Dual trajectories of allostatic load and depression among perimenopausal women

OBJECTIVE: Research on allostatic load (AL) and depression has been increasing, but has lacked attention on perimenopausal women. This study aimed to explore the dual trajectories of AL and depression in perimenopausal women and identify their common influencing factors. METHOD: Data from seven follow-up sites of the Study of Women's Health Across the Nation (SWAN) were used, and 1185 perimenopausal women aged 42-52 years were eventually included. Trajectories of AL and depression were identified by fitting different group-based trajectory models. A dual trajectory model was used to estimate the probability of the correlation between different level trajectory groups of AL and depression, and multivariate logistic regression was used to estimate the degree of association of demographic characteristics of perimenopausal women with AL and depression. RESULTS: In a dual trajectory model of AL and depression, AL and depression showed an interactive association, with high AL trajectories increasing the likelihood of high depression trajectories (14.65%) and high depression trajectories increasing the likelihood of high AL trajectories (41.2%). After considering demographic characteristics, age, race, income level, social support, hot flashes and night sweats were found to be common influences on AL and depression. CONCLUSION: Interventions should be tailored according to the different trajectory groups of AL and depression, with a focus on high-vulnerability subgroups (high AL without depression, low AL with high depression, high AL with high depression). AL monitoring should also be integrated into perimenopausal depression management. In addition, care should be taken to address the common risk factors behind these trajectories and develop interventions based on relevant determinants.