Do Stress Trajectories Predict Mortality in Older Men? Longitudinal Findings from the VA Normative Aging Study

We examined long-term patterns of stressful life events (SLE) and their impact on mortality contrasting two theoretical models: allostatic load (linear relationship) and hormesis (inverted U relationship) in 1443 NAS men (aged 41–87 in 1985; M = 60.30, SD = 7.3) with at least two reports of SLEs over 18 years (total observations = 7,634). Using a zero-inflated Poisson growth mixture model, we identified four patterns of SLE trajectories, three showing linear decreases over time with low, medium, and high intercepts, respectively, and one an inverted U, peaking at age 70. Repeating the analysis omitting two health-related SLEs yielded only the first three linear patterns. Compared to the low-stress group, both the moderate and the high-stress groups showed excess mortality, controlling for demographics and health behavior habits, HRs = 1.42 and 1.37, ps <.01 and <.05. The relationship between stress trajectories and mortality was complex and not easily explained by either theoretical model.

[1]  C. Holahan,et al.  Late-life alcohol consumption and 20-year mortality. , 2010, Alcoholism, clinical and experimental research.

[2]  S. Hewitt Coping , 1997, A Fly for the Prosecution.

[3]  David R. Cox,et al.  Regression models and life tables (with discussion , 1972 .

[4]  M. Rutter,et al.  Pathways from childhood to adult life. , 1989, Journal of child psychology and psychiatry, and allied disciplines.

[5]  F. Lorenz,et al.  Married and recently divorced mothers' stressful events and distress : Tracing change across time , 1997 .

[6]  R. Tedeschi,et al.  Handbook of posttraumatic growth : research and practice , 2006 .

[7]  David S. Krantz,et al.  Effects of psychological and social factors on organic disease: a critical assessment of research on coronary heart disease. , 2002, Annual review of psychology.

[8]  Richard M. Lerner,et al.  Theoretical models of human development , 2006 .

[9]  J. P. Newmann Aging and depression. , 1989, Psychology and aging.

[10]  R. Cooter Crisis , 2009, The Lancet.

[11]  É. Bourg,et al.  Mild Stress and Healthy Aging · Applying hormesis in aging research and interventions , 2008 .

[12]  R. Hayward Stress , 2005, The Lancet.

[13]  Sheldon Cohen,et al.  Psychological stress and disease. , 2007, JAMA.

[14]  Y. Benyamini,et al.  Self-rated health and mortality: a review of twenty-seven community studies. , 1997, Journal of health and social behavior.

[15]  C. Chiueh,et al.  Induction of Thioredoxin and Mitochondrial Survival Proteins Mediates Preconditioning‐Induced Cardioprotection and Neuroprotection , 2005, Annals of the New York Academy of Sciences.

[16]  Burton H. Singer,et al.  New Horizons in Health: An Integrative Approach , 2001 .

[17]  A. Vaiserman Irradiation and Hormesis , 2008 .

[18]  D. Carroll,et al.  Stressful life-events exposure is associated with 17-year mortality, but it is health-related events that prove predictive. , 2008, British journal of health psychology.

[19]  H. Friedman,et al.  Marital history at midlife as a predictor of longevity: alternative explanations to the protective effect of marriage. , 1996, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[20]  C. Aldwin,et al.  Does emotionality predict stress? Findings from the normative aging study. , 1989, Journal of personality and social psychology.

[21]  J. Réthelyi,et al.  Where psychology meets physiology: chronic stress and premature mortality—the Central-Eastern European health paradox , 2004, Brain Research Bulletin.

[22]  Edward J. Calabrese,et al.  What Is Hormesis , 2008 .

[23]  R. Schulz,et al.  Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. , 1999, JAMA.

[24]  K. Roeder,et al.  A SAS Procedure Based on Mixture Models for Estimating Developmental Trajectories , 2001 .

[25]  T. Seeman,et al.  Protective and Damaging Effects of Mediators of Stress: Elaborating and Testing the Concepts of Allostasis and Allostatic Load , 1999, Annals of the New York Academy of Sciences.

[26]  Diane Lambert,et al.  Zero-inflacted Poisson regression, with an application to defects in manufacturing , 1992 .

[27]  R. Verreault,et al.  Stressful Life Events and Survival After Breast Cancer , 2001, Psychosomatic medicine.

[28]  K. Land,et al.  How Many Latent Classes of Delinquent/ Criminal Careers? Results from Mixed Poisson Regression Analyses1 , 1998, American Journal of Sociology.

[29]  J. House,et al.  The relationship between age and depressive symptoms in two national surveys. , 1992, Psychology and aging.

[30]  W. Marsden I and J , 2012 .

[31]  J. Hollis,et al.  Stressful life events, Type A behavior, and the prediction of cardiovascular and total mortality over six years , 1990, Journal of Behavioral Medicine.

[32]  C. Aldwin,et al.  Coping, affect, and the metabolic syndrome in older men: how does coping get under the skin? , 2006, The journals of gerontology. Series B, Psychological sciences and social sciences.

[33]  Daniel S. Nagin,et al.  Analyzing developmental trajectories: A semiparametric, group-based approach , 1999 .

[34]  E. Calabrese Paradigm lost, paradigm found: the re-emergence of hormesis as a fundamental dose response model in the toxicological sciences. , 2005, Environmental pollution.

[35]  E. Handberg,et al.  Acute and chronic psychological stress in coronary disease , 2004, Current opinion in cardiology.

[36]  LambertDiane Zero-inflated Poisson regression, with an application to defects in manufacturing , 1992 .

[37]  L Wilhelmsen,et al.  Stressful life events, social support, and mortality in men born in 1933. , 1993, BMJ.

[38]  M. Shanahan,et al.  The Life Course and Human Development. , 2007 .

[39]  W. M. Ensel,et al.  Age, the Stress Process, and Physical Distress , 2000, Journal of aging and health.

[40]  R. Dienstbier,et al.  Arousal and physiological toughness: implications for mental and physical health. , 1989, Psychological review.

[41]  Rodney L. Bassett Aging Well: Surprising Guideposts to a Happier Life , 2009 .

[42]  S. Melov,et al.  Thermotolerance and extended life-span conferred by single-gene mutations and induced by thermal stress. , 1995, Proceedings of the National Academy of Sciences of the United States of America.

[43]  D. Dannefer What's in a name?: An account of the neglect of variability in the study of aging. , 1988 .

[44]  L. George,et al.  Race differences in depressive symptoms: a dynamic perspective on stress exposure and vulnerability. , 2003, Journal of health and social behavior.

[45]  P. Schnurr,et al.  Change in MMPI scores from college to adulthood as a function of military service. , 1993, Journal of Abnormal Psychology.

[46]  S. Hobfoll Social and Psychological Resources and Adaptation , 2002 .

[47]  P. Schnurr,et al.  Change in MMPI scores from college to adulthood as a function of military service. , 1993, Journal of abnormal psychology.

[48]  L. Wasserman,et al.  A Reference Bayesian Test for Nested Hypotheses and its Relationship to the Schwarz Criterion , 1995 .

[49]  B. McEwen Glucocorticoids, depression, and mood disorders: structural remodeling in the brain. , 2005, Metabolism: clinical and experimental.

[50]  C. Aldwin,et al.  Longitudinal findings from the Normative Aging Study: III. Personality, individual health trajectories, and mortality. , 2001, Psychology and aging.

[51]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[52]  T. W. Miller,et al.  Stressful life events , 1989 .

[53]  G. Schwarz Estimating the Dimension of a Model , 1978 .

[54]  N. Lin,et al.  Distal stressors and the life stress process , 1996 .

[55]  C. Whitlatch,et al.  Caregiving and its social support. , 1996 .

[56]  Q. Vuong Likelihood Ratio Tests for Model Selection and Non-Nested Hypotheses , 1989 .

[57]  C. Aldwin Does age affect the stress and coping process? Implications of age differences in perceived control. , 1991, Journal of gerontology.

[58]  A. Spiro,et al.  Do Health Behaviors Explain the Effect of Neuroticism on Mortality? Longitudinal Findings from the VA Normative Aging Study. , 2009, Journal of research in personality.

[59]  G. Krejs,et al.  Radiolabeled octreotide for the demonstration of somatostatin receptors in malignant lymphoma and lymphadenopathy. , 1995, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[60]  Age , 2000, BMJ : British Medical Journal.

[61]  S. Mann,et al.  Paradigm lost , 1993, Nature.

[62]  L. Rosero-Bixby,et al.  Stressors Over the Life Course and Neuroendocrine System Dysregulation in Costa Rica , 2010, Journal of aging and health.

[63]  David R. Williams,et al.  Stress, Life Events, and Socioeconomic Disparities in Health: Results from the Americans' Changing Lives Study∗ , 2005, Journal of health and social behavior.

[64]  B. McEwen,et al.  Allostatic load biomarkers of chronic stress and impact on health and cognition , 2010, Neuroscience & Biobehavioral Reviews.

[65]  C. Sherbourne,et al.  SHERBOURNE CD. THE MOS 36 ITEM SHORTFORM HEALTH SURVEY (SF-36) , 1992 .

[66]  C. Aldwin,et al.  Longitudinal findings from the normative aging study: 1. Does mental health change with age? , 1989, Psychology and aging.

[67]  L. George,et al.  Interlocking trajectories of loss-related events and depressive symptoms among elders. , 2002, The journals of gerontology. Series B, Psychological sciences and social sciences.

[68]  D. Stokols,et al.  The effects of environmental change on individuals and groups: Some neglected issues in stress research. , 1988 .

[69]  L. Fredman,et al.  Mortality Associated with Caregiving, General Stress, and Caregiving‐Related Stress in Elderly Women: Results of Caregiver‐Study of Osteoporotic Fractures , 2010, Journal of the American Geriatrics Society.