Allostatic Load and Mortality: A Systematic Review and Meta-Analysis

Area of Science:

• Physiology
• Public Health
• Epidemiology

Background:

• Allostatic load quantifies physiological dysregulation due to chronic stress.
• It is linked to various mortality risk factors.
• Understanding its impact on mortality is crucial for public health.

Purpose of the Study:

• To systematically review and meta-analyze the association between high allostatic load and mortality.
• To examine risks for both all-cause mortality and cardiovascular disease mortality.

Main Methods:

• Systematic searches of two databases in May 2021 identified 336 unique records.
• Seventeen eligible studies published between 2001 and 2020 were included in the analysis.
• Meta-analyses were performed to pool data on mortality risk.

Main Results:

• High allostatic load was consistently associated with increased all-cause mortality risk (HR=1.22) and cardiovascular disease mortality risk (HR=1.31).
• Individual studies showed hazard ratios ranging from 1.08-2.75 for all-cause mortality and 1.19-3.06 for cardiovascular disease mortality.
• High heterogeneity was noted in pooled estimates, indicating variability in allostatic load assessment.

Conclusions:

• High allostatic load is a significant, modifiable risk factor for all-cause and cardiovascular disease mortality.
• Standardized measurement of allostatic load is needed due to observed heterogeneity.
• Future research should focus on younger adults and personalized interventions to mitigate mortality risk.