生理系统造成的累积磨损。研究发现，较高的静力负荷与不良健康后果风险的增加有关，但有关中国老年人群功能障碍的研究却很有限。研究设计和方法这项前瞻性队列研究纳入了5880名年龄至少50岁、基线（2011年波）时参加了CHARLS的老年人，并进行了3次随访（2013年、2015年和2018年波）。我们从 4 个生理系统中选取了 11 个生物标志物来构建 AL。AL得分根据梯度分为三类：0-1（低负担）、2-3（中等负担）和 4-11（高负担）。功能障碍通过日常生活活动（ADL）和工具性日常生活活动（IADL）进行评估。多变量逻辑回归模型检验了基线AL、AL负担的转变与功能性残疾发生率之间的关联。结果在横断面分析中，中度和高度AL负担与ADL残疾发生率的增加有关，而高度AL负担与IADL残疾之间的关联仅有显著性。在7年的随访中，分别有1102名和1777名参与者出现了ADL残疾和IADL残疾。与低AL负担者相比，中度和高度AL负担者新发ADL残疾的风险更高（"中度"：OR=1.25，95%IR=1.25，95%IR=1.25）：OR=1.25，95%CI=1.01，1.55；"高"：OR=1.69，95%CI=1.32，2.18）。至于 IADL 残疾，只有 "高 "组的相关性显著（OR = 1.50，95% CI = 1.24，1.83）。我们还发现，2011 年和 2015 年的中/高 AL 负担与 2018 年新发的 ADL（OR = 2.27，95%CI = 1.50，3.44）和 IADL 残疾（OR = 1.51，95%CI = 1.11，2.05）相关。监测AL并密切关注中/高AL负担人群可能有助于预防不良健康后果，从而为大部分人群带来更健康的老年生活。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.