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Allostatic Load Index

Source: R/allostatic_load.R
allostatic_load.Rd

Computes a composite Allostatic Load (AL) score by flagging biomarkers that exceed user-specified high-risk thresholds (strict > when multiple biomarkers; inclusive >= when only one biomarker). Aligned with HM-CS v3: structured validation, diagnostic control, verbose reporting, and optional summary output.

Usage

allostatic_load(
  data,
  thresholds,
  col_map = NULL,
  na_action = c("keep", "omit", "error"),
  check_extreme = FALSE,
  extreme_action = c("cap", "NA", "error"),
  sds_limit = 6,
  return_summary = FALSE,
  verbose = FALSE
)

Arguments

data

data.frame or tibble of numeric biomarker columns.

thresholds

named list of scalar numeric cutoffs (names must match columns).

col_map

optional named list mapping keys in thresholds to column names in data.

na_action

one of c("keep","omit","error") ("keep" treats NA as zero contribution).

check_extreme

logical; scan columns with name containing "sds" for |value| > sds_limit.

extreme_action

one of c("cap","NA","error") for SDS-like extremes.

sds_limit

positive numeric cutoff for SDS-like scan (default 6).

return_summary

logical; TRUE returns list(data, summary, warnings).

verbose

logical; print progress messages via hm_inform() (also gated by options(healthmarkers.verbose)).

Value

tibble with AllostaticLoad or list when return_summary = TRUE.

Details

API pattern note: Unlike most HealthMarkers functions which follow the standard (data, col_map, ...) signature, allostatic_load() uses (data, thresholds, col_map = NULL, ...) because thresholds is a domain-specific required argument that cannot be inferred from column names alone. As a result, this function is not directly dispatchable through the standard all_health_markers() registry; a custom wrapper that supplies thresholds explicitly would be required.

References

McEwen BS, Stellar E (1993). “Stress and the Individual: Mechanisms Leading to Disease.” Archives of Internal Medicine, 153(18), 2093–2101. doi:10.1001/archinte.153.18.2093 . ; Seeman TE, Singer BH, Rowe JW, Horwitz RI, McEwen BS (1997). “Price of Adaptation—Allostatic Load and Its Health Consequences.” Archives of Internal Medicine, 157(19), 2259–2268. doi:10.1001/archinte.1997.00440400111013 . ; Juster R, McEwen BS, Lupien SJ (2010). “Allostatic Load Biomarkers of Chronic Stress and Impact on Health and Cognition.” Neuroscience and Biobehavioral Reviews, 35(1), 2–16. doi:10.1016/j.neubiorev.2009.10.002 . ; Wiley JF, Gruenewald TL, Karlamangla AS, Seeman TE (2016). “Modeling Multisystem Physiological Dysregulation.” Psychosomatic Medicine, 78(3), 290–301. doi:10.1097/PSY.0000000000000288 .

See also

adiposity_sds, adiposity_sds_strat

Examples

df <- tibble::tibble(
  SBP = c(118, 142, 130),
  DBP = c(76, 92, 85),
  CRP = c(1.2, 4.8, 2.1)
)
thr <- list(SBP = 130, DBP = 85, CRP = 3)
allostatic_load(df, thresholds = thr, na_action = "keep", verbose = FALSE)
#> # A tibble: 3 × 1
#>   AllostaticLoad
#>            <int>
#> 1              0
#> 2              3
#> 3              0

# Single biomarker uses inclusive >= rule
allostatic_load(df, thresholds = list(CRP = 3))
#> # A tibble: 3 × 1
#>   AllostaticLoad
#>            <int>
#> 1              0
#> 2              1
#> 3              0