Sex differences in allostatic load trajectories among midlife and older adults: Evidence from the China health and retirement longitudinal study
The female advantage in life expectancy sits uneasily with female disadvantage in health and well-being in later life compared to their male counterparts. This health disparity has been suggested to rest on sex difference in allostatic load (AL). We aim to delineate the sex-specific age trajectories...
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| description | The female advantage in life expectancy sits uneasily with female disadvantage in health and well-being in later life compared to their male counterparts. This health disparity has been suggested to rest on sex difference in allostatic load (AL). We aim to delineate the sex-specific age trajectories of AL among midlife and older adults in China and to interpret the contradiction between the female advantage in life expectancy and their disadvantage in health in later life from the perspective of physiological dysregulation. Using data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011 and 2015, we included 3,836 male and 3,308 female Chinese adults aged 45 and older. Two-level mixed-effects models were fitted to examine how AL changed over time. Missing values were addressed by performing multiple imputations using chained equations. Results show AL increases with age for both sexes, with a steeper rise in females and a slight decline in males after adjusting for the sex-age interaction. Older males born before the People's Republic of China (PRC) exhibited different AL trajectories from younger cohorts. The sex-specific trajectories converge around the late 60s, with females surpassing males, aligning with the life expectancy-health paradox. The presence of a healthier older male cohort in CHARLS suggests future studies should account for cohort effects. |
| doi_str_mv | 10.1371/journal.pone.0315594 |
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This health disparity has been suggested to rest on sex difference in allostatic load (AL). We aim to delineate the sex-specific age trajectories of AL among midlife and older adults in China and to interpret the contradiction between the female advantage in life expectancy and their disadvantage in health in later life from the perspective of physiological dysregulation. Using data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011 and 2015, we included 3,836 male and 3,308 female Chinese adults aged 45 and older. Two-level mixed-effects models were fitted to examine how AL changed over time. Missing values were addressed by performing multiple imputations using chained equations. Results show AL increases with age for both sexes, with a steeper rise in females and a slight decline in males after adjusting for the sex-age interaction. Older males born before the People's Republic of China (PRC) exhibited different AL trajectories from younger cohorts. The sex-specific trajectories converge around the late 60s, with females surpassing males, aligning with the life expectancy-health paradox. 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This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Li et al 2024 Li et al</rights><rights>2024 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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This health disparity has been suggested to rest on sex difference in allostatic load (AL). We aim to delineate the sex-specific age trajectories of AL among midlife and older adults in China and to interpret the contradiction between the female advantage in life expectancy and their disadvantage in health in later life from the perspective of physiological dysregulation. Using data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011 and 2015, we included 3,836 male and 3,308 female Chinese adults aged 45 and older. Two-level mixed-effects models were fitted to examine how AL changed over time. Missing values were addressed by performing multiple imputations using chained equations. Results show AL increases with age for both sexes, with a steeper rise in females and a slight decline in males after adjusting for the sex-age interaction. Older males born before the People's Republic of China (PRC) exhibited different AL trajectories from younger cohorts. The sex-specific trajectories converge around the late 60s, with females surpassing males, aligning with the life expectancy-health paradox. The presence of a healthier older male cohort in CHARLS suggests future studies should account for cohort effects.</description><subject>Adults</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Allostasis - physiology</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers</subject><subject>China</subject><subject>Female</subject><subject>Females</subject><subject>Gender differences</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Life Expectancy</subject><subject>Life span</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Males</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>People and Places</subject><subject>Retirement</subject><subject>Sex Characteristics</subject><subject>Sex differences</subject><subject>Sex Factors</subject><subject>Women</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99uFCEUxidGY2v1DYySmBi92BUG5p83ptlU3aRJE6veEgYOu2wY2ALTtG_hI8t2t82u6YXhghP4nQ_OB6coXhM8JbQhn1Z-DE7Y6do7mGJKqqpjT4pj0tFyUpeYPt2Lj4oXMa4wrmhb18-LI9o1JcNVe1z8uYQbpIzWEMBJiMg4JKz1MYlkJLJeKJSCWIFMPpi8LwbvFmgwyhoNSDiFvFUQkFCjTfEzOrs2aqOEdPADSktAs6VxAi1B2LS8SwiQTIABXMr6bmHSqDJhUczB7cvimRY2wqvdfFL8-nr2c_Z9cn7xbT47PZ_IqinThKiybaAva0GYqFhf4k52FWtUCbIktKulIgyzlopOMSVrVZeKUkJa3IsW5_ikeLvVXedi-c7MyClhHcsA7jIx3xLKixVfBzOIcMu9MPxuwYcFFyGbZIH3GnRPtGpFQ5hsm74WumYlsL4utdZV1vqyO23sB1Ay1x6EPRA93HFmyRf-mhNSN_kuJCt82CkEfzVCTHwwUYK1woEftxevaMcaltF3_6CPl7ejFiJXYJz2-WC5EeWnbbawpbjdaE0fofJQMBiZv542ef0g4eNBQmYS3KSFGGPk88sf_89e_D5k3--x298UvR2T8S4egmwLyuBjDKAfXCaYbzrn3g2-6Ry-65yc9mb_hR6S7luF_gUBORWn</recordid><startdate>20241226</startdate><enddate>20241226</enddate><creator>Li, Guannan</creator><creator>Tampubolon, Gindo</creator><creator>Maharani, Asri</creator><creator>Tu, Chenglin</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-8971-205X</orcidid><orcidid>https://orcid.org/0009-0007-3645-7546</orcidid></search><sort><creationdate>20241226</creationdate><title>Sex differences in allostatic load trajectories among midlife and older adults: Evidence from the China health and retirement longitudinal study</title><author>Li, Guannan ; Tampubolon, Gindo ; Maharani, Asri ; Tu, Chenglin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c572t-1d287eb26a14a54b209c9547d2ec21396cd140483a9d4dc6d62d331180ba802d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adults</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Allostasis - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Guannan</au><au>Tampubolon, Gindo</au><au>Maharani, Asri</au><au>Tu, Chenglin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex differences in allostatic load trajectories among midlife and older adults: Evidence from the China health and retirement longitudinal study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-12-26</date><risdate>2024</risdate><volume>19</volume><issue>12</issue><spage>e0315594</spage><pages>e0315594-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The female advantage in life expectancy sits uneasily with female disadvantage in health and well-being in later life compared to their male counterparts. This health disparity has been suggested to rest on sex difference in allostatic load (AL). We aim to delineate the sex-specific age trajectories of AL among midlife and older adults in China and to interpret the contradiction between the female advantage in life expectancy and their disadvantage in health in later life from the perspective of physiological dysregulation. Using data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011 and 2015, we included 3,836 male and 3,308 female Chinese adults aged 45 and older. Two-level mixed-effects models were fitted to examine how AL changed over time. Missing values were addressed by performing multiple imputations using chained equations. Results show AL increases with age for both sexes, with a steeper rise in females and a slight decline in males after adjusting for the sex-age interaction. Older males born before the People's Republic of China (PRC) exhibited different AL trajectories from younger cohorts. The sex-specific trajectories converge around the late 60s, with females surpassing males, aligning with the life expectancy-health paradox. The presence of a healthier older male cohort in CHARLS suggests future studies should account for cohort effects.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39724058</pmid><doi>10.1371/journal.pone.0315594</doi><tpages>e0315594</tpages><orcidid>https://orcid.org/0000-0002-8971-205X</orcidid><orcidid>https://orcid.org/0009-0007-3645-7546</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adults Age Aged Aged, 80 and over Allostasis - physiology Biology and Life Sciences Biomarkers China Female Females Gender differences Health aspects Humans Life Expectancy Life span Longitudinal Studies Male Males Medicine and Health Sciences Middle Aged Older people People and Places Retirement Sex Characteristics Sex differences Sex Factors Women |
| title | Sex differences in allostatic load trajectories among midlife and older adults: Evidence from the China health and retirement longitudinal study |
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