Measuring allostatic load: Approaches and limitations to algorithm creation.

Area of Science:

• Physiology
• Psychology
• Public Health

Background:

• Allostatic load (AL) is linked to numerous negative health outcomes.
• Challenges persist in consistently operationalizing and measuring AL.
• The proliferation of AL research necessitates a review of its measurement methodologies.

Purpose of the Study:

• To conduct a scoping review of methods used to create allostatic load algorithms.
• To identify challenges in the operationalization of allostatic load.
• To provide recommendations for advancing clinical applications of allostatic load theory.

Main Methods:

• A comprehensive search of seven electronic databases was performed using the term "allostatic load."
• Inclusion criteria were applied to 5280 initial search results, yielding 395 non-duplicate articles.
• Data extraction, compilation, and presentation in narrative, table, and figure formats were utilized.

Main Results:

• Over half (52.5%) of studies used biomarker cutoffs based on high-risk quartiles.
• 11.1% of studies summed at-risk clinical scores.
• A variety of other algorithms were employed across the remaining studies.

Conclusions:

• Allostatic load literature has grown exponentially, yet measurement algorithms may limit future utility.
• Emerging, more nuanced statistical approaches should be considered for AL measurement.
• A shift towards methods offering greater clinical utility is recommended for allostatic load research.