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Published in: BioPsychoSocial Medicine 1/2019

Open Access 01-12-2019 | Research

Measuring chronic stress exposure incorporating the active and healthy ageing (AHA) concept within the cross-sectional Bern cohort study 2014 (BeCS-14)

Authors: Petra Stute, Marion Anker, Laura Hollenstein, Michael von Wolff, Norman Bitterlich, Florian Meissner, Dagmar Poethig

Published in: BioPsychoSocial Medicine | Issue 1/2019

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Abstract

The aim of the study was to represent chronic stress exposure by a complex generic Active and Healthy (AHA) diagnostic assessment tool incorporating ICF. This is a single-centre, cross-sectional, observational, non-interventional, non-randomized trial in University based women’s hospital, division of Gynecological Endocrinology and Reproductive Medicine. All participants followed a standardized, holistic battery of biopsychosocial assessments consisting of bio-functional status (BFS), bio-functional age (BFA) and the questionnaire for chronic stress exposure (TICS). 624 non-pediatric, non-geriatric subjects were recruited in the BeCS-14 cohort. The mean difference between chronological age and BFA was 7.8 ± 8.0 year equivalents. The mean stress level score assessed by SSCS was 13.2 with 45.4% being exposed to above average stress intensity. 22 BFS items (14 objective, 7 subjective) significantly correlated with chronic stress exposure (TICS-SSCS). The constructed sum score composed of SOC_L9 and complaint questionnaire (physical and emotional wellbeing) represented chronic stress exposure best (pearson-correlation value 0.564, p < 0.0001). Higher chronic stress exposure was associated with bio-functional pro-aging (less vitality) in both sexes. In conclusion, chronic stress is accepted as a major risk factor for developing non-communicable diseases (NCD). Our ICF compatible, complex, generic BFS/BFA assessment tool reflects chronic stress exposure and may be applied in various health care settings, e.g., in health promotion and prevention of NCDs.
Literature
1.
go back to reference Kuh D, et al. A life course approach to healthy ageing. Oxford: Oxford University Press; 2014. Kuh D, et al. A life course approach to healthy ageing. Oxford: Oxford University Press; 2014.
2.
go back to reference Petrowski K, et al. Factor structure and psychometric properties of the trier inventory for chronic stress (TICS) in a representative German sample. BMC Med Res Methodol. 2012;12:42.CrossRef Petrowski K, et al. Factor structure and psychometric properties of the trier inventory for chronic stress (TICS) in a representative German sample. BMC Med Res Methodol. 2012;12:42.CrossRef
3.
go back to reference Roohafza H, et al. Association between acute and chronic life events on acute coronary syndrome: a case-control study. J Cardiovasc Nurs. 2010;25(5):E1–7.CrossRef Roohafza H, et al. Association between acute and chronic life events on acute coronary syndrome: a case-control study. J Cardiovasc Nurs. 2010;25(5):E1–7.CrossRef
4.
go back to reference Schüler J, Dietz F. Kurzlehrbuch Medizinische Psychologie und Soziologie. Stuttgart: Thieme; 2004.CrossRef Schüler J, Dietz F. Kurzlehrbuch Medizinische Psychologie und Soziologie. Stuttgart: Thieme; 2004.CrossRef
5.
go back to reference Buddberg C, et al. Psychophysiologie, in Psychosoziale Medizin. Berlin: Springer; 2004.CrossRef Buddberg C, et al. Psychophysiologie, in Psychosoziale Medizin. Berlin: Springer; 2004.CrossRef
6.
go back to reference Schulz P, Hellhammer J, Schlotz W. Occupational stress, social stress and sleep quality: differential effects in consideration of age, worry disposition, and health. Zeitschrift für Gesundheitspsychologie; 2003. Schulz P, Hellhammer J, Schlotz W. Occupational stress, social stress and sleep quality: differential effects in consideration of age, worry disposition, and health. Zeitschrift für Gesundheitspsychologie; 2003.
7.
go back to reference Ehrstrom S, et al. Chronic stress in women with localised provoked vulvodynia. J Psychosom Obstet Gynaecol. 2009;30(1):73–9.CrossRef Ehrstrom S, et al. Chronic stress in women with localised provoked vulvodynia. J Psychosom Obstet Gynaecol. 2009;30(1):73–9.CrossRef
8.
go back to reference Stute P, et al. Measuring active and healthy ageing: applying a generic interdisciplinary assessment model incorporating ICF. J Nutr Health Aging. 2017;21(9):1002–9.CrossRef Stute P, et al. Measuring active and healthy ageing: applying a generic interdisciplinary assessment model incorporating ICF. J Nutr Health Aging. 2017;21(9):1002–9.CrossRef
9.
go back to reference Bousquet J, et al. Operational definition of active and healthy aging (AHA): the European innovation partnership (EIP) on AHA reference site questionnaire: Montpellier October 20-21, 2014, Lisbon July 2, 2015. J Am Med Dir Assoc. 2015;16(12):1020–6.CrossRef Bousquet J, et al. Operational definition of active and healthy aging (AHA): the European innovation partnership (EIP) on AHA reference site questionnaire: Montpellier October 20-21, 2014, Lisbon July 2, 2015. J Am Med Dir Assoc. 2015;16(12):1020–6.CrossRef
10.
go back to reference Rüesch P, Bartlomé P, Huber C. Evaluation von Messinstrumenten für den strategischen Bereich ‘psychische Gesundheit/Stress’. Winterthur: Fachstelle Gesundheitswissenschaften, Zürcher Hochschule Winterthur (Departement Gesundheit); 2006. Rüesch P, Bartlomé P, Huber C. Evaluation von Messinstrumenten für den strategischen Bereich ‘psychische Gesundheit/Stress’. Winterthur: Fachstelle Gesundheitswissenschaften, Zürcher Hochschule Winterthur (Departement Gesundheit); 2006.
11.
go back to reference Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.CrossRef Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.CrossRef
12.
go back to reference Bullinger M, Kirchberger I, Ware J. Der deutsche SF-36 Health Survey. Übersetzung und psychometrische Testung eines krankheitsübergreifenden Instrumentes zur Erfassung der gesundheitsbezogenen Lebensqualität. Zeitschrift fuer Gesundheitswissenschaften. 1995;1:21–36. Bullinger M, Kirchberger I, Ware J. Der deutsche SF-36 Health Survey. Übersetzung und psychometrische Testung eines krankheitsübergreifenden Instrumentes zur Erfassung der gesundheitsbezogenen Lebensqualität. Zeitschrift fuer Gesundheitswissenschaften. 1995;1:21–36.
13.
go back to reference Schulz P, Schlotz W, Becker P. Trierer Inventar zum chronischen Stress (TICS). Göttingen: Hogrefe; 2004. Schulz P, Schlotz W, Becker P. Trierer Inventar zum chronischen Stress (TICS). Göttingen: Hogrefe; 2004.
14.
go back to reference Ardelt-Gattinger E, Meindl M. AD-EVA. Interdisziplinäres Testsystem zur Diagnostik und Evaluation bei Adipositas und anderen durch Ess- und Bewegungsverhalten beeinflussbaren Krankheiten. Bern: Huber; 2010. Ardelt-Gattinger E, Meindl M. AD-EVA. Interdisziplinäres Testsystem zur Diagnostik und Evaluation bei Adipositas und anderen durch Ess- und Bewegungsverhalten beeinflussbaren Krankheiten. Bern: Huber; 2010.
15.
go back to reference Zenz H, Bischoff C, Hrabal V. Patiententheorienfragebogen (PATEF). Handanweisung. Göttingen: Hogrefe; 1996. Zenz H, Bischoff C, Hrabal V. Patiententheorienfragebogen (PATEF). Handanweisung. Göttingen: Hogrefe; 1996.
16.
go back to reference Molnar M, Haiden C, Geißler-Gruber B. IMPULS-Broschüre und IMPULS-Test. In: Betriebliche Analyse der Arbeitsbedingungen. Wien: AUVA, AK, ÖGB, WKÖ (Hg.); 2012. Molnar M, Haiden C, Geißler-Gruber B. IMPULS-Broschüre und IMPULS-Test. In: Betriebliche Analyse der Arbeitsbedingungen. Wien: AUVA, AK, ÖGB, WKÖ (Hg.); 2012.
17.
go back to reference Camm AJ, Malik M, Bigger JT, Breithardt G, Cerutti S, Cohen R, Coumel P, Fallen E, Kennedy H, Kleiger RE, Lombardi F. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996;93(5):1043–65.CrossRef Camm AJ, Malik M, Bigger JT, Breithardt G, Cerutti S, Cohen R, Coumel P, Fallen E, Kennedy H, Kleiger RE, Lombardi F. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996;93(5):1043–65.CrossRef
18.
go back to reference Kalbe E, et al. Das Inventar zur Gedächtnisdiagnostik: Vorstellung der endgültigen Version. Akt Neurol. 2006;33(S 1):301.CrossRef Kalbe E, et al. Das Inventar zur Gedächtnisdiagnostik: Vorstellung der endgültigen Version. Akt Neurol. 2006;33(S 1):301.CrossRef
19.
go back to reference Poethig D. Experimental development of a clinical diagnostic model objectifying bio-functional age(ing) of human being. Habilitation thesis (dt.). German: National Library Leipzig; 1984. http://d-nb.info/850613108 Poethig D. Experimental development of a clinical diagnostic model objectifying bio-functional age(ing) of human being. Habilitation thesis (dt.). German: National Library Leipzig; 1984. http://​d-nb.​info/​850613108
20.
go back to reference Ries W, Poethig D. Chronological and biological age - a new method to measure healthy aging. Exp Gerontol. 1984;19(3):211–6.CrossRef Ries W, Poethig D. Chronological and biological age - a new method to measure healthy aging. Exp Gerontol. 1984;19(3):211–6.CrossRef
21.
go back to reference Dean W. Biological aging measurement: clinical applications. The German test battery, university Leipzig, 175–87. Los Angeles: The Center for Bio Gerontology; 1988. Dean W. Biological aging measurement: clinical applications. The German test battery, university Leipzig, 175–87. Los Angeles: The Center for Bio Gerontology; 1988.
22.
go back to reference Meissner-Poethig D, Michalak U. Vitalitaet und aerztliche Intervention. Vitalitaetsdiagnostik: Grundlagen - Angebote - Konsequenzen: Hippokrates-Verlag; 1997. Meissner-Poethig D, Michalak U. Vitalitaet und aerztliche Intervention. Vitalitaetsdiagnostik: Grundlagen - Angebote - Konsequenzen: Hippokrates-Verlag; 1997.
23.
go back to reference Schulz P, Schlotz W, Becker P. Trierer Inventar zum chronischen Streß (TICS). Göttingen: Hogrefe-Verlag; 2004. Schulz P, Schlotz W, Becker P. Trierer Inventar zum chronischen Streß (TICS). Göttingen: Hogrefe-Verlag; 2004.
24.
go back to reference Hapke U, et al. Chronic stress among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(5–6):749–54.CrossRef Hapke U, et al. Chronic stress among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(5–6):749–54.CrossRef
25.
go back to reference Meissner-Poethig D. Die Gesundheit der Frau: Klimakterium, Vitalität und Hormonsubstitution-Ergebnisse einer funktionsdiagnostischen Pilotstudie. Journal für Menopause. 2003;10(3):20–7. Meissner-Poethig D. Die Gesundheit der Frau: Klimakterium, Vitalität und Hormonsubstitution-Ergebnisse einer funktionsdiagnostischen Pilotstudie. Journal für Menopause. 2003;10(3):20–7.
26.
go back to reference Freude G, et al. Predictors of the discrepancy between calendar and biological age. Occup Med (Lond). 2010;60(1):21–8.CrossRef Freude G, et al. Predictors of the discrepancy between calendar and biological age. Occup Med (Lond). 2010;60(1):21–8.CrossRef
27.
go back to reference Schwarzer R. Stress, angst und Handlungsregulation. Stuttgart: Kohlhammer Verlag; 1993. Schwarzer R. Stress, angst und Handlungsregulation. Stuttgart: Kohlhammer Verlag; 1993.
28.
go back to reference Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Soc Health Soc Behav. 1983;24(4):385–96.CrossRef Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Soc Health Soc Behav. 1983;24(4):385–96.CrossRef
31.
go back to reference Antonovsky A. Unraveling the mystery of health. How people manage stress and stay well. San Francisco: Jossey-Bass; 1987. p. 189–94. Antonovsky A. Unraveling the mystery of health. How people manage stress and stay well. San Francisco: Jossey-Bass; 1987. p. 189–94.
32.
go back to reference Schumacher J, et al. The Antonovsky Sense of Coherence Scale. Test statistical evaluation of a representative population sample and construction of a brief scale. Psychother Psychosom Med Psychol. 2000;50(12):472–82.CrossRef Schumacher J, et al. The Antonovsky Sense of Coherence Scale. Test statistical evaluation of a representative population sample and construction of a brief scale. Psychother Psychosom Med Psychol. 2000;50(12):472–82.CrossRef
33.
go back to reference Singer S, Brähler E. Die “sense of coherence scale” (Testhandbuch zur deutschen version). Göttingen: Vandenhoeck & Ruprecht; 2007. Singer S, Brähler E. Die “sense of coherence scale” (Testhandbuch zur deutschen version). Göttingen: Vandenhoeck & Ruprecht; 2007.
34.
go back to reference Wild K, et al. Strategies against burnout and anxiety in medical education--implementation and evaluation of a new course on relaxation techniques (Relacs) for medical students. PLoS One. 2014;9(12):e114967.CrossRef Wild K, et al. Strategies against burnout and anxiety in medical education--implementation and evaluation of a new course on relaxation techniques (Relacs) for medical students. PLoS One. 2014;9(12):e114967.CrossRef
35.
go back to reference Zirke N, et al. Antonovsky’s sense of coherence in psychosomatic patients - a contribution to construct validation. Psychosoc Med. 2007;4:Doc03.PubMedPubMedCentral Zirke N, et al. Antonovsky’s sense of coherence in psychosomatic patients - a contribution to construct validation. Psychosoc Med. 2007;4:Doc03.PubMedPubMedCentral
36.
go back to reference Hautzinger M, et al. Beck- Depressions-Inventar (BDI): Bearbeitung der deutschen Ausgabe. Testhandbuch. Bern: Hans Huber; 1994. Hautzinger M, et al. Beck- Depressions-Inventar (BDI): Bearbeitung der deutschen Ausgabe. Testhandbuch. Bern: Hans Huber; 1994.
37.
go back to reference Fahrenberg J. Die Freiburger Beschwerdenliste (FBL). Form FBL-G und revidierte form FBL-R. Handanweisung. Göttingen: Hogrefe; 1994. Fahrenberg J. Die Freiburger Beschwerdenliste (FBL). Form FBL-G und revidierte form FBL-R. Handanweisung. Göttingen: Hogrefe; 1994.
38.
go back to reference Fahrenberg J, Hampel R, Selg H. Das Freiburger Persönlichkeitsinventar FPI. Revidierte Fassung FPI-R und teilweise geänderte Fassung FPI-A1. Handanweisung. Göttingen: Hogrefe; 1994. Fahrenberg J, Hampel R, Selg H. Das Freiburger Persönlichkeitsinventar FPI. Revidierte Fassung FPI-R und teilweise geänderte Fassung FPI-A1. Handanweisung. Göttingen: Hogrefe; 1994.
39.
go back to reference Franke G. Die symptom-Checkliste von Derogatis - deutsche version - (SCL-90-R). Manual. Beltz test GmbH. Göttingen: Hogrefe; 1995. Franke G. Die symptom-Checkliste von Derogatis - deutsche version - (SCL-90-R). Manual. Beltz test GmbH. Göttingen: Hogrefe; 1995.
40.
go back to reference Becker P, Schulz P, Schlotz W. Persönlichkeit, chronischer Stress und körperliche Gesundheit. Zeitschrift fuer Gesundheitspsychologie. 2004;12(1):11–23.CrossRef Becker P, Schulz P, Schlotz W. Persönlichkeit, chronischer Stress und körperliche Gesundheit. Zeitschrift fuer Gesundheitspsychologie. 2004;12(1):11–23.CrossRef
41.
go back to reference Schulz P, Schlotz W. Das Trierer Inventar zur Erfassung von chronischem Stress - Version 2 (TICS 2). Trierer Psychologische Berichte. 2002;29(2). Schulz P, Schlotz W. Das Trierer Inventar zur Erfassung von chronischem Stress - Version 2 (TICS 2). Trierer Psychologische Berichte. 2002;29(2).
42.
go back to reference Beckmann D, Brähler E, Richter H-E. Der Gießen-Test (GT). Vol. 4. erweiterte und überarbeitete Auflage mit Neustandardisierung 1990. Bern: Huber; 1991. Beckmann D, Brähler E, Richter H-E. Der Gießen-Test (GT). Vol. 4. erweiterte und überarbeitete Auflage mit Neustandardisierung 1990. Bern: Huber; 1991.
43.
go back to reference Stalder T, Kirschbaum C. Analysis of cortisol in hair--state of the art and future directions. Brain Behav Immun. 2012;26(7):1019–29.CrossRef Stalder T, Kirschbaum C. Analysis of cortisol in hair--state of the art and future directions. Brain Behav Immun. 2012;26(7):1019–29.CrossRef
44.
go back to reference Weitzman ED, et al. Twenty-four hour pattern of the episodic secretion of cortisol in normal subjects. J Clin Endocrinol Metab. 1971;33(1):14–22.CrossRef Weitzman ED, et al. Twenty-four hour pattern of the episodic secretion of cortisol in normal subjects. J Clin Endocrinol Metab. 1971;33(1):14–22.CrossRef
45.
go back to reference Steptoe A, Ussher M. Smoking, cortisol and nicotine. Int J Psychophysiol. 2006;59(3):228–35.CrossRef Steptoe A, Ussher M. Smoking, cortisol and nicotine. Int J Psychophysiol. 2006;59(3):228–35.CrossRef
46.
go back to reference Mendelson JH, Stein S. Serum cortisol levels in alcoholic and nonalcoholic subjects during experimentally induced ethanol intoxication. Psychosom Med. 1966;28(4):616–26.CrossRef Mendelson JH, Stein S. Serum cortisol levels in alcoholic and nonalcoholic subjects during experimentally induced ethanol intoxication. Psychosom Med. 1966;28(4):616–26.CrossRef
47.
go back to reference Gibson EL, et al. Increased salivary cortisol reliably induced by a protein-rich midday meal. Psychosom Med. 1999;61(2):214–24.CrossRef Gibson EL, et al. Increased salivary cortisol reliably induced by a protein-rich midday meal. Psychosom Med. 1999;61(2):214–24.CrossRef
48.
go back to reference Galbo H. Endocrinology and metabolism in exercise. Curr Probl Clin Biochem. 1982;11:26–44.PubMed Galbo H. Endocrinology and metabolism in exercise. Curr Probl Clin Biochem. 1982;11:26–44.PubMed
49.
go back to reference Karelis AD, et al. Psychosocial correlates of cardiorespiratory fitness and muscle strength in overweight and obese post-menopausal women: a MONET study. J Sports Sci. 2008;26(9):935–40.CrossRef Karelis AD, et al. Psychosocial correlates of cardiorespiratory fitness and muscle strength in overweight and obese post-menopausal women: a MONET study. J Sports Sci. 2008;26(9):935–40.CrossRef
50.
go back to reference Keller-Ross ML, et al. Muscle fatigability and control of force in men with posttraumatic stress disorder. Med Sci Sports Exerc. 2014;46(7):1302–13.CrossRef Keller-Ross ML, et al. Muscle fatigability and control of force in men with posttraumatic stress disorder. Med Sci Sports Exerc. 2014;46(7):1302–13.CrossRef
51.
go back to reference Rossi S, et al. Dysfunctions of cortical excitability in drug-naive posttraumatic stress disorder patients. Biol Psychiatry. 2009;66(1):54–61.CrossRef Rossi S, et al. Dysfunctions of cortical excitability in drug-naive posttraumatic stress disorder patients. Biol Psychiatry. 2009;66(1):54–61.CrossRef
52.
go back to reference Falconer E, et al. The neural networks of inhibitory control in posttraumatic stress disorder. J Psychiatry Neurosci. 2008;33(5):413–22.PubMedPubMedCentral Falconer E, et al. The neural networks of inhibitory control in posttraumatic stress disorder. J Psychiatry Neurosci. 2008;33(5):413–22.PubMedPubMedCentral
53.
go back to reference Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRef Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRef
54.
go back to reference Poethig D, et al. Experimentelle Untersuchungen zum psychomotorischen Grundtempo im Alternsgang. Medizin und Sport. 1985;25(3):73–8. Poethig D, et al. Experimentelle Untersuchungen zum psychomotorischen Grundtempo im Alternsgang. Medizin und Sport. 1985;25(3):73–8.
55.
go back to reference Machado A, et al. Chronic stress as a risk factor for Alzheimer’s disease. Rev Neurosci. 2014;25(6):785–804.CrossRef Machado A, et al. Chronic stress as a risk factor for Alzheimer’s disease. Rev Neurosci. 2014;25(6):785–804.CrossRef
56.
go back to reference Swaab DF, Bao AM, Lucassen PJ. The stress system in the human brain in depression and neurodegeneration. Ageing Res Rev. 2005;4(2):141–94.CrossRef Swaab DF, Bao AM, Lucassen PJ. The stress system in the human brain in depression and neurodegeneration. Ageing Res Rev. 2005;4(2):141–94.CrossRef
57.
go back to reference McEwen BS. Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007;87(3):873–904.CrossRef McEwen BS. Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007;87(3):873–904.CrossRef
58.
go back to reference Bauer ME. Chronic stress and immunosenescence: a review. Neuroimmunomodulation. 2008;15(4–6):241–50.CrossRef Bauer ME. Chronic stress and immunosenescence: a review. Neuroimmunomodulation. 2008;15(4–6):241–50.CrossRef
59.
go back to reference Bauer ME, Jeckel CM, Luz C. The role of stress factors during aging of the immune system. Ann N Y Acad Sci. 2009;1153:139–52.CrossRef Bauer ME, Jeckel CM, Luz C. The role of stress factors during aging of the immune system. Ann N Y Acad Sci. 2009;1153:139–52.CrossRef
60.
go back to reference Prenderville JA, et al. Adding fuel to the fire: the impact of stress on the ageing brain. Trends Neurosci. 2015;38(1):13–25.CrossRef Prenderville JA, et al. Adding fuel to the fire: the impact of stress on the ageing brain. Trends Neurosci. 2015;38(1):13–25.CrossRef
61.
go back to reference Monaghan P. Organismal stress, telomeres and life histories. J Exp Biol. 2014;217(Pt 1):57–66.CrossRef Monaghan P. Organismal stress, telomeres and life histories. J Exp Biol. 2014;217(Pt 1):57–66.CrossRef
62.
go back to reference Oliveira BS, et al. Systematic review of the association between chronic social stress and telomere length: a life course perspective. Ageing Res Rev. 2016;26:37–52.CrossRef Oliveira BS, et al. Systematic review of the association between chronic social stress and telomere length: a life course perspective. Ageing Res Rev. 2016;26:37–52.CrossRef
63.
go back to reference Maestripieri D, Hoffman CL. Chronic stress, allostatic load, and aging in nonhuman primates. Dev Psychopathol. 2011;23(4):1187–95.CrossRef Maestripieri D, Hoffman CL. Chronic stress, allostatic load, and aging in nonhuman primates. Dev Psychopathol. 2011;23(4):1187–95.CrossRef
Metadata
Title
Measuring chronic stress exposure incorporating the active and healthy ageing (AHA) concept within the cross-sectional Bern cohort study 2014 (BeCS-14)
Authors
Petra Stute
Marion Anker
Laura Hollenstein
Michael von Wolff
Norman Bitterlich
Florian Meissner
Dagmar Poethig
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BioPsychoSocial Medicine / Issue 1/2019
Electronic ISSN: 1751-0759
DOI
https://doi.org/10.1186/s13030-019-0143-6

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