Allostatic Load and Its Impact on Health: A Systematic Review

Abstract

Introduction: Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. Objective: To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. Methods: PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. Results: A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. Conclusions: The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.

Quality of life in primary aldosteronism: A prospective observational study

“…A recent study expanded this concept, introducing and highlighting the importance of allostatic load in arterial hypertension 35 . Allostatic load is the reflection of cumulative effects of daily life experiences, including ordinary and extra‐ordinary events 36 . Allostatic load is significantly more prevalent in patients with arterial hypertension than individuals with normotension and patients with hypertension and allostatic load display significantly decreased quality of life 35 .…”

Stress overload in the spread of coronavirus

“…Many of these acknowledge stress theories as foundational to this body of research (Hussain, 2010;Juster et al, 2016;Koh, 2018;Marketon & Glaser, 2008;Reiche et al, 2005), and in accordance with theory, differentiate pathogenic stress from its other forms (Gouin, 2011;Hussain, 2010;Marketon & Glaser, 2008). Although not termed stress overload, pathogenic stress is defined similarly, either as allostatic load (excessive demands that exceed coping capacity; Guidi et al, 2020) or as chronic stress (persistent demands that do not relent with coping efforts; Hänsel et al, 2010).…”

“…Substantial evidence for a stress-illness link has accumulated, yielding a plethora of review articles (Glaser & Kiecolt-Glaser, 2009;Gouin, 2011;Guidi et al, 2020;Hänsel et al, 2010;Hussain, 2010;Juster et al, 2016;Koh, 2018;Marketon & Glaser, 2008;Pedersen et al, 2011;Reiche et al, 2005). Many of these acknowledge stress theories as foundational to this body of research (Hussain, 2010;Juster et al, 2016;Koh, 2018;Marketon & Glaser, 2008;Reiche et al, 2005), and in accordance with theory, differentiate pathogenic stress from its other forms (Gouin, 2011;Hussain, 2010;Marketon & Glaser, 2008).…”

Expert opinion in anxiety disorder: Corona-phobia, the new face of anxiety

“…It ensues when environmental challenges exceed the individual ability to cope [13] and represents a transition to an extreme state where stress response systems are repeatedly activated and buffering factors are not adequate. The situations which can lead to develop allostatic load are: (a) frequent stressors which determine a status of chronic stress and repeated physiological arousal; (b) lack of adaptation to repeated stressors; (c) inability to shut off the stress response after a stressor is terminated; (d) an allostatic response insufficient to deal with the stressor [14]. In the current pandemic we can argue that individuals are frequently exposed to stressors, they can have difficulties in adapting to such repeated stressful solicitations, may have an allostatic response insufficient to deal with the stressor.…”

“…In response to stressors, different physiological systems interact at varying degrees of activity [12]: the neuroendocrine and immune systems respond promote adaptation to threats or adversities; the hypothalamic-pituitaryadrenal axis plays a role in the pathophysiology of allostatic load; brain architecture and neurochemical functions are affected by both genomic and non-genomic mechanisms; immunosuppressive effects occur in the long run as well as alterations in body functions, involving cardiovascular and gastrointestinal systems, endocrine-metabolic balances and sleep [14]. As part of an imbalance in the complex inter-relations between systems, anxiety may rise.…”