Cumulative physiological dysregulation among midlife women in the U.S.: Findings from the National Health & Nutrition Examination Survey 1999-2004

While recent research has investigated cumulative physiological dysregulation (CPD) as a potentially important pathway between the social environment and health outcomes in elderly populations, characterization of CPD among younger populations, such as midlife women, has yet to be described. Investigating CPD among midlife women could help elucidate how CPD accrues earlier in midlife and how it affects health at midlife, the menopausal transition, and older ages. CPD is the mechanism by which physiological stress responses chronically exceed optimal operating ranges and result in wear and tear on the body's regulatory systems, which may eventually lead to disease pathology and disability. We conduct a cross-sectional analysis of women ages 40-55 years using data from the National Health and Nutrition Examination Survey (NHANES) from 1999-2004. The NHANES data are unique in that there is extensive biomarker information from a nationally representative sample of the US population. We create a composite CPD measure using a range of biomarkers representing cardiovascular, immune, and metabolic system functioning. Regression results are presented for sociodemographic and health behavior correlates of CPD. Analyses are weighted and account for complex sample design. Our earlier work analyzing midlife women using a community-based sample suggests that higher CPD is associated with older age, lower socioeconomic status, and disadvantaged minority groups; we expect to find similar trends among this national sample of midlife women. Information on women at risk for higher CPD and thus health problems in older age is potentially useful for clinical and public health interventions at earlier life stages.