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The Longitudinal Relationship Between Allostatic Load and Multimorbidity Among Older Americans
Rolla Mira1, Jonathon Timothy Newton1, Wael Sabbah1
1Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Bessemer Road, Denmark Hill, London SE5 9RS, UK.
Geriatrics (Basel, Switzerland)
|July 23, 2025
Summary
Allostatic load, a measure of biological stress, is linked to increased multimorbidity in older Americans. Socioeconomic factors influence this relationship by affecting stress levels and health behaviors.
Area of Science:
- Gerontology
- Public Health
- Biomedical Science
Background:
- Understanding factors influencing multimorbidity progression in aging populations is crucial.
- Allostatic load, reflecting cumulative physiological wear and tear, is a key area of investigation.
- Socioeconomic determinants play a significant role in health trajectories among older adults.
Purpose of the Study:
- To investigate the association between allostatic load and the progression of multimorbidity in older Americans.
- To examine the mediating role of socioeconomic factors in this relationship.
- To analyze the impact of behaviors on multimorbidity development.
Main Methods:
- Utilized longitudinal data from the Health and Retirement Study (HRS) spanning multiple waves (2006-2016).
- Defined multimorbidity based on self-reported diagnoses of five chronic conditions.
- Employed Structural Equation Modelling (SEM) to assess associations between allostatic load, socioeconomic factors, behaviors, and multimorbidity incidence.
Main Results:
- A total of 3336 participants were analyzed, with 19% incidence of multimorbidity in 2016.
- Higher allostatic load in 2012 significantly predicted multimorbidity incidence in 2016.
- Socioeconomic status (wealth, education) indirectly influenced multimorbidity via allostatic load and behaviors; smoking increased risk, while physical activity decreased it.
Conclusions:
- Biological markers of stress (allostatic load) are demonstrably associated with the development of multimorbidity.
- Adverse socioeconomic conditions appear to drive both allostatic load and unhealthy behaviors, contributing to multimorbidity.
- Targeting socioeconomic disparities and promoting healthy behaviors may mitigate allostatic load and reduce multimorbidity burden in older adults.
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