Correlation between allostatic load index and cumulative mortality: a register-based study of Danish municipalities

Objectives The aim of this study was to examine population-based allostatic load (AL) indices as an indicator of community health across 14 municipalities in Denmark.Design Register-based study.Setting Data derived from: the Lolland-Falster Health Study, the Copenhagen General Population Study and the Danish General Suburban Population Study. Nine biomarkers (systolic blood pressure, diastolic blood pressure, pulse rate, total serum cholesterol, high-density lipoprotein cholesterol, waist-to-hip ratio, triglycerides, C-reactive protein and serum albumin) were divided into high-risk and low-risk values based on clinically accepted criteria, and the AL index was defined as the average between the nine values. All-cause mortality data were obtained from Statistics Denmark.Participants We examined a total of 106 808 individuals aged 40–79 years.Primary outcome measure Linear regression models were performed to investigate the association between mean AL index and cumulative mortality risk.Results Mean AL index was higher in men (range 2.3–3.3) than in women (range 1.7–2.6). We found AL index to be strongly correlated with the cumulative mortality rate, correlation coefficient of 0.82. A unit increase in mean AL index corresponded to an increase in the cumulative mortality rate of 19% (95% CI 13% to 25%) for men, and 16% (95% CI 8% to 23%) for women but this difference was not statistically significant. The overall mean increase in cumulative mortality rate for both men and women was 17% (95% CI 14% to 20%).Conclusions Our findings indicate the population-based AL index to be a strong indicator of community health, and suggest identification of targets for reducing AL