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Allostatic load as predictor of mortality: a cohort study from Lolland-Falster, Denmark

Neda Esmailzadeh Bruun-Rasmussen1, George Napolitano2, Christian Christiansen3

  • 1Centre for Epidemiological Research, Nykobing Falster Hospital, Nykobing, Denmark neebruun@gmail.com.

BMJ Open
|May 27, 2022
PubMed

Insights

Higher allostatic load (AL), a measure of physiological burden across multiple systems, significantly increases all-cause mortality risk. This comprehensive biomarker index proved more predictive of mortality than individual health markers.

Area of Science:

  • Gerontology and Public Health
  • Biomarker Research
  • Epidemiology

Background:

  • Allostatic load (AL) reflects the cumulative wear and tear on the body from chronic stress.
  • Understanding the relationship between AL and mortality is crucial for public health interventions.
  • Individual biomarkers may not fully capture the complex physiological burden associated with mortality risk.

Purpose of the Study:

  • To investigate the association between 10 individual biomarkers and all-cause mortality.
  • To determine the relationship between allostatic load (AL) across cardiovascular, inflammatory, and metabolic systems and all-cause mortality.

Main Methods:

  • A prospective cohort study utilizing data from the Lolland-Falster Health Study (2016-2020).
  • Analysis included 13,725 adults, assessing 10 biomarkers (SBP, DBP, PR, WHR, LDL-c, HDL-c, triglycerides, HbA1c, CRP, albumin).
  • Allostatic load index was calculated, and Cox proportional hazard regression analyzed associations with mortality over a 2.6-year follow-up.

Main Results:

  • All-cause mortality demonstrated a clear increase with rising allostatic load index.
  • Individuals with high AL index had a hazard ratio (HR) of 2.37 (95% CI: 1.58–3.54) for mortality compared to those with low AL.
  • Mid AL index also showed an increased mortality risk with an HR of 1.33 (95% CI: 0.89–1.98).

Conclusions:

  • Elevated physiological burden, as measured by mid and high allostatic load index, is significantly associated with increased all-cause mortality.
  • The allostatic load index is a more potent predictor of mortality than individual biomarkers.
  • These findings highlight the importance of assessing cumulative physiological stress for risk stratification and health management.
Abstract

Keywords:
Allostatic LoadBiomarkerBloodLOFUSMortalitypopulation-based

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