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MacArthur Studies of Successful Aging

Teresa E. Seeman, PhD; Burton H. Singer, PhD; John W. Rowe, MD; Ralph I. Horwitz, MD; Bruce S. McEwen, PhD

Arch Intern Med. 1997;157(19):2259-2268.

Abstract
Background
Exponential growth in the population of older adults presents clinicians with special concerns about factors affecting risks for declines in cognitive and physical functioning.

Objectives
To examine the hypothesis that risks for such declines and for disease outcomes, such as cardiovascular disease, are related to differences in allostatic load, the cumulative physiologic toll exacted on the body over time by efforts to adapt to life experiences. To present an operational definition of allostatic load, along with preliminary evidence of its predictive validity in relation to salient outcomes of aging.

Methods
Data from a longitudinal, community-based study of successful aging were used to develop a measure of allostatic load based on 10 parameters reflecting levels of physiologic activity across a range of important regulatory systems. Allostatic load is the sum of the number of parameters for which the subject was rated in the highest-risk quartile.

Results
Higher allostatic load scores were associated with poorer cognitive and physical functioning and predicted larger decrements in cognitive and physical functioning as well as being associated with an increased risk for the incidence of cardiovascular disease, independent of sociodemographic and health status risk factors.

Conclusions
Findings are consistent with the conceptualization of allostatic load as an index of wear and tear on the body, with elevations in allostatic load predicting an increased risk for a decline in cognitive and physical functioning as well as cardiovascular disease in a cohort of older men and women. From a clinical perspective, the concept of allostatic load may provide the basis for a more comprehensive assessment of major risks in the aging process.

Arch Intern Med. 1997;157:2259-2268

Author Affiliations
From the Andrus Gerontology Center, University of Southern California, Los Angeles (Dr Seeman); the Office of Population Research, Princeton University, Princeton, NJ (Dr Singer); Mount Sinai Medical School, New York, NY (Dr Rowe); the Department of Internal Medicine, Yale University, New Haven, Conn (Dr Horwitz); and the Laboratory of Neuroendocrinology, Rockefeller University, New York (Dr McEwen).

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