Allostatic load and frailty do not covary significantly among older residents of Greater Poland.

BACKGROUND: Physiological dysregulation/allostatic load and the geriatric syndrome frailty increase with age. As a neurophysiological response system, allostasis supports survival by limiting stressor-related damage. Frailty reflects decreased strength, endurance, and physical abilities secondary to losses of muscle and bone with age. One suggestion, based on large cohort studies of person's ages 70 + years, is that frailty contributes to allostatic load at older ages. However, small community-based research has not confirmed this specific association. METHODS: To further explore possible associations between allostatic load and frailty, we enrolled 211 residents of Greater Poland aged 55-91 years living in a small village (Nekla, N = 104) and an urban center and capital of Greater Poland (Poznan, N = 107). For each, we recorded age, self-reported sex, and residence and estimated a 10-biomarker allostatic load score (ALS) and an 8-biomarker frailty index. We anticipated the following: higher ALS and frailty among men and rural residents; for frailty but not ALS to be higher at older ages; significant associations of ALS with sex and place of residence, but not with age or frailty. The significance of observed associations was evaluated by t-tests and multivariate regression. RESULTS: ALS did not vary significantly between men and women nor between Nekla and Poznan residents overall. However, women showed significantly higher frailty than men. Nekla men showed significantly higher ALS but not frailty, while Nekla women showed nonsignificantly higher ALS and lower frailty than Poznan. In multivariate analyses, neither age, nor sex, nor residence was associated with ALS. Conversely, age, sex, and residence, but not ALS, are associated significantly with frailty. In Nekla, both age and sex, but in Poznan only age, are associated with ALS. Among women, both age and residence, but among men, neither associated with ALS. In no case did ALS associate significantly with frailty. CONCLUSION: In this sample, lifestyle factors associated with residence, age, and sex influence stress-related physiology, less so in women, while ALS and frailty do not covary, suggesting their underlying promoters are distinct. Similar complex associations of physiological dysregulation with frailty, age, sex, and residence likely exist within many local settings. Knowledge of this variation likely will aid in supporting health and healthcare services among seniors.

Demography and epidemiology of captive former biomedical research chimpanzees (Pan troglodytes) 1: Survival and mortality.

Accurate and up-to-date data on longevity and mortality are essential for describing, analyzing, and managing animal populations in captivity. We assembled a comprehensive demography data set and analyzed survival and mortality patterns in a population of captive former biomedical research chimpanzees. The study synthesized over 51,000 life-years of demographic data collected on 2349 individuals between 1923 and 2014. Our goal was to assess the population's current age-sex composition, estimate rates of survivorship, mortality and life expectancy, and compare findings with other chimpanzee populations of interest. Results indicated an increasingly geriatric contemporary population declining in size. The median life expectancy (MLE) of the entire population was 32.6 years (males 29.1, females 36.1). For chimpanzees who reached 1 year of age, the MLE increased to 34.9 years (males 31.0, females 38.8). Survival probability was influenced by both sex and birth type. Females exhibited greater survivorship than males (ß1 = -0.34, z = -5.74, p < 0.001) and wild-born individuals exhibited greater survivorship than captive-born individuals (ß2 = -0.55, z = -5.89, p < 0.001). There was also a seasonal trend in mortality, wherein more individuals died during the winter months (December-February) compared with other seasons. Analyses of life expectancy over time showed continual increases in both median age of living individuals and median age at death, suggesting that these chimpanzees have yet to reach their full aging potential in a postresearch environment. As they continue to age, ongoing monitoring and analysis of demographic changes will be necessary for science-based population and program management until extinction occurs some decades in the future.

Aging, frailty, and design of built environments.

Before developing agriculture, herding or metallurgy, humans occupied most of the world. Multiple socioculturally-based responses supported their migration, including building shelters and constructing niches to limit environmental stressors. Sheltered settings provided social support and security during stressful times, along with opportunities for injured, aging, and frail members to survive. Modern built environments are designed for similar purposes, to support human growth, development, reproduction, and maintenance. However, extended survival in modern settings has costs. With age, muscle (sarcopenia) and bone loss (osteopenia, osteoporosis), along with somatic, physiological, and sensory dysfunction, reduce our physical capabilities, increase our frailty, and impede our abilities to interface with built and natural environments and manufactured artifacts. Thereby, increasing our dependence on built environments to maintain autonomy and quality of life.What follows is a conceptual review of how frailty may limit seniors within modern built environments. It suggests age-related frailty among seniors provides specific data for those designing environments for accessibility to all users. It is based in human ecological theory, and physiological and gerontological research showing senescent alterations, including losses of muscle, bone, and sensory perceptions, produce a frail phenotype with increasing age limiting our mobility, activity, use of space, and physical abilities. As an individual phenotype, frailty leads to age-related physical and performance declines. As a physiological assessment, frailty indices amalgamate individual measures of functional abilities into a single score. Such frailty indices increase with age and differ betwixt individuals and across groups. To design built environments that improve access, usability, and safety for aging and frail citizens, today's seniors provide living samples and evidence for determining their future abilities, limitations, and design needs. Designing built environments to accommodate and improve the quality of human-environment interactions for frail seniors will improve usability and accessibility for most user groups.

Individual measures of social support may have limited impact on physiological parameters among elderly Kuwaitis.

OBJECTIVES: Social support can buffer physiological stress responses, reducing morbidity and mortality risk, but research has occurred primarily in western populations. We examined whether social support was associated with physiological biomarkers in a non-western sample. METHODS: We predicted evidence of increased physiological dysregulation in those with less social support among elderly Kuwaitis (≥60 years, n = 253). Measures of social support included marital status (married/unmarried), religiosity (low/high), whether adult children lived at home (yes/no), and perceived social support (low/medium/high). Using linear regression, we tested relationships between each social support measure and 17 biomarkers: cortisol, dehydroepiandrosterone-sulfate (DHEA-S), epinephrine, norepinephrine, systolic blood pressure (SBP), diastolic blood pressure (DBP), waist-hip ratio (WHR), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), TC/HDL, LDL/HDL, glycated hemoglobin (HbA1c), C-reactive protein (CRP), and resting heart rate (RHR). We analyzed two models for each, one with the independent variable only and a second including age, smoking, and education as covariates. RESULTS: Married participants had lower norepinephrine, but higher TC/HDL and LDL/HDL. Higher religiosity was negatively associated with TC (men only) but higher LDL, TC/HDL, and LDL/HDL. Participants with low self-reported social support had higher DBP and HbA1c than those reporting medium or high levels. CONCLUSIONS: Relatively few biomarkers associated significantly with individual social support measures in a way that suggests improved health for those with more support. As such, some measures of social support may not be universally beneficial across cultures. Additionally, the high degree of respect for and integration of elders in Kuwait society may collectively buffer against negative effects. Cross-cultural comparisons are critical to better understand how social support influences morbidity and mortality across populations.

Assessing Allostatic Load in Ring-Tailed Lemurs (Lemur catta).

Responses to stress are unavoidable, adaptive mechanisms in humans and non-human animals. However, in humans, chronic stress has been linked to poor health outcomes and early mortality. Allostatic load, the physiologic dysregulation that occurs when an organism is exposed to chronic stressors, has been used to assess stress in humans; less work has been done using non-human primates. Our aim was to determine the relationship between allostatic load in ring-tailed lemurs (Lemur catta) under human care and potentially stressful individual, social, medical and husbandry factors, as well a sex and age. An allostatic load index (ALI) was calculated for 38 lemurs using six biomarkers measured in serum (albumin, cortisol, dehydroepiandrosterone-sulfate, DNA damage, glucose and prostaglandin E2). Potentially stressful factors were recorded over the lifetime of each lemur using medical and husbandry records. Animals with a higher percentage of time spent indoors, those kept in smaller average group sizes, and those with fewer minor group composition changes had, or tended to have, higher ALI. There was no relationship between ALI and sex or age. Some social and husbandry factors were associated with allostatic load in lemurs, indicating that this index may be a useful tool in assessing and determining factors contributing to stress of lemurs and other animals under human care.

Testing a method to improve predictions of disease and mortality risk in western lowland gorillas (gorilla gorilla gorilla) using allostatic load.

Allostatic load is the wear-and-tear organisms accumulate due to senescence and stress; it is measured by combining biomarkers from multiple somatic systems into allostatic load indices (ALIs). Frequently used in human research, ALIs have shown consistent results across samples despite different biomarkers and methods. However, determining optimal models likely is necessary if ALIs are to be feasible research tools in other species. Herein, we build on prior research in western lowland gorillas to explore one potential method for determining which biomarkers may be best for estimating allostatic load. After narrowing down which biomarkers to include using a combination of forward stepwise regression and independent biomarker associations with project variables, we estimated allostatic load using both the traditional one-tailed quartile method as well as a multi-method approach. There was a significant positive association between allostatic load and triglycerides, but not cholesterol, both of which are commonly used as diagnostic markers of poor health. Using binomial generalized linear models, a one-unit increase in allostatic load was associated with increased risk of all-cause morbidity and mortality, but reduced risk of cardiac disease. Although conclusions were similar, compared to our original ALIs, these new ALIs had weaker effect sizes and poorer relative goodness of fit, suggesting this method for identifying the best possible list of biomarkers to include in an index was not effective. This report continues the development of ALIs as a clinical tool in wildlife while systematically testing one possible method for determining an optimal ALI for a particular species.

Allostatic Load Indices With Cholesterol and Triglycerides Predict Disease and Mortality Risk in Zoo-Housed Western Lowland Gorillas (Gorilla gorilla gorilla).

Allostatic load, or the physiological dysregulation accumulated due to senescence and stress, is an established predictor of human morbidity and mortality and has been proposed as a tool for monitoring health and welfare in captive wildlife. It is estimated by combining biomarkers from multiple somatic systems into allostatic load indices (ALIs), providing a score representing overall physiological dysregulation. Such ALIs have been shown to predict disease and mortality risk in western lowland gorillas. In these prior analyses, we were unable to include lipid markers, a potential limitation as they are key biomarkers in human models. Recently, we were able to assay serum cholesterol and triglycerides and add them to our previous ALI. We then re-examined associations with health outcomes using binomial generalized linear models. We constructed ALIs using 2 pooling strategies and 2 methods. By itself, a 1-unit increase in allostatic load was associated with higher odds of all-cause morbidity and mortality, but results were mixed for cardiac disease. However, the best fit models for all-cause morbidity and cardiac disease included only age and sex. Allostatic load was retained alongside age in the best fit models for mortality, with a 1-unit increase associated with 23% to 45% higher odds of death. Compared with previous results, ALIs containing cholesterol and triglycerides better predict disease risk in zoo-housed western lowland gorillas, as evidenced by larger effect sizes for some models and better goodness of fit for all ALIs. Based on these results, we address methodology for future allostatic load research on wildlife.

Stress, migration, and allostatic load: a model based on Mexican migrants in Columbus, Ohio.

BACKGROUND: Immigration is a disruptive event with multiple implications for health. Stressors, including family separation, acculturation, job insecurity, restricted mobility, sojourns, dangerous border crossings, stigmatization, and marginalization, shape immigrant health in ways we are only beginning to untangle. Around the world, there are over 200 million international migrants. In 2015, there were 43.2 million immigrants living in the US, 26.8% of whom were born in Mexico. Investigating how stress affects health among migrants facilitates better understanding of their experiences. METHODS: Here, we review existing research on stress and how allostatic load varies among migrants with specific attention to Mexican migrants in the US. Next, we explore research incorporating biomarkers of allostasis and narratives of migration and settlement to examine disease risks of Mexican migrants residing in Columbus, Ohio. This mixed-methods approach allowed us to examine how social stressors may influence self-reports of health differentially from associations with assessed discrimination and physiological biomarkers of health. RESULTS: These data sources are not significantly associated. Neither narratives nor self-reports of health provide significant proxies for participants' physiological health. CONCLUSIONS: We propose, the pairing of objectively assessed health profiles with narratives of migration better illustrate risks migrants face, while allowing us to discern pathways through which future health challenges may arise. Immigration and acculturation to a new nation are biologically and culturally embedded processes, as are stress and allostatic responses. To understand how the former covary with the latter requires a mixed-methods bioethnographic approach. Differences across multiple social and physiological systems, affect individual health over time. We propose incorporating physiological biomarkers and allostatic load with migrants' narratives of their migration to unravel complex relationships between acculturation and health.

EVALUATING ALLOSTATIC LOAD: A NEW APPROACH TO MEASURING LONG-TERM STRESS IN WILDLIFE.

Animal welfare, conservation, and stress assessment are all critical components of species survival. As organisms experience stressors, they accumulate physiologic dysregulation, leading to multiple negative health outcomes. This brief review suggests measuring the degree of stress-induced damage, known as allostatic load, and then using allostatic load to evaluate changes implemented to improve animal welfare and conservation efforts. Over the past two decades, human clinical research has developed multiple allostatic load indices constructed from composites of neuroendocrine, cardiovascular, metabolic, and immune biomarkers. These indices are designed to estimate allostatic load in hopes of ameliorating or even negating damaging effects of stress. Among humans, allostatic load is associated with a variety of factors such as age, sex, stressful experiences, personality, social position, and early life history. Despite conservation of stress responses throughout mammalian species, reported allostatic load indices for animals are rare. Because many zoo researchers and field scientists already collect data on multiple biomarkers, constructing allostatic load indices may be a relatively affordable, easily implemented, and powerful tool for assessing relative risks of morbidity and mortality within wildlife. As an example, in a study among zoo-housed gorillas, an allostatic load index constructed using seven biomarkers was associated significantly with age, sex, stressful experiences, rearing history, markers of poor health, and mortality risk. Such results evidence that allostatic load is as applicable to animal populations as it is to humans. By using allostatic load as a predictive tool, human caretakers will be better informed of individuals at greatest risk for health declines. Most importantly, allostatic load may provide earlier opportunity for preemptive care while contributing a transformational tool to animal welfare research. Additionally, allostatic load may be compared between individuals and groups within the same population and allow comparisons of health between and across populations, consequently informing habitat and population protection efforts.

The first multi-zoo application of an allostatic load index to western lowland gorillas (Gorilla gorilla gorilla).

Vertebrate stress responses are highly adaptive biological functions, maximizing survival probability in life-threatening situations. However, experiencing repeated and/or chronic stressors can generate physiological dysregulation and lead to disease. Because stress responses are multi-systemic and involve a wide range of physiological functions, identifying responses to stressors is best accomplished using integrated biomarker models. Allostatic load, defined as the physiological dysregulation that accumulates over the lifespan due to stressful experiences, is one such model. Allostatic load is measured using allostatic load indices, which are composites of biomarkers from multiple somatic systems. Previously, we reported the use of a 7-biomarker allostatic load index (albumin, CRH, cortisol, DHEA-S, glucose, IL-6, TNF-α) in western lowland gorillas housed at a single zoo. Herein, this index is expanded to examine allostatic load responses to lifetime stressors in gorillas from two additional zoos (n = 63) as well as two pooled samples. The index was created using quartile cut-points for each biomarker. Significant associations were observed between multiple predictor variables and allostatic load, including sex, age, number of stressful events (anesthetic events, zoo transfers, agonistic interactions with wounding, pregnancies), and rearing history (mother-reared, nursery-reared, wild-caught). Additionally, allostatic load was associated with indicators of morbidity (creatinine, cholesterol, triglycerides), age at death, and mortality risk. These results are consistent with those reported in human allostatic load research, suggesting allostatic load indices have potential as an investigative and clinical tool for gorillas and other great apes.

Frail or hale: Skeletal frailty indices in Medieval London skeletons.

To broaden bioarchaeological applicability of skeletal frailty indices (SFIs) and increase sample size, we propose indices with fewer biomarkers (2-11 non-metric biomarkers) and compare these reduced biomarker SFIs to the original metric/non-metric 13-biomarker SFI. From the 2-11-biomarker SFIs, we choose the index with the fewest biomarkers (6-biomarker SFI), which still maintains the statistical robusticity of a 13-biomarker SFI, and apply this index to the same Medieval monastic and nonmonastic populations, albeit with an increased sample size. For this increased monastic and nonmonastic sample, we also propose and implement a 4-biomarker SFI, comprised of biomarkers from each of four stressor categories, and compare these SFI distributions with those of the non-metric biomarker SFIs. From the Museum of London WORD database, we tabulate multiple SFIs (2- to 13-biomarkers) for Medieval monastic and nonmonastic samples (N = 134). We evaluate associations between these ten non-metric SFIs and the 13-biomarker SFI using Spearman's correlation coefficients. Subsequently, we test non-metric 6-biomarker and 4-biomarker SFI distributions for associations with cemetery, age, and sex using Analysis of Variance/Covariance (ANOVA/ANCOVA) on larger samples from the monastic and nonmonastic cemeteries (N = 517). For Medieval samples, Spearman's correlation coefficients show a significant association between the 13-biomarker SFI and all non-metric SFIs. Utilizing a 6-biomarker and parsimonious 4-biomarker SFI, we increase the nonmonastic and monastic samples and demonstrate significant lifestyle and sex differences in frailty that were not observed in the original, smaller sample. Results from the 6-biomarker and parsimonious 4-biomarker SFIs generally indicate similarities in means, explained variation (R2), and associated P-values (ANOVA/ANCOVA) within and between nonmonastic and monastic samples. We show that non-metric reduced biomarker SFIs provide alternative indices for application to other bioarchaeological collections. These findings suggest that a SFI, comprised of six or more non-metric biomarkers available for the specific sample, may have greater applicability than, but comparable statistical characteristics to, the originally proposed 13-biomarker SFI.

Allostatic load and biological anthropology.

Multiple stressors affect developing and adult organisms, thereby partly structuring their phenotypes. Determining how stressors influence health, well-being, and longevity in human and nonhuman primate populations are major foci within biological anthropology. Although much effort has been devoted to examining responses to multiple environmental and sociocultural stressors, no holistic metric to measure stress-related physiological dysfunction has been widely applied within biological anthropology. Researchers from disciplines outside anthropology are using allostatic load indices (ALIs) to estimate such dysregulation and examine life-long outcomes of stressor exposures, including morbidity and mortality. Following allostasis theory, allostatic load represents accumulated physiological and somatic damage secondary to stressors and senescent processes experienced over the lifespan. ALIs estimate this wear-and-tear using a composite of biomarkers representing neuroendocrine, cardiovascular, metabolic, and immune systems. Across samples, ALIs are associated significantly with multiple individual characteristics (e.g., age, sex, education, DNA variation) of interest within biological anthropology. They also predict future outcomes, including aspects of life history variation (e.g., survival, lifespan), mental and physical health, morbidity and mortality, and likely health disparities between groups, by stressor exposures, ethnicity, occupations, and degree of departure from local indigenous life ways and integration into external and commodified ones. ALIs also may be applied to similar stress-related research areas among nonhuman primates. Given the reports from multiple research endeavors, here we propose ALIs may be useful for assessing stressors, stress responses, and stress-related dysfunction, current and long-term cognitive function, health and well-being, and risk of early mortality across many research programs within biological anthropology.

SPOUSAL INFLUENCES ON HEALTH AND WELL-BEING OF OLDER KUWAITI MEN AND WOMEN.

The aim of the study was to determine the associations of the self-perceptions of health and social support among Kuwaitis who were 60 years old and older, who either were or were not currently living with a spouse. A sample of 1427 was selected (472 men and 955 women). Social Affairs nurses completed all interviews in the participants' homes. A single questionnaire was designed; SPSS (version 21) was used for data entry and analysis. Participants living with their spouse reported significantly greater social support, more frequent contact with others and greater strength of social relationships than those without a spouse. Significant differences between those with and without a spouse were observed for all physically assessed and self-reported aspects of health. Of 60 items included in the somatic symptoms, participants with a spouse reported fewer poor health symptoms than those without a spouse. More children living in the same household, along with greater frequency of contact, strength of contact and social support significantly and independently predicted positive somatic symptoms in the total sample as well as in both sexes. Participants with a spouse reported fewer poor health symptoms than did those without a spouse. Having a spouse is a significant benefit to many aspects of elder Kuwaitis' daily lives, including their health and well-being.

In sickness and in death: Assessing frailty in human skeletal remains.

Stress plays an important role in the etiology of multiple morbid and mortal outcomes among the living. Drawing on health paradigms constructed among the living augments our evolving knowledge of relationships between stress and health. Therefore, elucidating relationships between stress and both chronic and acute skeletal lesions may help clarify our understanding of long-term health trends in the past. In this study, we propose an index of "skeletal frailty," based on models of frailty used to evaluate the life-long effects of stress on health among living populations. Here, we assess the possible applicability of frailty to archaeological populations. The skeletal frailty index (SFI) is proposed as a methodological liaison between advances made by biological anthropologists studying relationships between stress and health among the living and bioarchaeologists studying stress and health among the dead. In a case study examining skeletal stress in Medieval London, the SFI is applied to nonmonastic (N = 60) and monastic (N = 74) samples. We used analysis of variance/analysis of covariance to compare SFI values between nonmonastic-monastic groups, sexes, and age cohorts. Results indicate higher lifetime morbidity among monastic groups. These results complement previous bioarchaeological findings on the same London populations, wherein lower risks of mortality and longer lifespans were observed for monastic populations. SFI data reflect the morbidity-mortality paradox observed in modern populations and accompany recent findings in bioarchaeology of variation in Medieval monastic and nonmonastic "health." Ultimately, this study demonstrates the SFI's utility in bioarchaeology, through its application of commonly assessed skeletal biomarkers, its ease of applicability, and its potential usefulness for assessing changes in skeletal health over time and across specific geographies.

Rearing history and allostatic load in adult western lowland gorillas (Gorilla gorilla gorilla) in human care.

Disrupted rearing history is a psychological and physical stressor for nonhuman primates, potentially resulting in multiple behavioral and physiological changes. As a chronic, soma-wide stressor, altered rearing may be best assessed using a holistic tool such as allostatic load (AL). In humans, AL estimates outcomes of lifetime stress-induced damage. We predicted mother-reared gorillas would have lower AL than nursery-reared and wild-caught conspecifics. We estimated AL for 27 gorillas housed at the Columbus Zoo and Aquarium between 1956 and 2014. AL estimates were calculated using biomarkers obtained during previous anesthetic events. Biomarkers in the high-risk quartile were counted toward a gorilla's AL. Rearing history was categorized as mother-reared, nursery-reared, and wild-caught. Using ANCOVA, rearing history and AL are significantly associated when age and sex are entered as covariates. Wild-caught gorillas have significantly higher AL than mother-reared gorillas. Neither wild-caught nor mother-reared gorillas are significantly different from nursery-reared gorillas. When examined by sex, males of all rearing histories have significantly lower AL than females. We suggest males face few stressors in human care and ill effects of rearing history do not follow. Wild-caught females have significantly higher AL than mother-reared females, but neither is significantly different from nursery-reared females. Combined with our previous work on AL in this group, wherein females had twofold higher AL than males, we suggest females in human care face more stressors than males. Disrupted rearing history may exacerbate effects of these stressors. Providing opportunities for females to choose their distance from males may help reduce their AL.

Allostatic load differs by sex and diet, but not age in older Japanese from the Goto Islands.

BACKGROUND: Lifelong exposure to stressors promotes physiological dysregulation and produces an allostatic load (AL). In European-derived samples, AL associates significantly with sex, age and health. AIM: To assess associations of AL with age, sex, socio-demographic differences and self-reports of diet and ability to complete activities of daily living in older Japanese residing in rural Nagasaki Prefecture. SUBJECTS AND METHODS: In 2011, 96 older residents of Nagasaki Prefecture, Japan, were assessed for components of AL. They also self-reported their age, principal life-long occupational activity, educational attainments, marital status, dietary choices and abilities to complete daily living activities. RESULTS: Average age was 67.9 years (range = 55-89; SD = 8.65). Among these 48 men and 48 women, AL was not related significantly to age, although women showed lower AL than men. AL did not differ significantly between respondents by occupation, marital status, education or abilities to complete daily activities. Women who reported eating more green/yellow vegetables or consuming more meat had lower AL than their counterparts. Men who reported drinking more alcohol spirits had higher AL. CONCLUSIONS: Among older Japanese residing outside a major urban area, AL varies significantly by sex, but not age, while being associated with dietary choices. Although lack of association with life ways was not expected, AL apparently assesses physiological dysregulation cross-culturally.

Correlates of Frailty among Aging Residents of Upper Selska Valley Villages under Ratitovec Mountain.

Frailty, multi-system dysregulation following multiple life stressors, is associated with age and vulnerability to negative health. Our model posits that variables such as age and sex affect biocultural changes resulting from lifestyle and alter frailty. We assessed frailty with a four-factor index. We expand understanding of frailty by examining associations with demographic, health, and lifestyle factors in a Slovenian sample. Between 2008 and 2009, 40 residents of the Selska Valley, Slovenia aged 55 to 85 years (X = 72, SD = 7.24) participated in physical assessments, responded to the SF-36, and self-reported their own and family history of non-communicable diseases. Participants included 26 women (age 59-86) and 14 men (age 57-82). We used linear regression and t-tests to assess associations of these factors with frailty. Frailty was significantly positively associated with age, sex, length of residence in the village, and multiple self-reported health factors. Conversely, frailty was significantly negatively associated with height and showed a borderline significant association with diastolic blood pressure. Controlling for age and sex, significant associations remained between frailty and self-reports of health, along with painful and reduced activity levels. Frailty also interacts with lifestyle factors. Results suggest the model proposed by Walston and colleagues (2005) is a valid cross-cultural measure of frailty.

Social support and health among elderly Kuwaitis.

The aim of this study was to examine differences in several aspects of health between Kuwaiti men and women aged 60 years and over across three age categories (60-69, 70-79, 80+ years). The relationships between several social support variables, somatic symptoms and systolic and diastolic blood pressures were examined. A total of 1427 adult men (472) and women (955) aged 60 years and over representing all six governorates were selected. Data were collected during 2008-2009 by interview and completion of a questionnaire by participants in their own homes, after obtaining their informed consent. The Social Support Scale (SSS), Frequency of Contact Scale (FOC), Strength of Relations (SOR), Somatic Symptoms Inventory (SSI) and self-rated scales of general health were included. Systolic and diastolic blood pressures were measured. The data show that self-rated health and health in the last year differ significantly across age groups. Glycaemia differed significantly across the three age groups for the total sample. Systolic and diastolic blood pressure were higher in older respondents than younger ones, but no significant differences were observed between men and women. No significant differences in somatic symptoms were observed across the three age groups. Strength of relationship, frequency of contact, social support and children living with an elderly adult were all associated with fewer somatic symptoms, and all, except social support, were associated with lower systolic and diastolic blood pressure. Having children, the perception of social support, frequency of contact with, and strength of, relationships with kin are important modulators of somatic symptoms and blood pressure among elderly Kuwaitis.

Physiological dysregulation and somatic decline among elders: modeling, applying and re-interpreting allostatic load.

Mortality rates continue to decline among post-reproductive individuals. This makes understanding long-term physiological responses to stress increasingly important. Allostatic load (AL) was developed to assess detrimental effects on the soma of responding to multiple stressors over a lifetime. AL arises from developmental experiences, genetic predispositions, environmental, psychosocial, life style and other stressors. In early life stress responsive systems are initiated that produce hormones that maintain the soma through continual allostatic responses. Later in life, systems designed to mitigate stressors may fail or be compromised, promoting unwanted somatic changes and dysregulation. This places a load on the regulatory system that impedes day-to-day stress responses, predisposing to cellular damage and degenerative diseases. Here we review 44 peer-reviewed 2005-2010 publications reportedly examining relationships between AL and risk factors, chronic diseases, morbidity and mortality in samples of elderly adults. The sum of results suggests that AL does assess aspects of physiological dysregulation and somatic decline, predicts detrimental age-related declines, and is associated with negative sociocultural attributes and psychological outcomes. Such consistent results and wide application of AL, while it is still being modeled and re-interpreted, suggest its perceived usefulness as a research and clinical tool. AL provides a possible biomarker of senescence, assessing it over the life span will aid in predicting future negative health outcomes.