Social isolation, C-reactive protein, and coronary heart disease mortality among community-dwelling adults

The Rochester Center for Mind-Body Research, Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Box PSYCH-BPSM, Rochester, NY 14642, United States.
Social Science [?] Medicine (Impact Factor: 2.56). 05/2011; 72(9):1482-8. DOI: 10.1016/j.socscimed.2011.03.016
Source: PubMed

ABSTRACT Social isolation confers increased risk for coronary heart disease (CHD) events and mortality. In two recent studies, low levels of social integration among older adults were related to higher levels of C-reactive protein (CRP), a marker of inflammation, suggesting a possible biological link between social isolation and CHD. The current study examined relationships among social isolation, CRP, and 15-year CHD death in a community sample of US adults aged 40 years and older without a prior history of myocardial infarction. A nested case-cohort study was conducted from a parent cohort of community-dwelling adults from the southeastern New England region of the United States (N = 2321) who were interviewed in 1989 and 1990. CRP levels were measured from stored sera provided by the nested case-cohort (n = 370), which included all cases of CHD death observed through 2005 (n = 48), and a random sample of non-cases. We found that the most socially isolated individuals had two-and-a-half times the odds of elevated CRP levels compared to the most socially integrated. In separate logistic regression models, both social isolation and CRP predicted later CHD death. The most socially isolated continued to have more than twice the odds of CHD death compared to the most socially integrated in a model adjusting for CRP and more traditional CHD risk factors. The current findings support social isolation as an independent risk factor of both high levels of CRP and CHD death in middle-aged adults without a prior history of myocardial infarction. Prospective study of inflammatory pathways related to social isolation and mortality are needed to fully delineate whether and how CRP or other inflammatory markers contribute to mechanisms linking social isolation to CVD health.

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Available from: Mary Roberts, Aug 28, 2015
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    • "People who are socially isolated have increased risk of all-cause mortality (Cacioppo and Hawkley, 2003; Seeman, 1996), and several infectious , neoplastic, and cardiovascular diseases (Caspi et al., 2006; Cohen et al., 1997; Cole et al., 2003; Kroenke et al., 2006). A possible biological mechanism of these effects is systemic inflammation, as social isolation has been shown to predict heightened systemic inflammation as assessed by circulating levels of inflammatory markers (Heffner et al., 2011). Furthermore, it is thought that social isolation is associated with sleep disturbance through a disruption of social zeitgebers (i.e., social cues that maintain the sleep–wake activity schedule), which are increasingly viewed as being critical in the homeostatic regulation of sleep–wake activity (Mistlberger and Skene, 2004). "
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    ABSTRACT: Both sleep disturbance and social isolation increase the risk for morbidity and mortality. Systemic inflammation is suspected as a potential mechanism of these associations. However, the complex relationships between sleep disturbance, social isolation, and inflammation have not been examined in a population-based longitudinal study. This study examined the longitudinal association between sleep disturbance and systemic inflammation, and the moderating effects of social isolation on this association. The CARDIA study is a population-based longitudinal study conducted in four US cities. Sleep disturbance - i.e., insomnia complaints and short sleep duration - was assessed in 2962 African-American and white adults at baseline (2000-2001, ages 33-45 years). Circulating C-reactive protein (CRP) was measured at baseline and follow-up (2005-2006). Interleukin-6 (IL-6) and subjective and objective social isolation (i.e., feelings of social isolation and social network size) were measured at follow-up. Sleep disturbance was a significant predictor of inflammation five years later after full adjustment for covariates (adjusted betas: 0.048, P=0.012 for CRP; 0.047, P=0.017 for IL-6). Further adjustment for baseline CRP revealed that sleep disturbance also impacted the longitudinal change in CRP levels over five years (adjusted beta: 0.044, P=0.013). Subjective social isolation was a significant moderator of this association between sleep disturbance and CRP (adjusted beta 0.131, P=0.002). Sleep disturbance was associated with heightened systemic inflammation in a general population over a five-year follow-up, and this association was significantly stronger in those who reported feelings of social isolation. Clinical interventions targeting sleep disturbances may be a potential avenue for reducing inflammation, particularly in individuals who feel socially isolated. Copyright © 2015. Published by Elsevier Inc.
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    • "Active engagement with life consists of interpersonal relationships and social contacts as well as productive activity, which creates a sense of societal value (Rowe and Kahn, 1997). Social isolation occurs when an individual has few social contacts or relationships and few connections or ties within the community, and social isolation has been found to be a risk factor for health and mortality (Berkman et al., 2000; House, 2001; Strike and Steptoe, 2004; Heffner et al., 2011). Alternatively, remaining active and maintaining a social network has been linked to longevity and to positive health-related effects (Cohen, 2004; Uchino, 2004; Cohen and Janicki- Deverts, 2009). "
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