Date of Conferral
2-18-2025
Degree
Ph.D.
School
Public Health
Advisor
Manoj Sharma
Abstract
Allostatic load (AL), the cumulative physiological burden of chronic stress, is a significant health problem, and it has been associated with adverse health outcomes, including cognitive functioning. There is a paucity of literature examining associations between AL and incident dementia in the United States. This quantitative study used data from the United States Health and Retirement Study cohort (2016-2020) to examine the association between AL quartile and incident dementia among participants who were aged 56 and older at baseline. Dementia status was determined measuring immediate and delayed recall, serial seven subtraction, and backward count, as well as self-report conditions for dementia status and Alzheimer’s disease. A composite score of 20 biomarkers from neuroendocrine, immune, metabolic, and cardiovascular systems was used to create a quartile of AL. The Cox regression model was used to examine the association between AL quartile and incident dementia. Of the 7,003 participants, 342 (4.9%) experienced dementia by the end of 5 years. In the unadjusted model, incident dementia was higher in the highest AL quartile than the lowest Al quartile (HR = 2.55, 95% CI [1.74, 3.71], p < .001). In a fully adjusted model, the hazard ratio was attenuated (HR = 1.46, 95% CI [1.0, 2.14], p = .05), but the overall test of AL quartile was not significant. Race/ethnicity and apolipoprotein did not modify the association. Findings highlight the relationship between AL and incident dementia, and further study regarding social determinants of health is needed. Findings may inform health professionals to develop strategies to reduce stress stimuli and monitor biomarkers, reducing AL, delaying dementia onset, and improving quality of life.
Recommended Citation
Kabeto, Mohammed Usman, "Allostatic Load and Incident Dementia Among Older Adults in the United States" (2025). Walden Dissertations and Doctoral Studies. 17394.
https://scholarworks.waldenu.edu/dissertations/17394
