The Associations Between Socioeconomic Status, Allostatic Load and Measures of Health in Older Taiwanese Persons: Taiwan Social Environment and Biomarkers of Aging Study

Abstract

SummaryData from a national representative sample of 1023 elderly and near-elderly Taiwanese were used to explore whether allostatic load is associated with health outcomes and mediates the association between socioeconomic status and health in a non-Western population. The information collected included: demographic characteristics; allostatic load scores; socioeconomic status, measured by education and income; health behaviours; health-related variables, including self-rated health, basic activities of daily living difficulties, instrumental activities of daily living difficulties, and physical activity difficulties. The adjusted prevalent odds ratios of higher allostatic load level were 1·25 (95% CI: 1·00, 1·56) for reporting one level worse in self-rated health and 1·43 (95% CI: 1·14, 1·82) for reporting one more physical activity difficulty. There were significant associations of lower education or less income with worse self-rated health and more difficulties with physical functioning. The associations between education, income and health status are not mediated by the conventional ten-point measure of allostatic load in older Taiwanese adults.

Sociodemographic, behavioral and genetic determinants of allostatic load in a Swiss population-based study

“…Women abstaining from alcohol were also at increased risk of high AL. However, individuals might restrain from alcohol consumption due to medical conditions or other reasons such as past drinking (Gallo et al, 2011;Hu et al, 2007). Consistently with previous research showing the beneficial effects of physical activity on various physiological processes (Warburton et al, 2006), we found that men and women reporting high physical activity had lower AL and lower dysregulation of several physiological axes including metabolism, cardiovascular axis, lipidic profile and oxidative stress.…”

“…In addition to the research that has investigated determinants of AL in Western populations, several studies have also been conducted in Asian countries such as Japan, Taiwan or Nepal, and may therefore provide an interesting ethnic or cultural contrast for the study of determinants of AL (Hu et al, 2007;Kusano et al, 2015;Worthman and Panter-Brick, 2008). Kusano et al (2015) have shown that in elderly Japanese, high alcohol intake was associated with high AL, and increased vegetable consumption was associated with lower AL, a tendency which was also observed in our study.…”

“…Other factors such as work-life balance, social support, psychosocial factors, early life conditions and better measurements of stress and financial strain can potentially contribute to explain the observed social differences in physiological dysregulation (Gallo et al, 2011;Hawkley et al, 2011;Hu et al, 2007;Kubzansky et al, 1999). In terms of education results were more consistent than for occupational position (Hu et al, 2007;Nicod et al, 2014;Seeman et al, 2004). A previous study performed by Nicod et al (2014) also found a negative association between this indicator and AL, in a Swiss population from which a subset of the participants were also included in SKIPOGH.…”

“…However, in our study lifestyle factors (including marital status and stress only) slightly attenuated the association between SES indicators and AL. Other factors such as work-life balance, social support, psychosocial factors, early life conditions and better measurements of stress and financial strain can potentially contribute to explain the observed social differences in physiological dysregulation (Gallo et al, 2011;Hawkley et al, 2011;Hu et al, 2007;Kubzansky et al, 1999). In terms of education results were more consistent than for occupational position (Hu et al, 2007;Nicod et al, 2014;Seeman et al, 2004).…”

“…Gallo et al (2011) showed, for example, that moderate alcohol consumption was associated with decreased AL, whereas Crimmins et al (2009) found no association between alcohol intake and AL. Similarly, results for the effect of smoking on AL were inconsistent (Crimmins et al, 2009;Hu et al, 2007). Finally, AL has mainly been studied as a consequence of chronic environmental demands, whereas a limited number of studies have examined the contribution of selected genetic determinants using a candidate gene approach to this phenotype (Brody et al, 2013;Cicchetti et al, 2011).…”