Allostatic Load and Cognitive Function Among Urban Adults in the Healthy Aging in Neighborhoods of Diversity across the Life Span Study

Article type: Research Article

Authors: Beydoun, Hind A.^{a; *; 1; 2} | Beydoun, May A.^{b; 1; 2} | Maldonado, Ana I.^c | Fanelli-Kuczmarski, Marie T.^b | Weiss, Jordan^d | Evans, Michele K.^{b; 3} | Zonderman, Alan B.^{b; 3}

Affiliations: [a] Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA | [b] Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA | [c] Department of Psychology, University of Maryland Baltimore County, Baltimore, MD, USA | [d] Stanford Center on Longevity, Stanford University, Stanford, CA, USA

Correspondence: [*] Correspondence to: Hind A. Beydoun, PhD, MPH, Department of Research Programs, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060, USA. Tel.: +1 571 231 1681; Fax: +1 571 231 6667; E-mail: [email protected].

Note: [1] These authors contributed equally to this work.

Note: [2] HAB and MAB had full access to the data used in this manuscript and completed all the statistical analyses.

Note: [3] Co-senior authors.

Abstract: Background:Cross-sectional studies have linked cognition to allostatic load (AL) which reflects multisystem dysregulation from life course exposure to stressors. Objective:To examine baseline and changes in AL and their relationships with 11 cognitive function test scores, while exploring health disparities according to sex and race. Methods:Longitudinal [Visit 1 (2004–2009) and Visit 2 (2009–2013)] data were analyzed from 2,223 Healthy Aging in Neighborhoods of Diversity across the Life Span participants. We calculated AL total score using cardiovascular, metabolic, and inflammatory risk indicators, and applied group-based trajectory modeling to define AL change. Results:Overall and stratum-specific relationships were evaluated using mixed-effects linear regression models that controlled for socio-demographic, lifestyle, and health characteristics. Baseline AL was significantly associated with higher log-transformed Part A Trail Making Test score [Loge (TRAILS A)] (β= 0.020, p = 0.004) and increasing AL was associated with higher Benton Visual Retention Test score [BVRT] (β= 0.35, p = 0.002) at baseline, in models that controlled for age, sex, race, poverty status, education, literacy, smoking, drug use, the 2010 healthy eating index and body mass index. Baseline AL and AL change were not related to change in cognitive function between visits. There were no statistically significant interaction effects by sex or race in fully-adjusted models. Conclusion:At baseline, AL was associated with worse attention or executive functioning. Increasing AL was associated with worse non-verbal memory or visuo-constructional abilities at baseline. AL was not related to change in cognitive function over time, and relationships did not vary by sex or race.

Keywords: Adults, allostatic load, cognitive function, health disparities, longitudinal study

DOI: 10.3233/JAD-220888

Journal: Journal of Alzheimer's Disease, vol. 92, no. 2, pp. 425-443, 2023