Abstract
The association between social relations and health outcomes is well described, but pathways are relatively poorly understood. Inflammation has been suggested as a potential physiological pathway, linking social relations to adverse health outcomes. However, previous studies have shown ambiguous results and have for the vast majority been based on studies small in sample size. The aim of the present study is to examine the association between comprehensive measures of structural and positive as well as negative functional aspects of social relations, across four relational domains—partner/spouse, children, other family and friends, and the level of systemic low-grade inflammation in a large population-based middle-aged cohort and to examine variation by gender and socioeconomic position in these associations. The study comprised of 5576 participants in the Copenhagen Aging and Midlife Biobank. The inflammatory biomarkers collected in late midlife included C-reactive protein, Interleukin-6, and TNF-alpha. Multiple linear regression models were implemented to explore associations between social relations and inflammatory measures controlling for gender, age, socioeconomic position, marital status, early major lifeevents and morbidity. Results show weak and ambiguous associations in all analyses. There were no strong indications of interaction with socioeconomic position. Concluding cautiously, men appear to be more vulnerable toward living alone and low contact frequency with family compared to women as regards high level of low-grade inflammation. In conclusion, this large-scale population-based study among middle-aged men and women showed no association between social relations and low-grade inflammation.
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References
Aartsen M, Veenstra M, Hansen T (2017) Social pathways to health: on the mediating role of the social network in the relation between socio-economic position and health. SSM Popul. Health 3:419–426. https://doi.org/10.1016/j.ssmph.2017.05.006
Avlund K et al (2014) Copenhagen Aging and Midlife Biobank (CAMB): an introduction. J Aging Health 26(1):5–20. https://doi.org/10.1177/0898264313509277
Bajaj A, John-Henderson NA, Cundiff JM, Marsland AL, Manuck SB, Kamarck TW (2016) Daily social interactions, close relationships, and systemic inflammation in two samples: healthy middle-aged and older adults. Brain Behav. Immun. 58:152–164. https://doi.org/10.1016/j.bbi.2016.06.004
Brown EG, Gallagher S, Creaven AM (2018) Loneliness and acute stress reactivity: a systematic review of psychophysiological studies. Psychophysiology 55(5):e13031. https://doi.org/10.1111/psyp.13031
Bruunsgaard H, Pedersen M, Pedersen BK (2001) Aging and proinflammatory cytokines. Curr. Opin. Hematol. 8(3):131–136
Cerhan JR, Wallace RB (1993) Predictors of decline in social relationships in the rural elderly. Am. J. Epidemiol. 137(8):870–880
Cevenini E, Monti D, Franceschi C (2013) Inflamm-ageing. Clin. Nutr. Metabol. Care 16(1):14–20. https://doi.org/10.1097/MCO.0b013e32835ada13
Chiang JJ, Eisenberger NI, Seeman TE, Taylor SE (2012) Negative and competitive social interactions are related to heightened proinflammatory cytokine activity. Proc. Natl. Acad. Sci. USA 109(6):1878–1882. https://doi.org/10.1073/pnas.1120972109
Christensen U et al (2014) Addressing social inequality in aging by the Danish occupational social class measurement. J. Aging Health 26(1):106–127. https://doi.org/10.1177/0898264314522894
Dich N et al (2015) Early life adversity potentiates the effects of later life stress on cumulative physiological dysregulation. Anxiety Stress Coping 28(4):372–390. https://doi.org/10.1080/10615806.2014.969720
Donoho CJ, Crimmins EM, Seeman TE (2013) Marital quality, gender, and markers of inflammation in the MIDUS Cohort. J. Marriage Fam. 75(1):127–141. https://doi.org/10.1111/j.1741-3737.2012.01023.x
Due P, Holstein B, Lund R, Modvig J, Avlund K (1999) Social relations: network, support and relational strain. Soc. Sci. Med. 48(5):661–673
Eisenberger NI, Moieni M, Inagaki TK, Muscatell KA, Irwin MR (2017) In sickness and in health: the co-regulation of inflammation and social behavior. Neuropsychopharmacology 42(1):242–253. https://doi.org/10.1038/npp.2016.141
Ekmann A, Avlund K, Osler M, Lund R (2012) Do negative aspects of social relations influence fatigue? A cross-sectional study on a non-clinical sample of middle-aged Danish men. J. Psychosom. Res. 73(4):277–282. https://doi.org/10.1016/j.jpsychores.2012.08.005
Elliot AJ, Heffner KL, Mooney CJ, Moynihan JA, Chapman BP (2018) Social relationships and inflammatory markers in the Midus cohort: the role of age and gender differences. J. Aging Health 30(6):904–923. https://doi.org/10.1177/0898264317698551
Ershler WB, Keller ET (2000) Age-associated increased interleukin-6 gene expression, late-life diseases, and frailty. Ann. Rev. Med. 51:245–270. https://doi.org/10.1146/annurev.med.51.1.245
Fagundes CP, Bennett JM, Derry HM, Kiecolt-Glaser JK (2011) Relationships and inflammation across the lifespan: social developmental pathways to disease. Soc. Pers. Psychol. Compass 5(11):891–903. https://doi.org/10.1111/j.1751-9004.2011.00392.x
Ford ES, Loucks EB, Berkman LF (2006) Social integration and concentrations of C-reactive protein among US adults. Ann. Epidemiol. 16(2):78–84. https://doi.org/10.1016/j.annepidem.2005.08.005
Ford J et al (2019) Social integration and quality of social relationships as protective factors for inflammation in a nationally representative sample of black women. J. Urb. Health Bull. New York Acad. Med. 96(Suppl 1):35–43. https://doi.org/10.1007/s11524-018-00337-x
Friedman EM, Herd P (2010) Income, education, and inflammation: differential associations in a national probability sample (The MIDUS study). Psychosom. Med. 72(3):290–300. https://doi.org/10.1097/PSY.0b013e3181cfe4c2
Glei DA, Goldman N, Ryff CD, Lin YH, Weinstein M (2012) Social relationships and inflammatory markers: an analysis of Taiwan and the US. Soc. Sci. Med. 74(12):1891–1899. https://doi.org/10.1016/j.socscimed.2012.02.020
Heap J, Fors S, Lennartsson C (2017) Coexisting disadvantages in later life: demographic and socio-economic inequalities. J. Popul. Ageing 10(3):247–267. https://doi.org/10.1007/s12062-016-9158-y
Holt-Lunstad J (2018) Why social relationships are important for physical health: a systems approach to understanding and modifying risk and protection. Ann. Rev. Psychol. 69:437–458. https://doi.org/10.1146/annurev-psych-122216-011902
Holt-Lunstad J, Smith TB, Layton JB (2010) Social relationships and mortality risk: a meta-analytic review. PLoSMed 7(7):e1000316. https://doi.org/10.1371/journal.pmed.1000316
Kamiya Y, Whelan B, Timonen V, Kenny RA (2010) The differential impact of subjective and objective aspects of social engagement on cardiovascular risk factors. BMC Geriatr. 10:81. https://doi.org/10.1186/1471-2318-10-81
Kiecolt-Glaser JK, Gouin JP, Hantsoo L (2010) Close relationships, inflammation, and health. Neurosci. Biobehav. Rev. 35(1):33–38. https://doi.org/10.1016/j.neubiorev.2009.09.003
Kim DA, Benjamin EJ, Fowler JH, Christakis NA (2016) Social connectedness is associated with fibrinogen level in a human social network. In: Proceedings biological sciences, vol 283(1837), https://doi.org/10.1098/rspb.2016.0958
Krause N, Borawski-Clark E (1995) Social class differences in social support among older adults. Gerontologist 35(4):498–508
Lara J et al (2015) A proposed panel of biomarkers of healthy aging. BMC Med. 13:222. https://doi.org/10.1186/s12916-015-0470-9
Liu RS et al (2017) Socioeconomic status in childhood and C reactive protein in adulthood: a systematic review and meta-analysis. J. Epidemiol. Commun. Health 71(8):817–826. https://doi.org/10.1136/jech-2016-208646
Loucks EB, Berkman LF, Gruenewald TL, Seeman TE (2006a) Relation of social integration to inflammatory marker concentrations in men and women 70 to 79 years. Am. J. Cardiol. 97(7):1010–1016. https://doi.org/10.1016/j.amjcard.2005.10.043
Loucks EB, Sullivan LM, D’Agostino RB Sr, Larson MG, Berkman LF, Benjamin EJ (2006b) Social networks and inflammatory markers in the Framingham Heart Study. J. Biosoc. Sci. 38(6):835–842. https://doi.org/10.1017/s0021932005001203
Loucks EB et al (2006c) Association of educational level with inflammatory markers in the Framingham Offspring Study. Am. J. Epidemiol. 163(7):622–628. https://doi.org/10.1093/aje/kwj076
Lund R, Rod NH, Christensen U (2010) Are negative aspects of social relations predictive of angina pectoris? A 6-year follow-up study of middle-aged Danish women and men. J. Epidemiol. Commun. Health. https://doi.org/10.1136/jech.2009.106153
Lund R, Nielsen LS, Henriksen PW, Schmidt L, Avlund K, Christensen U (2013) Content validity and reliability of the Copenhagen Social Relations Questionnaire (CSRQ). J. Aging Health 26(1):128–150
Lund R, Christensen U, Nilsson CJ, Kriegbaum M, Hulvej Rod N (2014a) Stressful social relations and mortality: a prospective cohort study. J. Epidemiol. Commun. Health 68(8):720–727. https://doi.org/10.1136/jech-2013-203675
Lund R, Rod NH, Thielen K, Nilsson CJ, Christensen U (2014b) Negative aspects of close social relations and 10-year incident ischaemic heart disease hospitalization among middle-aged Danes. Eur. J. Prev. Cardiol. 21(10):1249–1256. https://doi.org/10.1177/2047487313486041
Lund R et al (2015) Cohort profile: the Copenhagen aging and midlife Biobank (CAMB). Int. J. Epidemiol. https://doi.org/10.1093/ije/dyv149
McDade TW, Lindau ST, Wroblewski K (2011) Predictors of C-reactive protein in the national social life, health, and aging project. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 66(1):129–136. https://doi.org/10.1093/geronb/gbq008
Mezuk B, Diez Roux AV, Seeman T (2010) Evaluating the buffering vs direct effects hypotheses of emotional social support on inflammatory markers: the multi-ethnic study of atherosclerosis. Brain Behav. Immun. 24(8):1294–1300. https://doi.org/10.1016/j.bbi.2010.06.006
Nakata A, Irie M, Takahashi M (2014) Source-specific social support and circulating inflammatory markers among white-collar employees. Ann. Behav. Med. Publ. Soc. Behav. Med. 47(3):335–346. https://doi.org/10.1007/s12160-013-9555-x
Nersesian PV et al (2018) Loneliness in middle age and biomarkers of systemic inflammation: findings from Midlife in the United States. Soc. Sci. Med. 209:174–181. https://doi.org/10.1016/j.socscimed.2018.04.007
Pedersen JM et al (2016) Late midlife C-reactive protein and interleukin-6 in middle aged danish men in relation to body size history within and across generations. Obesity (Silver Spring, Md) 24(2):461–468. https://doi.org/10.1002/oby.21311
Puustinen PJ, Koponen H, Kautiainen H, Mantyselka P, Vanhala M (2011) Psychological distress and C-reactive protein: do health behaviours and pathophysiological factors modify the association? Eur. Arch. Psychiatry Clin. Neurosci. 261(4):277–284. https://doi.org/10.1007/s00406-010-0134-x
Rook KS (2015) Social networks in later life: weighing positive and negative effects on health and well-being. Curr. Dir. Psychol. Sci. 24(1):45–51. https://doi.org/10.1177/0963721414551364
Stepanikova I, Bateman LB, Oates GR (2017) Systemic inflammation in midlife: race, socioeconomic status, and perceived discrimination. Am. J. Prev. Med. 52(1s1):S63–S76. https://doi.org/10.1016/j.amepre.2016.09.026
Uchino BN et al (2016) Ethnic/racial differences in the association between social support and levels of C-reactive proteins in the North Texas Heart Study. Psychophysiology 53(1):64–70. https://doi.org/10.1111/psyp.12499
Uchino BN, Trettevik R, Kent de Grey RG, Cronan S, Hogan J, Baucom BRW (2018) Social support, social integration, and inflammatory cytokines: a meta-analysis. Health Psychol. Off. J. Div. Health Psychol. Am. Psychol. Assoc. 37(5):462–471. https://doi.org/10.1037/hea0000594
Walen HR, Lachman ME (2000) Social support and strain from partner, family, and friends: costs and benefits for men and women in adulthood. J. Soc. Pers. Relationsh. 17(1):5–30. https://doi.org/10.1177/0265407500171001
Wang X et al (2013) Inflammatory markers and risk of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 36(1):166–175. https://doi.org/10.2337/dc12-0702
Weddell-Neergaard et al (2018) Cardiorespiratory fitness and the metabolic syndrome: roles of inflammation and abdominal obesity. PLoS One 13(3):e0194991. https://doi.org/10.1371/journal.pone.0194991
Weyers S et al (2008) Low socio-economic position is associated with poor social networks and social support: results from the Heinz Nixdorf Recall Study. Int. J. Equity Health 7:13. https://doi.org/10.1186/1475-9276-7-13
Wilson RS, Boyle PA, James BD, Leurgans SE, Buchman AS, Bennett DA (2015) Negative social interactions and risk of mild cognitive impairment in old age. Neuropsychology 29(4):561–570. https://doi.org/10.1037/neu0000154
Yang YC, McClintock MK, Kozloski M, Li T (2013) Social isolation and adult mortality: the role of chronic inflammation and sex differences. J. Health Soc. Behav. 54(2):183–203. https://doi.org/10.1177/0022146513485244
Yang YC, Schorpp K, Harris KM (2014) Social support, social strain and inflammation: evidence from a national longitudinal study of U.S. adults. Soc. Sci. Med. 107:124–135. https://doi.org/10.1016/j.socscimed.2014.02.013
Yang YC, Boen C, Gerken K, Li T, Schorpp K, Harris KM (2016) Social relationships and physiological determinants of longevity across the human life span. Proc. Natl. Acad. Sci. USA 113(3):578–583. https://doi.org/10.1073/pnas.1511085112
Acknowledgements
The Copenhagen Aging and Midlife Biobank was Funded by generous Grants from the VELUX FOUNDATION (VELUX26145 and 31539). The authors thank the staff at Department of Public Health and National Research Centre for the Working Environment, who undertook the data collection. Further thanks to Kirsten Avlund†, Helle Bruunsgaard, Nils-Erik Fiehn, Åse Marie Hansen, Poul Holm-Pedersen, Rikke Lund, Erik Lykke Mortensen and Merete Osler, who initiated and established the Copenhagen Aging and Midlife Biobank from 2009 to 2011. The authors acknowledge the crucial role of the initiators and steering groups of The Metropolit Cohort, The Copenhagen Perinatal Cohort and The Danish Longitudinal Study on Work, Unemployment and Health. The Centre for Physical Activity Research is supported by a grant from TrygFonden.
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Nilsson, C.J., Nørgaard, S., Foverskov, E. et al. Positive and negative aspects of social relations and low-grade inflammation in Copenhagen Aging and Midlife Biobank. Eur J Ageing 17, 531–546 (2020). https://doi.org/10.1007/s10433-020-00561-y
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DOI: https://doi.org/10.1007/s10433-020-00561-y