Stress and Aging: A Biological Double Jeopardy?
Gruenewald, Tara L., Seeman, Teresa E., Annual Review of Gerontology & Geriatrics
Chronic stress may take its toll on the body at any period in the life course, but age may be linked to characteristics of stressor exposure and response, as well as underlying biological vulnerabilities, which modulate the effects of stressor experience on biological well-being. In this review, we first address age-related patterns of stressor exposure and response, highlighting commonly experienced stressors in older adults and characteristics of stressor appraisal and coping in later life. We then review patterns of biological functioning associated with chronic stress experience and aging in an effort to highlight the biological commonalities associated with both conditions. We conclude with an examination of the idea that the biological changes typically observed with advancing age may render older adults more susceptible to negative biological and health consequences of chronic stress experience.
Although we are all susceptible to the slings and arrows of life, characteristics of stressor experience and stressor response may change across the life course, modulating associated vulnerability to ill health and well-being. Older adulthood may be an important period to examine potential health impacts of stressor experience as certain major and traumatic stressors occur frequently in later life and the biological perturbations that ensue are experienced in the context of aging-related changes in physiology. On the other hand, certain psychological and social characteristics more common in older adulthood may render older individuals less likely to perceive stressors or may dampen negative reactions to events. In the following, we first provide a brief overview of concepts and definitions in stress research and review age-related characteristics of stress experience. We then provide an overview of certain physiological changes that occur with chronological aging to provide a portrait of our internal milieu in later life. We follow this overview with a discussion of the physiological processes associated with acute and chronic stress experience. We conclude with the proposition that the experience of stress-related physiology in the context of normal physiological aging may act as a form of double jeopardy for poor functioning and health in later adulthood and provide some examples of this late-life vulnerability
AGING AND STRESS EXPERIENCE
Stress is one of those concepts known to all but that typically eludes exact or consistent definition. One framework that we find useful in the study of stress and connections to health distinguishes between eliciting events/conditions, perceptual or appraisal processes, and psychological, behavioral, and physiological responses (e.g., Cohen, Kessler, & Underwood Gordon, 1995). Stressor is the term typically assigned to an event or situation that is appraised as stressful or has the potential to be perceived as stressful. The appraisal of an event or situation as a stressor typically follows from perceptions that the event/situation contains some element of threat, harm, or unpleasantness. Additional evaluations of one's ability to successfully meet the demands of an event or cope with its aversiveness are hypothesized to further modulate the appraisal of an event as a stressor or one's response to the stressor. The cognitive, affective, behavioral, and physiological responses that follow perception of a stressor are referred to as stress responses.
Age may play a role in each of these aspects of stress experience. Specific types of major or chronic stressors may be more likely to occur in later life, including the death of social network members, disability and serious health conditions faced by the self and others, the loss of social connections due to role loss, relocation, or the health status of social network members or the self, and caregiving for a disabled or ill spouse (e.g., Boeninger, Shiraishi, Aldwin, & Spiro, 2009; Folkman, Lazarus, Pimley & Novacek, 1987; Glass, Kasl, & Berkman, 1997). …