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Allostatic Load as a Biological Substrate to Intrinsic Capacity: A Secondary Analysis of Creles

  • Luis Miguel Gutiérrez-RobledoEmail author
  • R. E. García-Chanes
  • M. U. Pérez-Zepeda
Article
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Abstract

Objectives

Intrinsic capacity (IC) is one of the latest views of positive aging. In its current status lacks a biological substrate amenable to be intervened. The aim of this study was to determine the association of allostatic load (AL) with IC.

Design

We present a cross-sectional analysis of the Costa Rican Longevity and Healthy Aging Study.

Setting

This report is from a representative sample of Costa Rican older adults; one of the countries that integrate the Central America region.

Participants

2,827, 60-year or older community-dwelling individuals.

Methods

An IC index was gathered and validated, including different domains: cognitive, psychological, sensory, vitality and locomotion. AL was integrated with: blood pressure, abdominal obesity, body mass index, HDL-cholesterol, glycosylated hemoglobin, DHEAS, cortisol, epinephrine and norepinephrine. AL was grouped in three categories according to the number of abnormal biomarkers (0–1, 2–3 and ≥4). Chronic diseases, socioeconomic level, sex and age were the adjusting variables. Ordinal logistic regression models were estimated in order to test the strength of the association.

Results

From a total sample of 1,888 individuals, 51% (n=962) were women, 36.4% were in the 60–69 age category. The mean score of the IC index was of 6.6 (±2.2). Odds ratio (OR) of the adjusted models were significant for the group of those with 2–3 abnormal biomarkers of AL (OR 0.67, p=0.007) and also for those with ≥4 (OR 0.56, p=0.002), when compared to the reference group of AL (0–1 abnormal biomarkers).

Conclusions and implications

AL showed an incremental association with IC, even when adjusted for factors such as socioeconomic status and chronic diseases. Targeting therapeutically AL could potentially improve IC in older adults and therefore decreasing the progression to disability or to overt dependency.

Key words

Intrinsic capacity healthy aging allostasis aging 

Notes

Funding sources: The publication of this project was supported by a grant from the Secretaría de Educación, Ciencia, Tecnología e Innovación de la Ciudad de México SECITI/042/2018 “Red colaborativa de Investigación Traslacional para el Envejecimiento Saludable de la Ciudad de México (RECITES).

Ethical Standards: CRELES was approved by the Ethical Science Committee of the University of Costa Rica (VI-763- CEC-23-04). All subjects signed informed consent and procedures were according to Helsinki’s declaration.

Supplementary material

12603_2019_1251_MOESM1_ESM.docx (182 kb)
Supplementary material, approximately 182 KB.

References

  1. 1.
    Beard, JR, Officer, AM, Cassels, AK. The World Report on Ageing and Health. Gerontologist 2016;56 Suppl 2:S163–166.CrossRefGoogle Scholar
  2. 2.
    Beard, JR, Officer, A, de Carvalho, IA, et al. The World report on ageing and health: a policy framework for healthy ageing. Lancet 2016;387(10033):2145–2154.CrossRefGoogle Scholar
  3. 3.
    Lopez-Otin, C, Blasco, MA, Partridge, L, et al. The hallmarks of aging. Cell 2013;153(6):1194–1217.CrossRefGoogle Scholar
  4. 4.
    Cesari, M, Perez-Zepeda, MU, Marzetti, E. Frailty and Multimorbidity: Different Ways of Thinking About Geriatrics. J Am Med Dir Assoc 2017;18(4):361–364.CrossRefGoogle Scholar
  5. 5.
    Verbrugge, LM, Jette, AM. The disablement process. Soc Sci Med 1994;38(1):1–14.CrossRefGoogle Scholar
  6. 6.
    Cesari, M, Marzetti, E, Thiem, U, et al. The geriatric management of frailty as paradigm of “The end of the disease era”. Eur J Intern Med 2016;31:11–14.CrossRefGoogle Scholar
  7. 7.
    Belanger, E, Ahmed, T, Filiatrault, J, et al. An Empirical Comparison of Different Models of Active Aging in Canada: The International Mobility in Aging Study. Gerontologist 2015.Google Scholar
  8. 8.
    Burggraf, V, Kim, KY, Knight, AL. Healthy aging: principles and clinical practice for clinicians. First edition. ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2014.Google Scholar
  9. 9.
    Prince, MJ, Wu, F, Guo, Y, et al. The burden of disease in older people and implications for health policy and practice. Lancet 2015;385(9967):549–562.CrossRefGoogle Scholar
  10. 10.
    Cesari, M, Araujo de Carvalho, I, Amuthavalli Thiyagarajan, J, et al. Evidence for the Domains Supporting the Construct of Intrinsic Capacity. J Gerontol A Biol Sci Med Sci 2018;73(12):1653–1660.CrossRefGoogle Scholar
  11. 11.
    Stuck, AE, Walthert, JM, Nikolaus, T, et al. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med 1999;48(4):445–469.CrossRefGoogle Scholar
  12. 12.
    Cigolle, CT, Langa, KM, Kabeto, MU, et al. Geriatric conditions and disability: the Health and Retirement Study. Ann Intern Med 2007;147(3):156–164.CrossRefGoogle Scholar
  13. 13.
    Chaudhry, SI, Wang, Y, Gill, TM, et al. Geriatric conditions and subsequent mortality in older patients with heart failure. J Am Coll Cardiol 2010;55(4):309–316.CrossRefGoogle Scholar
  14. 14.
    Hu, P, Wagle, N, Goldman, N, et al. The associations between socioeconomic status, allostatic load and measures of health in older Taiwanese persons: Taiwan social environment and biomarkers of aging study. J Biosoc Sci 2007;39(4):545–556.CrossRefGoogle Scholar
  15. 15.
    Seeman, TE, Singer, BH, Ryff, CD, et al. Social relationships, gender, and allostatic load across two age cohorts. Psychosom Med 2002;64(3):395–406.CrossRefGoogle Scholar
  16. 16.
    Seeman, TE, McEwen, BS, Rowe, JW, et al. Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. Proc Natl Acad Sci U S A 2001;98(8):4770–4775.CrossRefGoogle Scholar
  17. 17.
    Seeman, TE, Singer, BH, Rowe, JW, et al. Price of adaptation—allostatic load and its health consequences. MacArthur studies of successful aging. Arch Intern Med 1997;157(19):2259–2268.CrossRefGoogle Scholar
  18. 18.
    Rosero-Bixby, L, Dow, WH. Surprising SES Gradients in mortality, health, and biomarkers in a Latin American population of adults. J Gerontol B Psychol Sci Soc Sci 2009;64(1):105–117.CrossRefGoogle Scholar
  19. 19.
    Yesavage, JA, Brink, TL, Rose, TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982;17(1):37–49.CrossRefGoogle Scholar
  20. 20.
    Reyes Fernandez, B, Rosero-Bixby, L, Koivumaa-Honkanen, H. Effects of Self-Rated Health and Self-Rated Economic Situation on Depressed Mood Via Life Satisfaction Among Older Adults in Costa Rica. J Aging Health 2016;28(2):225–243.CrossRefGoogle Scholar
  21. 21.
    Angel, RJ, Angel, JL, Hill, TD. Subjective control and health among Mexican-origin elders in Mexico and the United States: structural considerations in comparative research. J Gerontol B Psychol Sci Soc Sci 2009;64(3):390–401.CrossRefGoogle Scholar
  22. 22.
    Castagne, R, Gares, V, Karimi, M, et al. Allostatic load and subsequent all-cause mortality: which biological markers drive the relationship? Findings from a UK birth cohort. European journal of epidemiology 2018;33(5):441–458.CrossRefGoogle Scholar
  23. 23.
    Ahn, AC, Tewari, M, Poon, CS, et al. The limits of reductionism in medicine: could systems biology offer an alternative? PLoS Med 2006;3(6):e208.CrossRefGoogle Scholar
  24. 24.
    Tinetti, ME, Fried, T. The end of the disease era. Am J Med 2004;116(3):179–185.CrossRefGoogle Scholar
  25. 25.
    Heinz, W, Marshall, V. Social Dynamics of Life Course: Transitions, Institutions and Interrelations. New York: Walter de Gruyert Inc., 2003.Google Scholar
  26. 26.
    Sanchez-Garrido, N, Cesari, M, Sgaravatti, A, et al. The Chimeric Nihilism of Geriatrics. J Am Geriatr Soc 2016;64(11):e213–e214.CrossRefGoogle Scholar
  27. 27.
    Hopman, P, de Bruin, SR, Forjaz, MJ, et al. Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review. Health Policy 2016;120(7):818–832.CrossRefGoogle Scholar
  28. 28.
    Cesari, M, Gambassi, G, van Kan, GA, et al. The frailty phenotype and the frailty index: different instruments for different purposes. Age Ageing 2014;43(1):10–12.CrossRefGoogle Scholar
  29. 29.
    Cesari, M, Vellas, B, Gambassi, G. The stress of aging. Exp Gerontol 2013;48(4):451–456.CrossRefGoogle Scholar

Copyright information

© Serdi and Springer-Verlag International SAS, part of Springer Nature 2019

Authors and Affiliations

  • Luis Miguel Gutiérrez-Robledo
    • 1
    Email author
  • R. E. García-Chanes
    • 1
  • M. U. Pérez-Zepeda
    • 1
    • 2
  1. 1.Instituto Nacional de Geriatríaciudad de MéxicoMéxico
  2. 2.Geriatric Medicine ResearchDalhousie UniversityHalifaxCanada

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