Indicators of stress and their association with frailty in the precontact Southwestern United States

Abstract

Objectives: Physiological disturbances in early life have been shown to increase individual mortality risk and impact health in adulthood. This study examines frailty through analysis of lesion status of two commonly collected skeletal indicators of stress (cribra orbitalia [CO] and porotic hyperostosis [PH]) and their association with mortality risk in the precontact U.S. Southwest. Several predictions are addressed: (a) individuals with active skeletal lesions are the frailest; (b) individuals with healed lesions are the least frail; (c) CO lesions, regardless of status, are associated with increased mortality risk. Materials and methods: Odds ratios and Kaplan-Meier survival analysis are used to examine the association between stress indicators and mortality in the U.S. Southwest. This study includes 335 individuals (75 females, 81 males, 20 adults of unknown sex, and 159 juveniles) from precontact New Mexico archaeological sites dating to A.D. 1,000-1,400. Results: Active CO and PH lesions are associated with lower survivorship and greater mortality risk than healed or absent lesions. Only juvenile individuals have active CO and PH lesions, as is expected given their physiology. CO lesions in any state are associated with greater mortality risk and earlier ages of death. Discussion: Individuals with active lesions are the frailest; while individuals with healed lesions are the least frail. CO and PH likely have different etiologies: CO lesions are associated with increased mortality risk and decreased individual longevity. These results indicate that CO's presence suggests a more severe underlying condition than PH lesions alone. K E Y W O R D S cribra orbitalia, hidden heterogeneity, porotic hyperostosis, stress, survival analysis

Cribra orbitalia and porotic hyperostosis are associated with respiratory infections in a contemporary mortality sample from New Mexico

“…Further, individuals who survived childhood respiratory infection may carry the physical scars of these infections in the form of PCLs. Second, CO is associated with a wider variety of diagnoses than PH, adding to the growing body of evidence that CO and PH are distinct phenomena likely resulting from an overlapping set of health conditions (O'Donnell, 2019; Rivera & Mirazón Lahr, 2017). Finally, this study models an approach that provides interesting and exciting avenues for further research.…”

“…Regardless of the underlying mechanism, CO and PH typically form between the ages of 6 months and 12 years (Blom et al, 2005; DeWitte & Slavin, 2013; Watts, 2013). In skeletal studies that report lesion status, most report active PCLs as restricted to juveniles (Mensforth, Lovejoy, Lallo, & Armelagos, 1978; Mittler & Van Gerven, 1994; O'Donnell, 2019). The physiology of bone marrow, which changes with age, determines the potential for lesion expression.…”

Phenotypes and pathways: Working toward an integrated skeletal biology in biological anthropology

“…Skeletal phenotypes serve as biomarkers of age, sex, and disease states (Arriaza, Salo, Aufderheide, & Holcomb, 1995; Calce, 2012; Cole & Waldron, 2011; Wrobel, 2014), as well as markers of cultural factors such as diet (Ezzo, Larsen, & Burton, 1995; Müldner & Richards, 2007; Siebke, Moghaddam, Cunningham, Witzel, & Lösch, 2019), activity and occupation (Okumura, Boyadjian, & Eggers, 2007; Stock & Pfeiffer, 2001), and mobility (Hakenbeck, McManus, Geisler, Grupe, & O'Connell, 2010; Knudson & Tung, 2011). A number of articles also utilize bone as a marker of more nebulous biological states, such as health and stress (Dabbs, 2011; Geber, 2014; O'Donnell, 2019), and problems associated with this usage have been addressed elsewhere (Reitsema & McIlvaine, 2014; Temple & Goodman, 2014). The category 2 articles primarily detail the growth, morphological variation, and function of skeletal elements or phenotypes (García‐Martínez et al, 2017; Korioth, Romilly, & Hannam, 1992; Peck & Stout, 2007).…”

An epidemiological approach to the analysis of cribra orbitalia as an indicator of health status and mortality in medieval and post‐medieval London under a model of parasitic infection

“…In addition, a binary logit model is used to generate the odds ratio for age‐at‐death. While a variety of hazard models are commonly used in paleopathological research, only a few studies have incorporated the Cox proportional hazards model (DeWitte et al, 2016; Godde et al, 2020; Stirrat et al, 2012; Walter & DeWitte, 2017; Watts, 2015; Whittington, 1991) and the binomial regression (Boldsen, 2005; DeWitte, 2014a; DeWitte & Bekvalac, 2011; Godde, 2020; Godde et al, 2020; Hens et al, 2019; O'Donnell, 2019).…”