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Depressive symptoms and allostatic load have a bidirectional association among Puerto Rican older adults

Published online by Cambridge University Press:  14 January 2021

Amanda C. McClain Open the ORCID record for Amanda C. McClain [Opens in a new window] ,
Rui S. Xiao ,
Katherine L. Tucker ,
Luis M. Falcón  and
Josiemer Mattei Open the ORCID record for Josiemer Mattei [Opens in a new window]
Amanda C. McClain
Affiliation:
School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
Rui S. Xiao
Affiliation:
IQVIA, Real-World Evidence, Cambridge, MA, USA
Katherine L. Tucker
Affiliation:
Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
Luis M. Falcón
Affiliation:
College of Fine Arts, Humanities and Social Sciences, University of Massachusetts, Lowell, MA, USA
Josiemer Mattei*
Affiliation:
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
*
Author for correspondence: Josiemer Mattei, E-mail: jmattei@hsph.harvard.edu
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Abstract

Background

Depression is strongly associated with chronic disease; yet, the direction of this relationship is poorly understood. Allostatic load (AL) provides a framework for elucidating depression-disease pathways. We aimed to investigate bidirectional, longitudinal associations of baseline depressive symptoms or AL with 5-year AL or depressive symptoms, respectively.

Methods

Data were from baseline, 2-year, and 5-year visits of 620 adults (45–75 years) enrolled in the Boston Puerto Rican Health Study. The Center for Epidemiology Studies Depression (CES-D) scale (0–60) captured depressive symptoms, which were categorized at baseline as low (<8), subthreshold (8–15), or depression-likely (⩾16) symptoms. AL was calculated from 11 parameters of biological functioning, representing five physiological systems. Baseline AL scores were categorized by the number of dysregulated parameters: low (0–2), moderate (3–5), or high (⩾6) AL. Multivariable, multilevel random intercept and slope linear regression models were used to examine associations between 3-category baseline CES-D score and 5-year continuous AL score, and between baseline 3-category AL and 5-year continuous CES-D score.

Results

Baseline subthreshold depressive symptoms [(mean (95% CI)): 4.8 (4.5–5.2)], but not depression-likely symptoms [4.5 (4.2–4.9)], was significantly associated with higher 5-year AL scores, compared to low depressive symptoms [4.3 (3.9–4.7)]. Baseline high AL [19.4 (17.6–21.2)], but not low AL [18.5 (16.5–20.6)], was significantly associated with higher 5-year CES-D score, compared to baseline moderate AL [16.9 (15.3–18.5)].

Conclusions

Depressive symptoms and AL had a bi-directional relationship over time, indicating a nuanced pathway linking depression with chronic diseases among a minority population.

Keywords

Allostatic loaddepressiondepressive symptomsHispanicsLatinosPuerto Ricans
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 14 , October 2022 , pp. 3073 - 3085
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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