Allostatic Load, Psychiatric Morbidity and Cortisol Responses to Awakening in Midlife Immigrant Women

Abstract

Background: The healthy migrant effect hypothesis suggests that the immigrants’ health conditions deteriorate over time, perhaps due to the adoption of different lifestyle behaviours or exposure to stressful events (i.e., wear and tear condition). We investigated whether allostatic load markers were related to perceived stress, psychiatric morbidity and cortisol awakening response in midlife, immigrant women. Methods: Fifty-six immigrant women, aged 40-60 years, were consecutively assessed at a women’s clinic in Ontario with the use of the PRIME-MD, Perceived Stress Scale (PSS), and Resilience Scale (RS). Other assessments included information on time since immigration, menopause-related complaints and acculturation issues. Weight, BMI and waist/hip ratio measures were obtained and saliva samples were collected on awakening, and after 30 and 60 minutes. Results: There was a significant, negative correlation between perceived stress and resilience in this sub-population studied (rs= -.49, p<0.001); in addition, waist/hip ratio was inversely correlated with time since immigration (rs= -.33, p<0.05) and positively correlated with heightened psychiatric morbidity, menopause-related complaints and reported difficulties in acculturating (e.g., language barriers, work-related difficulties, poor access to culturally-sensitive health care). The decline in cortisol levels over time (AUC) was neg atively related to waist/hip ratio, but did not reach significant correlation with psychiatric morbidity.Conclusions: Midlife, immigrant women may be exposed to stressors inherent to either the immigration or the menopausal transition processes; the resulting allostatic load can contribute to neuroendocrine disturbances and heightened psychiatric morbidity.