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Prev Med. 2018 May;110:9-15. doi: 10.1016/j.ypmed.2018.02.002. Epub 2018 Feb 5.

Relationships between allostatic load, unhealthy behaviors, and depressive disorder in U.S. adults, 2005-2012 NHANES.

Author information

1
Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA; Center for Aging in Diverse Communities, University of California, San Francisco, CA, USA. Electronic address: erik.rodriquez@nih.gov.
2
Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA. Electronic address: jennifer.toman@ucsf.edu.
3
Center for Aging in Diverse Communities, University of California, San Francisco, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA. Electronic address: gregorich@medicine.ucsf.edu.
4
Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. Electronic address: jamessj@umich.edu.
5
Center for Aging in Diverse Communities, University of California, San Francisco, CA, USA; Office of the Scientific Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA. Electronic address: anna.napoles@nih.gov.
6
Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA; Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA. Electronic address: eliseo.perez-stable@nih.gov.

Abstract

Unhealthy behaviors may modify relationships between chronic stress and depression among diverse older adults. We analyzed nationally representative cross-sectional data from participants aged 40-79 years of the 2005-2012 National Health and Nutrition Examination Survey. Unhealthy behaviors included current smoking, excessive/binge drinking, insufficient physical activity, and fair/poor diet. Allostatic load was defined by 10 biomarkers indicating the cumulative physiologic burden of stress. Depressive disorder was assessed using the Patient Health Questionnaire. Multivariable logistic regression examined whether current smoking, excessive/binge drinking, insufficient physical activitiy, and fair/poor diet modified relationships between allostatic load and depressive disorder. Mean age of 12,272 participants was 55.6 years (standard error = 0.19), 51.9% were women, and most had at least a high school education (81.8%). Latinos (11.3%) and African Americans (10.4%) were more likely than Whites (7.1%; p < 0.001) to meet depressive disorder criteria. Allostatic load was not associated independently with depressive disorder in any racial/ethnic group and this lack of a relationship did not differ by the extent of unhealthy behaviors. Although Latinos and African Americans report higher levels of depression than Whites, physiological markers of stress do not appear to explain these differences.

KEYWORDS:

African Americans; Alcohol use; Allostatic load; Cigarette smoking; Depression; Diet; Health behavior; Hispanics/Latinos; Physical activity; Stress

PMID:
29421445
PMCID:
PMC5845838
[Available on 2019-05-01]
DOI:
10.1016/j.ypmed.2018.02.002

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