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1 a Historical Perspective on Skeletal Frailty in Medieval A Historical Perspective on Skeletal Frailty in Medieval Poland: Evidence from an Early Piast Dynasty Site Thesis Presented in Partial Fulfillment of the Requirements for the Degree Master of Arts in the Graduate School of The Ohio State University By Alexandra Christianne Tuggle Graduate Program in Anthropology The Ohio State University 2018 Thesis Committee Dr. Douglas E. Crews, Advisor Dr. Mark Hubbe Dr. Samuel Stout 1 Copyrighted by Alexandra Christianne Tuggle 2018 2 Abstract In humans, stress and health are fundamentally intertwined. Recently, Marklein et al. (2016) proposed a skeletal frailty index (SFI) based upon clinical research methods. Such SFIs estimate somatic frailty by assessing acute and chronic skeletal lesions. My hypothesis is that skeletal frailty, as estimated using a SFI, differed by both age and sex at the medieval Polish site Kałdus (n=108). During the 10th to 13th centuries, Kałdus was a regional economic center of Poland with a population expressing a variety of religious and cultural practices. Relying on 11 biomarkers of frailty, this sample was analyzed for skeletal markers of lifetime stressors used to estimate skeletal frailty. All skeletons were assigned to an age group: 18-25 (n=21), 26-35 (n=31), 36-45 (n=31), and >45 (n=25). In the full sample, SFI averaged 4.13 (range 0-9). Among men (n=56), SFI averaged 4.45 (sd = 1.90; range 1-8); among women (n=52), it was 3.79 (sd = 2.03; range 0-9; p = 0.044). SFI was lowest in the youngest age group, 2.38 (sd = 1.83; range 0-6) and highest in the oldest, 5.48 (sd = 1.50; range 2-9; p < 0.001). In these medieval skeletons, an 11- biomarker SFI shows a significant difference between those ascribed as male or female. Additionally, frailty differs significantly by age. Skeletal frailty as estimated from biomarkers of skeletal stress suggests these individuals were exposed to a harsh environmental setting during their lives. ii Dedication This work is dedicated to my parents Gerald and Sandra Tuggle, my number one cheerleaders and source of encouragement. I could not have accomplished this without your unwavering support. iii Acknowledgments First and foremost, I would like to acknowledge my advisor Dr. Douglas Crews. This project would not have been possible without his guidance, support, and countless hours spent helping me improve my writing. I would also like to thank Katy Marklein for taking me under her wing and providing invaluable advice and direction, and for helping me dream this project into existence. Your pep talks and constant encouragement kept me going through all my doubts. Additionally I would like to thank my committee members Dr. Mark Hubbe and Dr. Sam Stout for their invaluable input and advice through all stages of this research. Importantly, I would like to thank Dr. Rick Steckel and Dr. Tomasz Kozłowski for granting me access to work on this exceedingly fascinating collection. Many thanks go to all my past educators in Arizona at Mountain View High School and the University of Arizona for fostering my love of anthropology and science and encouraging me to pursue my curiosity. Much gratitude goes out to my fellow cohort members and graduate students in the Department of Anthropology, this work would not have been possible without your friendship and support. Lastly, I would like to thank all my friends and family in Arizona and across the world for their confidence and reassurance when I needed it most. iv Vita 2009………………………………………….Mountain View High School 2012………………………………………….B.S. Anthropology, University of Arizona 2016………………………………………….University Fellow, The Ohio State University 2017 to present………………………………Graduate Teaching Associate, The Ohio State University Fields of Study Major Field: Anthropology v Table of Contents Abstract .......................................................................................................................... ii Dedication ...................................................................................................................... iii Acknowledgments .......................................................................................................... iv Vita ................................................................................................................................. v List of Tables ............................................................................................................... viii List of Figures ................................................................................................................. x Chapter 1. Introduction ................................................................................................... 1 Background ................................................................................................................. 4 Biocultural Context: Medieval Poland ..................................................................... 4 Burial Context ......................................................................................................... 9 Diet at Kałdus: Historical and isotopic evidence .................................................... 13 Purpose and Hypotheses ............................................................................................ 15 Chapter 2. Materials and Methods ................................................................................ 17 Materials ................................................................................................................... 17 11-biomarker SFI construct ................................................................................... 18 6-biomarker SFI construct ..................................................................................... 19 Methods .................................................................................................................... 21 11-biomarker SFI construct ................................................................................... 21 6-biomarker SFI construct ..................................................................................... 32 Statistical analyses ................................................................................................. 33 Chapter 3. Results ......................................................................................................... 34 Gross Prevalence ....................................................................................................... 34 11-biomarker SFI construct ....................................................................................... 35 6-biomarker SFI construct ......................................................................................... 38 Chapter 4. Discussion .................................................................................................... 41 Gross prevalence ....................................................................................................... 41 vi Sex ............................................................................................................................ 43 Age ........................................................................................................................... 44 Limitations ................................................................................................................ 46 Chapter 5. Conclusions ................................................................................................. 47 References .................................................................................................................... 49 Appendix A. Skeletal biomarkers of frailty included in the 11-biomarker SFI (N=108) . 55 Appendix B. Skeletal biomarkers of frailty included in the 6-biomarker SFI (N=176) ... 60 vii List of Tables Table 1. Sex and age distribution of individuals in skeletal sample from Kałdus site 4 used in the 11-biomarker SFI. ....................................................................................... 18 Table 2. Sex and age distribution of individuals in skeletal sample from Kałdus site 4 used in a 6-biomarker SFI. ............................................................................................ 20 Table 3. Skeletal biomarkers of frailty incorporated into the 11-biomarker skeletal frailty index with designated scores and measurements for frailty and frailty cut-off scores (table adapted from Marklein et al., 2016). .............................................................................. 22 Table 4. Skeletal biomarkers of frailty incorporated into the non-metric 6-biomarker skeletal frailty index. ..................................................................................................... 32 Table 5. Average femoral lengths (mm), femoral head diameters (mm), and gross prevalence values of skeletal and dental lesions among males and females at Kałdus site 4 (N=108). ....................................................................................................................... 35 Table 6. Results for skeletal frailty by sex (Welch two sample t-test) and by sex with age as a covariate (ANCOVA) for Kałdus site 4 using an 11-biomarker skeletal frailty index (N=108). ....................................................................................................................... 36 Table 7. Results for skeletal frailty by sex within each age cohort (Welch two sample t- test) and between all age cohorts (ANOVA) for Kałdus site 4 using an 11-biomarker skeletal frailty index (N=108). ......................................................................................
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