title: Allostatic load and pain severity in older adults: Results from the English Longitudinal Study of Ageing.
abstract: Pain is common in older adults, is frequently experienced as stressful, and is associated with increased morbidity and mortality. Stress regulatory systems are adaptive to challenge and change, allostasis, until demands exceed the adaptive capacity contributing to dysregulation, resulting in a high allostatic load. A high allostatic load is associated with increased risk of morbidity and mortality. Pain severity, based on the average intensity of frequent pain, was hypothesized to be positively associated with AL. Four formulations of AL were investigated. Cross-sectional data from Wave 4 (2008-2009) of the English Longitudinal Study of Aging (ELSA) were analyzed. Covariates in the model included age, sex, education, smoking status, alcohol consumption, activity level, depression and common comorbid health conditions. A total of 5341 individuals were included; mean age 65.3(±9.2) years, 55% female, 62.4% infrequent or no pain, 12.6% mild pain, 19.1% moderate pain, and 5.9% severe pain. Severe pain was associated with greater AL defined by all four formulations. The amount of variance explained by pain severity and the covariates was highest when allostatic load was defined by the high risk quartile (12.9%) and by the clinical value (11.7%). Findings indicate a positive relationship between pain severity and AL. Further investigation is needed to determine if there is a specific AL signature for pain that differs from other health conditions.
authors.affiliation: Department of Aging and Geriatric Research, College of Medicine, University of Florida, USA. Electronic address: ksibille@ufl.edu.
authors.forename: Kimberly T
authors.initials: KT
authors.lastname: Sibille
authors.affiliation: Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, The University of Manchester, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: McBeth
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, United Kingdom.
authors.forename: Diane
authors.initials: D
authors.lastname: Smith
authors.affiliation: Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, United Kingdom.
authors.forename: Ross
authors.initials: R
authors.lastname: Wilkie
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology* / Q000523:psychology; D052636:Allostasis; D015415:Biomarkers; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement; D013315:Stress, Psychological
chemical_list: D015415:Biomarkers
keywords: Allostatic load; Health behaviors; Older adults; Pain severity; Stress