Reduction in allostatic load in older adults is associated with lower all-cause mortality risk: MacArthur studies of successful aging
Reduction in allostatic load in older adults is associated with lower all-cause mortality risk: MacArthur studies of successful aging
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DOI：
10.1097/01.psy.0000221270.93985.82
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发表时间：
2006-05-01
影响因子：
3.3
通讯作者：
Seeman, Teresa E.
中科院分区：
文献类型：
--
作者：
Karlamangla, Arun S.;Singer, Burton H.;Seeman, Teresa E.
目的：研究老年人 2.5 年期间的非稳态负荷变化（由多种生物标志物构建的风险评分）与随后 4.5 年死亡率之间的关联。方法：我们在基线（1988 年）测量了 171 名居住在社区的 70 至 79 岁高功能成年人的 10 项生理参数。 2.5 年后，即 1991 年，重复了这些测量。 1988 年和 1991 年的总动态负荷评分是由 10 种生物标志物及其二阶项的加权总和创建的。 4.5 年后，即 1995 年，确定了参与者的死亡率（活着或死亡）。使用逻辑回归研究了非稳态负荷评分的变化（1988-1991）与随后的死亡率（1991-1995）之间的关联。结果：与 1988 至 1991 年间别动负荷评分下降的参与者相比，1991 至 1995 年间别动负荷评分上升的个体全因死亡风险更高（15% 与 5%，p =.047）。根据年龄和基线别静态负荷进行调整后，别静态负荷变化评分的每个单位增量与 3.3 的死亡率比值比相关（95% 置信区间，1.1-9.8）。结论：我们的结果表明，即使在老年人中，也可以跟踪风险评分的变化，以改善对死亡风险的评估。
Objectives: To study the association between change in allostatic load (a risk score constructed from multiple biological markers) over a 2.5-year period and mortality in the following 4.5 years in older adults. Methods: We measured 10 physiologic parameters at baseline (1988) in a cohort of 171 high-functioning, community-dwelling, 70- to 79-year-old adults. These measurements were repeated 2.5 years later, in 1991. Summary allostatic load scores for 1988 and 1991 were created as the weighted sum of the 10 biological markers and their second-order terms. Mortality status (alive or dead) for participants was determined 4.5 years later, in 1995. The association between change in allostatic load score (1988-1991) and subsequent mortality (1991-1995) was studied using logistic regression. Results: Compared with participants whose allostatic load score decreased between 1988 and 1991, individuals whose allostatic load score increased had higher risk of all-cause mortality between 1991 and 1995 (15% versus 5%, p =.047). Adjusted for age and baseline allostatic load, each unit increment in the allostatic load change score was associated with mortality odds ratio of 3.3 (95% confidence interval, 1.1-9.8). Conclusion: Our results suggest that even in older ages, change in risk scores can be followed to improve assessment of mortality risk.