Longitudinal association of allostatic load with depressive symptoms among urban adults: Healthy Aging in Neighborhoods of Diversity across the Life Span study

Hind A Beydoun; May A Beydoun; Edward Kwon; Sharmin Hossain; Marie T Fanelli-Kuczmarski; Ana Maldonado; Michele K Evans; Alan B Zonderman

doi:10.1016/j.psyneuen.2022.106022

Longitudinal association of allostatic load with depressive symptoms among urban adults: Healthy Aging in Neighborhoods of Diversity across the Life Span study

Psychoneuroendocrinology. 2023 Mar:149:106022. doi: 10.1016/j.psyneuen.2022.106022. Epub 2023 Jan 3.

Authors

Hind A Beydoun¹, May A Beydoun², Edward Kwon³, Sharmin Hossain², Marie T Fanelli-Kuczmarski², Ana Maldonado⁴, Michele K Evans², Alan B Zonderman²

Affiliations

¹ Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA. Electronic address: hindb2020@gmail.co.
² Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA.
³ Department of Family Medicine, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
⁴ Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA.

Abstract

Background: Evidence suggests that lifetime exposure to stressful life events and chronic stressors may be linked to geriatric depression. Allostatic load (AL) is considered a mediator of the stress-health relationship and has been linked to psychosocial factors reflecting health disparities. The purpose of this study was to examine the longitudinal associations of AL with depressive symptoms scores among urban adults, before and after stratifying by sex and race.

Methods: Secondary analyses were performed using Visit 1 (2004-2009), Visit 2 (2009-2013) and Visit 3 (2013-2017) data collected on 2298 Healthy Aging in Neighborhoods of Diversity across the Life Span study participants (baseline age: 30-64 y). AL at Visit 1 (AL_v1) and z-transformed probability of higher AL trajectory (AL_traj) between Visits 1 and 3 were calculated using cardiovascular, metabolic and inflammatory risk indicators. The 20-item Center for Epidemiologic Studies Depression (CES-D) scale was used to calculate total and domain-specific depressive symptoms scores. Mixed-effects linear models controlled for socio-demographic, lifestyle and health characteristics.

Results: In fully adjusted models, a positive cross-sectional relationship was observed between AL_v1 and "somatic complaints" depressive symptoms (β = 0.21, P = 0.006) score at Visit 1, whereas AL_traj was associated with increasing depressive symptoms score (β = 0.086, P = 0.003) between Visits 1 and 3. An inverse relationship was observed between AL_traj and "positive affect" depressive symptoms score at Visit 1 among women (β = -0.31, P < 0.0001) and White adults (β = -0.32, P = 0.004). Among women, AL_traj was also positively related to change in "somatic complaints" depressive symptoms score between Visits 1 and 3 (β = 0.043, P = 0.020).

Conclusions: Among urban adults, AL may be associated with "somatic complaints" depressive symptoms at baseline. Higher AL trajectories may predict increasing depressive symptoms (overall) and increasing "somatic complaints" depressive symptoms (among women). A higher AL trajectory may be associated with lower "positive affect" depressive symptoms at baseline among women and White adults only.

Keywords: Allostatic load; Depressive Symptoms; Disparities; Longitudinal study; Race; Sex.

Publication types

Research Support, N.I.H., Intramural

MeSH terms

Adult
Aged
Allostasis*
Depression / metabolism
Female
Healthy Aging*
Humans
Longevity
Longitudinal Studies
Middle Aged
Risk Factors

Grants and funding

Z01 AG000513/ImNIH/Intramural NIH HHS/United States