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van der Velpen IF, Yaqub A, Vernooij MW, Perry M, Vernooij-Dassen MJF, Ghanbari M, Ikram MA, Melis RJF. Sex-differences in the association of social health and marital status with blood-based immune and neurodegeneration markers in a cohort of community-dwelling older adults. Brain Behav Immun 2024; 120:71-81. [PMID: 38782212 DOI: 10.1016/j.bbi.2024.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/24/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The immune system has been proposed to play a role in the link between social health and all-cause dementia risk. We explored cross-sectional and longitudinal associations between social health, immune system balance and plasma neurodegeneration markers in community-dwelling older adults, and explored whether the balance between innate and adaptive immunity mediates associations between social health and both cognition and total brain volume. METHODS Social health markers (social support, marital status, loneliness) were measured in the Rotterdam Study between 2002-2008. Immune system cell counts and balance were assessed repeatedly from 2002 to 2016 using white blood-cell-based indices and individual counts (granulocyte-to-lymphocyte ratio (GLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)). Plasma neurodegeneration biomarkers (amyloid-β40, amyloid-β42, total tau and neurofilament light chain) were measured once from blood samples collected between 2002-2008. Global cognitive function and total brain volume (MRI) were measured at the follow-up visit between 2009-2014. We used linear mixed models to study longitudinal associations and performed causal mediation analyses. RESULTS In 8374 adults (mean age 65.7, 57 % female), never married participants (n = 394) had higher GLR, PLR and SII compared to married peers at baseline and during follow-up, indicating imbalance towards innate immunity. Being never married was associated with higher plasma amyloid-β40, and being widowed or divorced with higher plasma total tau levels at baseline. Widowed or divorced males, but not females, had higher GLR, PLR and SII at baseline. Higher social support was associated with lower PLR in females, but higher PLR in males. Loneliness was not associated with any of the immune system balance ratios. Never married males had higher levels of all plasma neurodegeneration markers at baseline. Immune system balance did not mediate associations between social health and cognition or total brain volume, but does interact with marital status. CONCLUSION This study indicates that marital status is associated with blood-based immune system markers toward innate immunity and higher levels of plasma neurodegeneration markers. This is particularly evident for never married or previously married male older adults compared to married or female peers.
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Affiliation(s)
- Isabelle F van der Velpen
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Amber Yaqub
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | - Marieke Perry
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
| | - René J F Melis
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands; Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
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Kemp JM, Taylor VH, Kanagasabai T. Access to healthcare and depression severity in vulnerable groups the US: NHANES 2013-2018. J Affect Disord 2024; 352:473-478. [PMID: 38401808 DOI: 10.1016/j.jad.2024.02.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Access to healthcare is essential for managing chronic diseases, yet it often poses a barrier, contributing to a significant burden of conditions like depression. This study aimed to investigate the association between healthcare access and depression severity in contemporary free-living adults in the US, with a focus on identifying vulnerable populations. METHOD Data from the National Health and Nutrition Examination Survey cycles 2013-2018 were utilized, involving 13,689 participants aged 20 years or older. Multivariable multinomial logistic regression models were conducted, adjusting for various confounding variables. RESULTS Approximately 17 % of US adults lacked access to healthcare, while 24 % experienced varying levels of depression severity, with 8 % having moderate-to-severe depression. More males faced challenges accessing healthcare, while more females reported diverse levels of depression. Both healthcare access and depression severity were associated with low educational attainment, low familial income, lacking spousal support, lacking health insurance coverage, and worse self-reported overall health. We found a higher vulnerability to moderate-to-severe depression among females (OR (95 % CI): 1.20 (0.91, 1.59)), individuals identifying as the Other ethnic group (1.69 (1.02, 2.79)), and those living without a spouse (1.57 (1.10, 2.26)). LIMITATIONS Our cross-sectional study cannot establish causality, and potential biases related to self-reported data exist. CONCLUSIONS Access to healthcare emerged as a crucial predictor of moderate-to-severe depression among females, individuals of the Other ethnic group, and those without a spouse. Longitudinal research is needed to confirm and enhance our understanding of factors that shape the relationship between healthcare access and depression in free-living US adults.
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Affiliation(s)
- James M Kemp
- Department of Public Health, St. Lawrence University, Canton, NY, USA
| | - Valerie H Taylor
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Liu H, Copeland M, Nowak G, Chopik WJ, Oh J. Marital Status Differences in Loneliness Among Older Americans During the COVID-19 Pandemic. POPULATION RESEARCH AND POLICY REVIEW 2023; 42:74. [PMID: 38264508 PMCID: PMC10805368 DOI: 10.1007/s11113-023-09822-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 08/14/2022] [Indexed: 01/25/2024]
Abstract
Guided by the social integration perspective, we conducted one of the first population-based studies on marital status differences in loneliness during the COVID-19 pandemic among older Americans. Analysis of data from the 2020 National Health and Aging Trends Study COVID-19 supplement (n = 2861) suggested that, compared to their married counterparts, divorced and widowed older adults reported higher levels of loneliness during the pandemic, and divorced older adults also felt lonely more often when compared to before the pandemic. These marital status differences in pandemic loneliness cannot be explained by changes in social participation (e.g., working for pay, volunteering, attending religious services, or attending clubs, classes, or other organized activities) or changes in contact frequency with family and friends (via phone calls, emails/texts/social media messages, video calls, or in-person visits). No gender difference was found in the association between marital status and loneliness during the pandemic. These results, coupled with the growth of the unmarried older population, highlight that policymakers, health care providers, and researchers should think creatively about ways to reduce the loneliness gap between married and unmarried groups to promote healthy aging for all older adults, particularly in the face of emerging pandemics that may complicate strategies to improve population health in the future.
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Affiliation(s)
- Hui Liu
- Center on Aging and the Life Course and Department of Sociology, Purdue University, MSEE Room 308B, 501 Northwestern Avenue, West Lafayette, IN 47907, USA
| | - Molly Copeland
- Department of Sociology, Michigan State University, 509 E. Circle Drive, 317 Berkey Hall, East Lansing, MI 48824, USA
| | - Gerald Nowak
- Department of Sociology, Michigan State University, 509 E. Circle Drive, 317 Berkey Hall, East Lansing, MI 48824, USA
| | - William J. Chopik
- Department of Psychology, Michigan State University, 316 Physics Rd, East Lansing, MI 48824, USA
| | - Jeewon Oh
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244, USA
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Liu H, Nowak GR, Wang J, Luo Z. A National Study of Marital Status Differences in Early Uptake of COVID-19 Vaccine among Older Americans. Geriatrics (Basel) 2023; 8:69. [PMID: 37489317 PMCID: PMC10366868 DOI: 10.3390/geriatrics8040069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/07/2023] [Accepted: 06/23/2023] [Indexed: 07/26/2023] Open
Abstract
We provide one of the first nationally representative studies to examine COVID-19 vaccine uptake differences by marital status within the first year after the vaccine was recommended among older Americans. Data were drawn from the National Health and Aging Trends Study (2021). The study sample included 3180 participants aged 65 and older with 1846 women and 1334 men. Results from logistic regression models suggest that divorced/separated older adults were less likely to receive at least one dose of the COVID-19 vaccine in 2021 than their married counterparts, especially among women and individuals with higher education. Widowed and never married respondents were generally not significantly different from married respondents in COVID-19 vaccination status, with only one exception: less-educated never-married respondents were more likely to receive COVID-19 vaccination than their less-educated married counterparts. Our study highlights divorce/separation as a significant social factor associated with COVID-19 vaccine uptake among older adults in the U.S. These findings suggest that divorced/separated older adults are the most vulnerable population segment at risk of low COVID-19 vaccine uptake. Future efforts to improve vaccine equity and uptake should target this group specifically, with tailored interventions to increase their access and uptake of the vaccine.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State University, 509 E. Circle Drive 316, East Lansing, MI 48824, USA; (G.R.N.III); (J.W.)
| | - Gerald Roman Nowak
- Department of Sociology, Michigan State University, 509 E. Circle Drive 316, East Lansing, MI 48824, USA; (G.R.N.III); (J.W.)
| | - Juwen Wang
- Department of Sociology, Michigan State University, 509 E. Circle Drive 316, East Lansing, MI 48824, USA; (G.R.N.III); (J.W.)
| | - Zhehui Luo
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, USA;
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Scheckler S. Household Composition Under Strain: Regional Unemployment Rates and the Older American Housing Decision. J Aging Soc Policy 2023; 35:125-153. [PMID: 34420481 DOI: 10.1080/08959420.2021.1941703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This research explored the relationship between regional unemployment rates and the community-based housing configuration of older Americans. The analysis used the American Community Survey from 2006 to 2016 to examine regions experiencing high unemployment for differences in the likelihood of older adults to live alone, with a spouse or partner, or in a multigenerational household. Findings demonstrated that under the strain of higher regional unemployment, older adults were less likely to live alone and more likely to live in a multigenerational household. Additionally, older adults with a difficulty that could signify a need for support were less likely to live with a spouse or partner, while those without a difficulty were more likely to live with a spouse or partner. Recession-related safety-net policy should target supports to community-dwelling older adults, particularly those living alone, those with more support needs, with lower income, and older renters, because their housing arrangements may become vulnerable during regional economic contraction. Implications during COVID-19 are discussed.
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Affiliation(s)
- Samara Scheckler
- Joint Center for Housing Studies, Harvard University, Cambridge, Massachusetts, United States of America Postdoctoral Fellow
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Lee C, Min SH. Racial Differences in C-Reactive Protein, Depression Symptoms, and Social Relationships in Older Adults: A Moderated Network Analysis. Biol Res Nurs 2023:10998004231157767. [PMID: 36802354 DOI: 10.1177/10998004231157767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
INTRODUCTION We introduce moderated network analysis as an integrative approach to assess the moderation effects of race on the relationship between C-reactive protein (CRP) and depression symptoms in older adults. This study further explores how the observed relationships differ adjusting for social relationships. METHODS This secondary analysis of cross-sectional data from the National Social Life, Health, and Aging Project (2010-2011) includes 2,880 older adults. We used different depression symptom domains (depressed affect, low positive affect, somatic symptoms, and interpersonal problems) from the Center for Epidemiologic Studies-Depression Scale. Social relationships were assessed with measures of social integration, social support, and social strain. The moderated networks were constructed using the R-package mgm. The racial moderator was coded as White/African American racial groups. RESULTS In the moderated networks of CRP and depression symptoms, CRP-"interpersonal problems" edge was present only among African Americans. CRP-"somatic symptoms" edge was present in both racial groups with equal edge weights. After adjusting for social relationships, the aforementioned patterns remained the same, but the edge weights were attenuated. We additionally observed CRP-social strain and social integration-"depressed affect" edges only in African Americans. DISCUSSION Race may moderate the relationship between the CRP and depression symptoms in older adults and social relationships might be important covariates to consider while analyzing them. This study as an initiation point; future network investigations would benefit from leveraging more contemporary cohorts of older adults, gaining a large sample size with diverse racial/ethnic backgrounds, and important covariates. Several important methodological issues of the current study are addressed.
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Affiliation(s)
- Chiyoung Lee
- School of Nursing & Health Studies, University of Washington Bothell, Bothell, WA, USA
| | - Se Hee Min
- Columbia University School of Nursing, New York, NY, USA
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Examining Between-Group Differences in Social Network Density and High-Sensitivity C-Reactive Protein in Older Adults: Implications for the Hispanic Mortality Paradox. Psychosom Med 2023; 85:165-174. [PMID: 36729601 PMCID: PMC9924960 DOI: 10.1097/psy.0000000000001157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hispanic/Latino(x) and African American/Black older adults experience disproportionate cardiometabolic disease burdens when compared with their non-Hispanic White counterparts. Sources of resilience such as social networks have been found to mitigate the risk of this disease and its end points like high-sensitivity C-reactive protein (hs-CRP). However, little is known about the social network infrastructure among these groups. Moreover, existing work has largely ignored the degree to which members of one's network are connected to one another (network density), which may be important for navigating structural barriers within interdependent groups. The objective of this study was to understand the association between network density and 5-year hs-CRP (blood spot) and whether this association was moderated by race-ethnicity. METHODS A subsample of Hispanic/Latino(x), African American/Black, and non-Hispanic White older adults ( N = 1431) from the National Social Life Health and Aging Project was used. Multivariable regression was used to estimate the association between network density and its interaction with race-ethnicity, with hs-CRP 5 years later. RESULTS Although no main effect of network density on 5-year hs-CRP was found, results revealed a significant network density by race-ethnicity interaction (Wald χ2 (2, 1242) = 3.31, p = .037). Simple slopes analyses revealed that Hispanic/Latino(x) older adults with high network density had significantly lower hs-CRP levels when compared with their same-ethnic counterparts with low network density ( b = -0.73, standard error = 0.31, 95% confidence interval = -1.33 to -0.13, p = .018). CONCLUSIONS Results demonstrate population-level differences in social network structure and differential associations of this infrastructure with health. Implications for the Hispanic Mortality Paradox are discussed.
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Larnyo E, Dai B, Nutakor JA, Ampon-Wireko S, Larnyo A, Appiah R. Examining the impact of socioeconomic status, demographic characteristics, lifestyle and other risk factors on adults' cognitive functioning in developing countries: an analysis of five selected WHO SAGE Wave 1 Countries. Int J Equity Health 2022; 21:31. [PMID: 35216605 PMCID: PMC8876754 DOI: 10.1186/s12939-022-01622-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background Though extensive studies have been conducted on assessing the predictors of cognitive functioning among older adults in small community-based samples, very few studies have focused on understanding the impact of socioeconomic status (SES), demographic characteristics and other risk factors such as lifestyle and chronic diseases on the cognitive functioning among adults of all ages in a nationally representative population-based sample across low- and middle-income countries. This study, therefore, seeks to evaluate the impact of SES, demographic characteristics and risk factors on the cognitive functioning of adults across all ages in five selected developing countries. Methods Data from 12,430 observations obtained from the WHO Study on Global AGEing and Adult Health (SAGE) Wave 1; consisting of 2,486 observations each for China, Ghana, India, the Russian Federation, and South Africa, were used for the study. A meta-regression and a five-step hierarchical linear regression were used to analyze the data, with cognitive functioning as the dependent variable. Independent variables used in this study include SES; assessed by household income and education, demographic characteristics, other risk factors such as lifestyle, self-reported memory difficulty and chronic diseases. Results This study found that SES and lifestyle significantly predicted cognitive functioning in all the five selected countries as obtained by the pooled results of the meta-regression analysis. The hierarchical linear regression results also revealed that demographic characteristics such as age, type of residency, and self-reported memory difficulty significantly impact cognitive functioning in China, Ghana, Russia, and South Africa. Conclusion The findings in this study provide new insights for policymakers, caregivers, parents, and individuals, especially those in developing countries, to implement policies and actions targeted at improving SES and eliminating risk factors associated with cognitive decline, as these measures could help improve the cognitive functioning among their populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-022-01622-7.
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Affiliation(s)
- Ebenezer Larnyo
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Baozhen Dai
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China. .,Department of Labor and Social Security, School of Public Health, Southeast University, 87# Dingjiaqiao, Nanjing, 210009, Jiangsu province, China.
| | - Jonathan Aseye Nutakor
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Sabina Ampon-Wireko
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Abigail Larnyo
- School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
| | - Ruth Appiah
- Department of Health Policy and Management, School of Management, Jiangsu University, 301# Xuefu Road, Zhenjiang, 212013, Jiangsu Province, China
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Davidsen K, Carstensen S, Kriegbaum M, Bruunsgaard H, Lund R. Do partnership dissolutions and living alone affect systemic chronic inflammation? A cohort study of Danish adults. J Epidemiol Community Health 2022; 76:jech-2021-217422. [PMID: 35012967 DOI: 10.1136/jech-2021-217422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/13/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Partnership breakups and living alone are associated with several adverse health outcomes. The aim of this study, carried out in Denmark, is to investigate whether accumulated numbers of divorces/partnership breakups or years lived alone across 26 years of adult life are associated with levels of inflammation, and if vulnerability with regards to gender or educational level can be identified. METHODS 4835 participants from the Copenhagen Aging and Midlife Biobank (CAMB) aged 48-62 years were included. Data on accumulated numbers of partnership breakups and years living alone were retrieved from a national standardised annual register. Inflammatory markers interleukin 6 (IL-6) and high sensitivity C-reactive protein (hsCRP) were measured in blood samples. Multivariate linear regression analyses were adjusted for age, educational level, early major life events, body mass index, chronic diseases, medicinal intake affecting inflammation, acute inflammation and personality scores. RESULTS For men, an association was found between an increasing number of partnership breakups or number of years living alone and higher levels of inflammatory markers. No such association was found for women, and no evidence of partnership breakups and educational level having a joint effect was found for either gender. CONCLUSION The findings suggest a strong association between years lived alone or accumulated number of partnership breakups and low-grade inflammation for middle-aged men, but not for women. Among those of either sex with a lower level of education, no specific vulnerability to accumulated years lived alone or number of breakups was identified.
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Affiliation(s)
- Karolina Davidsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Simon Carstensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Margit Kriegbaum
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Helle Bruunsgaard
- Department of Clinical Immunology; Centre of Inflammation and Metabolism; Centre for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rikke Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Helath, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Kobenhavn, Denmark
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Waite LJ, Duvoisin R, Kotwal AA. Social Health in the National Social Life, Health, and Aging Project. J Gerontol B Psychol Sci Soc Sci 2021; 76:S251-S265. [PMID: 34918156 PMCID: PMC8678439 DOI: 10.1093/geronb/gbab138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES In this article, we present the theoretical framework that guided the development of the National Social Life, Health, and Aging Project (NSHAP) including the measures of social health. We discuss the literature that links social measures to other outcomes, and we discuss in detail how researchers might construct common measures of social health, including those that reflect social relationships, sexuality, social networks, social resources, and social participation. METHODS The NSHAP includes multiple detailed measures of social health, collected in the rounds of data collection carried out in 2005, 2010, and 2015, allowing for study of changes over time and as people age among a nationally representative sample of the community-dwelling population of older adults in the United States. RESULTS We define indicators of social health, describe measures of each in the 2015 round of NSHAP, and show the distribution of the measures by gender and age. We present scales of dimensions of social health that have been developed elsewhere and describe their properties. DISCUSSION We briefly discuss the distribution of these measures by age and gender in the 2015 round of NSHAP. Simple analyses of these categorized measures reveal differences by age and gender that deserve closer attention in future investigations using the NSHAP data.
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Affiliation(s)
- Linda J Waite
- Department of Sociology, University of Chicago, Illinois, USA
- NORC at the University of Chicago, Illinois, USA
| | | | - Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California San Francisco, USA
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Upenieks L, Uecker JE, Schafer MH. Couple Religiosity and Well-Being Among Older Adults in the United States. J Aging Health 2021; 34:266-282. [PMID: 34510947 DOI: 10.1177/08982643211042159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: This article evaluates whether couples' religious similarity is consequential for the health of older married men and women. Alternatively, we examine whether women's religiosity alone is health-protective to their husbands. Methods: Using dyadic data from the US National Social Life, Health, and Aging Project, a representative sample of 913 individuals ages 62-91 plus their marital partners, we perform latent-class analysis to separate older couples into classes based on religious characteristics. Ordered logistic regression models are then used to assess whether different combinations of religious (dis)similarity are associated with married men and women's well-being. Results: We find that older women in highly religious, homogamous marriages report better mental and physical health relative to women in heterogamous and secular (non-religious) marriages. No significant associations were observed for men. Discussion: Our results emphasize that religiosity is not only an individual trait-dis/similarities within a couple have important implications for older women's well-being.
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Grippo AJ, McNeal N, Normann MC, Colburn W, Dagner A, Woodbury M. Behavioral and neuroendocrine consequences of disrupting a long-term monogamous social bond in aging prairie voles. Stress 2021; 24:239-250. [PMID: 32820956 PMCID: PMC7914264 DOI: 10.1080/10253890.2020.1812058] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 08/14/2020] [Indexed: 12/13/2022] Open
Abstract
Social support from a spouse, long-term partner, or someone who provides emotional or instrumental support may protect against consequences of aging, including mediating behavioral stress reactivity and altering neurobiological process that underlie short-term stress responses. Therefore, long-term social bonding may have behavioral and neurobiological benefits. The socially monogamous prairie vole provides a valuable experimental model for investigating the benefits of long-term social bonds on short-term stress reactivity in aging animals, given their unique social structure of forming enduring opposite-sex bonds, living in family groups, and bi-parental rearing strategies. Male-female pairs of long-term, cohabitating prairie voles were investigated for short-term behavioral and neuroendocrine stress reactivity following either long-term social pairing (control), or a period of social isolation. In Experiment 1, social isolation was associated with altered behavioral reactivity to an acute swim stressor, and greater neural activation in the hypothalamic paraventricular nucleus, as well as specifically the parvocellular region, following the swim stressor (vs. control). In Experiment 2, social isolation was associated with greater corticosterone reactivity following an acute restraint stressor (vs. control). No sex differences were observed. Exploratory correlation and subgroup analyses revealed systematic relationships among various demographic variables (such as age of the subjects, amount of time the pair cohabitated together, and number of litters the pair reared together) and the behavioral and neuroendocrine outcome measures. These findings may inform our understanding of the benefits of long-term social bonding on modulating short-term behavioral and neuroendocrine responses to stress.LAY SUMMARYReceiving social support from a long-term spouse or partner, or having a strong support network from friends, may have important health benefits as people age. In aging monogamous prairie voles, social isolation from a long-term social partner disrupted behaviors and short-term stress responses, whereas living with a long-term partner protected against these disruptions. This research is important for our understanding of the benefits of social support on stress responses as we age.
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Affiliation(s)
- Angela J Grippo
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Neal McNeal
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Marigny C Normann
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - William Colburn
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Ashley Dagner
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
| | - Matthew Woodbury
- Department of Psychology, Northern Illinois University, DeKalb, IL, USA
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Zhang Z, Liu H, Choi SWE. Marital loss and risk of dementia: Do race and gender matter? Soc Sci Med 2021; 275:113808. [PMID: 33713925 PMCID: PMC8015783 DOI: 10.1016/j.socscimed.2021.113808] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/02/2021] [Accepted: 02/26/2021] [Indexed: 12/22/2022]
Abstract
Recent studies have found that marital loss through divorce or widowhood is associated with a higher risk of dementia for older adults. However, whether these associations vary by race and gender is less clear. To address this gap, we drew upon longitudinal data from the Health and Retirement Study (2000-2016) to investigate the association between marital loss and dementia risk, separately for non-Hispanic Whites and non-Hispanic Blacks. We further examined gender variations in the link between marital loss and dementia risk within each racial group. Results from discrete-time event history models suggested that widowhood is significantly associated with a higher risk of dementia for both Whites and Blacks, controlling for basic demographic characteristics. However, while divorce is significantly associated with a higher risk of dementia for Blacks, the association is marginally significant (p < 0.1) for Whites. There are few significant gender variations in these associations except for the effect of divorce among Whites. Even after controlling for economic and health-related factors, we found that divorce is associated with a higher risk of dementia among White men but not among White women. Economic resources explain a significant portion of the association between widowhood and dementia risk, more so for Whites than for Blacks. Our findings call for more research into the pathways through which marital loss shapes the risk of dementia across racial and ethnic groups.
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Affiliation(s)
- Zhenmei Zhang
- Department of Sociology, Michigan State University, USA.
| | - Hui Liu
- Department of Sociology, Michigan State University, USA
| | - Seung-Won Emily Choi
- Department of Sociology, Anthropology, and Social Work, Texas Tech University, USA
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Quigley TP, Amdam GV. Social modulation of ageing: mechanisms, ecology, evolution. Philos Trans R Soc Lond B Biol Sci 2021; 376:20190738. [PMID: 33678020 DOI: 10.1098/rstb.2019.0738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Human life expectancy increases, but the disease-free part of lifespan (healthspan) and the quality of life in old people may not show the same development. The situation poses considerable challenges to healthcare systems and economies, and calls for new strategies to increase healthspan and for sustainable future approaches to elder care. This call has motivated innovative research on the role of social relationships during ageing. Correlative data from clinical surveys indicate that social contact promotes healthy ageing, and it is time to reveal the causal mechanisms through experimental research. The fruit fly Drosophila melanogaster is a prolific model animal, but insects with more developed social behaviour can be equally instrumental for this research. Here, we discuss the role of social contact in ageing, and identify lines of study where diverse insect models can help uncover the mechanisms that are involved. This article is part of the theme issue 'Ageing and sociality: why, when and how does sociality change ageing patterns?'
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Affiliation(s)
- Tyler P Quigley
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287, USA
| | - Gro V Amdam
- School of Life Sciences, Arizona State University, PO Box 874501, Tempe, AZ 85287, USA.,Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, PO Box 5002, N-1432 Aas, Norway
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15
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Ansley SD, Howard JT. Dietary Intake and Elevated C-Reactive Protein Levels in US Military Veterans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E403. [PMID: 33419190 PMCID: PMC7825497 DOI: 10.3390/ijerph18020403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 02/08/2023]
Abstract
Elevated inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), have been associated with the pathogenesis of cardiovascular disease (CVD)-related diseases. However, limited studies have evaluated the potential association between dietary consumption and hs-CRP levels in a large, nationally representative sample, and fewer have investigated their role in ethnic and racial minority military populations. The goal of this study is to explore the relationship between dietary intake, health behaviors, and hs-CRP in individuals with prior military status and whether these associations differ by race/ethnicity. A complex, multistage, probability sample design was used from the National Health and Nutrition Examination (NHANES) 2015-2018 waves. Our results indicate that previously deployed military service members had a higher prevalence of clinically elevated hs-CRP levels than civilians. Differences in hs-CRP among deployed veterans and civilians remained even after multivariable adjustment. Individuals classified as overweight and obese demonstrated clinically elevated hs-CRP levels compared with those with a normal body mass index (BMI). Dietary factors did not attenuate the association between changes in hs-CRP levels and veteran status. These findings suggest the need for further investigation into how military-specific stressors contribute to unfavorable health outcomes for the military population.
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Affiliation(s)
- Stephanie D. Ansley
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX 78249, USA;
- Consequences of Trauma Working Group, the Center for Community-Based and Applied Health Research, University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Jeffrey T. Howard
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX 78249, USA;
- Consequences of Trauma Working Group, the Center for Community-Based and Applied Health Research, University of Texas at San Antonio, San Antonio, TX 78249, USA
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Liu H, Zhang Z, Choi SW, Langa KM. Marital Status and Dementia: Evidence from the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2020; 75:1783-1795. [PMID: 31251349 PMCID: PMC7489107 DOI: 10.1093/geronb/gbz087] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES We provide one of the first population-based studies of variation in dementia by marital status in the United States. METHOD We analyzed data from the Health and Retirement Study (2000-2014). The sample included 15,379 respondents (6,650 men and 8,729 women) aged 52 years and older in 2000 who showed no evidence of dementia at the baseline survey. Dementia was assessed using either the modified version of the Telephone Interview for Cognitive Status (TICS) or the proxy's assessment. Discrete-time hazard regression models were estimated to predict odds of dementia. RESULTS All unmarried groups, including the cohabiting, divorced/separated, widowed, and never married, had significantly higher odds of developing dementia over the study period than their married counterparts; economic resources and, to a lesser degree, health-related factors accounted for only part of the marital status variation in dementia. For divorced/separated and widowed respondents, the differences in the odds of dementia relative to married respondents were greater among men than among women. DISCUSSION These findings will be helpful for health policy makers and practitioners who seek to better identify vulnerable subpopulations and to design effective intervention strategies to reduce dementia risk.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State University, East Lansing
| | - Zhenmei Zhang
- Department of Sociology, Michigan State University, East Lansing
| | - Seung-won Choi
- Department of Sociology, Anthropology, and Social Work, Texas Tech University, Lubbock
| | - Kenneth M Langa
- Department of Internal Medicine, Institute for Social Research and VA Center for Clinical Management Research, University of Michigan, Ann Arbor
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Ng SM, Leng LL, Xie QW, Chan JSM, Chan CHY, So KF, Li A, Po KKT, Yuen LP, Ku KS, Choi AWM, Chouliara Z, Cheung ACY, Chan CLW, Emery C. Trust as a mediator in the relationship between childhood sexual abuse and IL-6 level in adulthood. PLoS One 2020; 15:e0232932. [PMID: 32413063 PMCID: PMC7228092 DOI: 10.1371/journal.pone.0232932] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/25/2020] [Indexed: 12/20/2022] Open
Abstract
Childhood sexual abuse (CSA) has been shown to predict the coupling of depression and inflammation in adulthood. Trust within intimate relationships, a core element in marital relations, has been shown to predict positive physical and mental health outcomes, but the mediating role of trust in partners in the association between CSA and inflammation in adulthood requires further study. The present study aimed to examine the impact of CSA on inflammatory biomarkers (IL-6 and IL-1β) in adults with depression and the mediating role of trust. A cross-sectional survey data set of adults presenting with mood and sleep disturbance was used in the analysis. CSA demonstrated a significant negative correlation with IL-6 level (r = -0.28, p<0. 01) in adults with clinically significant depression, while trust showed a significant positive correlation with IL-6 level (r = 0.36, p < .01). Sobel test and bootstrapping revealed a significant mediating role for trust between CSA and IL-6 level. CSA and trust in partners were revealed to have significant associations with IL-6 level in adulthood. Counterintuitively, the directions of association were not those expected. Trust played a mediating role between CSA and adulthood levels of IL-6. Plausible explanations for these counterintuitive findings are discussed.
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Affiliation(s)
- Siu-Man Ng
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Ling-Li Leng
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Qian Wen Xie
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Jessie S. M. Chan
- Laboratory of Neuropsychology, The University of Hong Kong, sai wan, Hong Kong
- Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, sai wan, Hong Kong
| | - Celia H. Y. Chan
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Kwok Fai So
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, Guangdong, China
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, sai wan, Hong Kong
- State Key Laboratory of Brain and Cognitive Science, The University of Hong Kong, sai wan, Hong Kong
| | - Ang Li
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, Guangdong, China
| | - Kevin K. T. Po
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, sai wan, Hong Kong
| | - L. P. Yuen
- International Association for Health and Yangsheng, sai wan, Hong Kong
| | - Kam-Shing Ku
- District Elderly Community Service, Haven of Hope Haven of Hope Christian Service, sai wan, Hong Kong
| | - Anna W. M. Choi
- Department of Social and Behavioral Sciences, City University of Hong Kong, sai wan, Hong Kong
| | - Zoë Chouliara
- Division of Mental Health and Counselling, Abertay University, Dundee, United kingdom
| | - Amos C. Y. Cheung
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Cecilia L. W. Chan
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
| | - Clifton Emery
- The Department of Social Work and Social Administration, The University of Hong Kong, sai wan, Hong Kong
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Schafer MH, Settels J, Upenieks L. As Goes the City? Older Americans' Home Upkeep in the Aftermath of the Great Recession. SOCIAL PROBLEMS 2020; 67:379-397. [PMID: 32362689 PMCID: PMC7176998 DOI: 10.1093/socpro/spz022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The private home is a crucial site in the aging process, yet the upkeep of this physical space often poses a challenge for community-dwelling older adults. Previous efforts to explain variation in disorderly household conditions have relied on individual-level characteristics, but ecological perspectives propose that home environments are inescapably nested within the dynamic socioeconomic circumstances of surrounding spatial contexts, such as the metro area. We address this ecological embeddedness in the context of the Great Recession, an event in which some U.S. cities saw pronounced and persistent declines across multiple economic indicators while other areas rebounded more rapidly. Panel data (2005-6 and 2010-11) from a national survey of older adults were linked to interviewer home evaluations and city-level economic data. Results from fixed-effects regression support the hypothesis that older adults dwelling in struggling cities experienced an uptick in disorderly household conditions. Findings emphasize the importance of city-specificity when probing effects of a downturn. Observing changes in home upkeep also underscores the myriad ways in which a city's most vulnerable residents- older adults, in particular-are affected by its economic fortunes.
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Walker E, Ploubidis G, Fancourt D. Social engagement and loneliness are differentially associated with neuro-immune markers in older age: Time-varying associations from the English Longitudinal Study of Ageing. Brain Behav Immun 2019; 82:224-229. [PMID: 31491488 PMCID: PMC6997881 DOI: 10.1016/j.bbi.2019.08.189] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/17/2019] [Accepted: 08/26/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES This study aimed to explore time-varying associations between social engagement, living status and loneliness and neuro-immune markers in older adults, and ascertain whether results are explained by socioeconomic position, health behaviours or depression. METHODS We analysed blood samples from 8780 adults aged 50 and above from the English Longitudinal Study of Ageing across three waves of data collection: 2004/5, 2008/9 and 2012/2013. We used fixed effects modelling to estimate the relationship between loneliness, social isolation, living alone and levels of fibrinogen, insulin like growth factor-1 (IGF-1), white blood cell (WBC) count and C-reactive protein (CRP), whilst accounting for all time-invariant and identified time-varying confounders. RESULTS Higher levels of social engagement and living with somebody were associated with lower levels of CRP, fibrinogen and WBC, while lower levels of loneliness were associated with higher levels of IGF-1. These associations were found to be independent of time-invariant factors such as gender, medical history, previous patterns of social behaviours, unobserved aspects of social class, and genetics, and time-varying factors such as income, physical health, health behaviours, and depression. CONCLUSIONS Aspects of social engagement were associated with lower levels of inflammation whilst loneliness was inversely related to the regulation of inflammation. This suggests there could be different biological pathways involved in objective and subjective aspects of social connections.
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Affiliation(s)
- Emma Walker
- Department of Epidemiology and Public Health, University College London, United Kingdom
| | - George Ploubidis
- UCL Centre for Longitudinal Studies, Department of Social Science, University College London, United Kingdom
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, United Kingdom.
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Ghimire S, Hill CV, Sy FS, Rodriguez R. Decline in telomere length by age and effect modification by gender, allostatic load and comorbidities in National Health and Nutrition Examination Survey (1999-2002). PLoS One 2019; 14:e0221690. [PMID: 31469870 PMCID: PMC6716670 DOI: 10.1371/journal.pone.0221690] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 08/13/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study aims to assess the decline in telomere length (TL) with age and evaluate effect modification by gender, chronic stress, and comorbidity in a representative sample of the US population. METHODS Cross-sectional data on 7826 adults with a TL measurement, were included from the National Health and Nutrition Examination Survey, years 1999-2002. The population rate of decline in TL across 10-year age categories was estimated using crude and adjusted regression. RESULTS In an adjusted model, the population rate of decline in TL with age was consistent and linear for only three age categories: 20-29 (β = -0.0172, 95% CI: -0.0342, -0.0002), 50-59 (β = -0.0182, 95% CI: -0.0311, -0.0054) and 70-79 (β = -0.0170, 95% CI: -0.0329, -0.0011) years. The population rate of decline in TL with age was significantly greater for males and those with high allostatic load and a history of comorbidities. When the population rate of decline in TL was analyzed by gender in 10-year age bins, a fairly consistent yet statistically non-significant decline for males was observed; however, a trough in the rate was observed for females in the age categories 20-29 years (β = -0.0284, 95% CI: -0.0464, -0.0103) and 50-59 years (β = -0.0211, 95% CI: -0.0391, -0.0032). To further elucidate the gender difference observed in the primary analyses, secondary analyses were conducted with reproductive and hormonal status; a significant inverse association was found between TL and parity, menopause, and age at menopause. CONCLUSIONS TL was shorter with increasing age and this decline was modified by gender, chronic stress and comorbidities; individuals with chronic morbidity and/or chronic stress and females in their twenties and fifties experienced greater decline. Female reproductive factors, i.e., parity and menopause, were associated with TL.
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Affiliation(s)
- Saruna Ghimire
- Department of Sociology and Gerontology, Miami University, Oxford, OH, United States of America
- School of Public Health, University of Nevada Las Vegas, Las Vegas, NV, United States of America
- * E-mail:
| | - Carl V. Hill
- Office of Special Populations, National Institute of Aging, Bethesda, MD, United States of America
| | - Francisco S. Sy
- School of Public Health, University of Nevada Las Vegas, Las Vegas, NV, United States of America
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Liu H, Zhang Y, Burgard SA, Needham BL. Marital status and cognitive impairment in the United States: evidence from the National Health and Aging Trends Study. Ann Epidemiol 2019; 38:28-34.e2. [PMID: 31591027 DOI: 10.1016/j.annepidem.2019.08.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 08/05/2019] [Accepted: 08/14/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE We provide population-based longitudinal evidence of marital status differences in the risk of cognitive impairment and dementia in the United States. METHODS Data were from the longitudinal National Health and Aging Trends Study, 2011-2018. The sample included 7508 respondents aged 65 years and older who contributed 25,897 person-year records. We estimated discrete-time hazard models to predict the risk of dementia and cognitive impairment, not dementia (CIND), as well as impairment in three major cognitive domains: memory, orientation, and executive function. RESULTS Relative to their married counterparts, divorced and widowed elders had higher odds of dementia and CIND, as well as higher odds of impairment in each of the cognitive domains. Never-married elders had higher odds of impairment in memory and orientation than their married counterparts but did not differ significantly in the odds of impaired executive function, dementia, or CIND. Cohabiting elders did not differ significantly from married respondents on any measure of cognitive impairment. We found no gender differences in the associations between marital status and the measures of cognitive impairment. CONCLUSIONS Marital status is a potentially important but overlooked social risk/protective factor for cognitive impairment. Divorced and widowed older adults are particularly vulnerable to cognitive impairment.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State University, East Lansing, MI.
| | - Yan Zhang
- Department of Sociology, Michigan State University, East Lansing, MI
| | | | - Belinda L Needham
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor
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Wong JS, Hsieh N. Functional Status, Cognition, and Social Relationships in Dyadic Perspective. J Gerontol B Psychol Sci Soc Sci 2019; 74:703-714. [PMID: 28369622 PMCID: PMC6460338 DOI: 10.1093/geronb/gbx024] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/15/2017] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES Health limitations can change older adults' social relationships and social engagement. Yet, researchers rarely examine how the disability of one's spouse might affect one's social relationships, even though such life strains are often experienced as a couple. This study investigates the association between functional and cognitive limitations and social experience in a dyadic context. METHOD We use actor-partner interdependence models to analyze the partner data from 953 heterosexual couples in Wave II (2010-2011) of the National Social Life, Health, and Aging Project. RESULTS One spouse's functional and cognitive health is associated with the other's relationship quality, but the pattern varies by gender. Husbands' functional limitations are associated with lower marital support and higher marital strain in wives, but wives' functional limitations are related to lower family and friendship strain in husbands. Husbands' cognitive impairment also predicts higher family and friend support in wives. DISCUSSION Findings support a gendered dyadic relationship between health and social life and highlight women's caregiver role and better connection with family and friends. There are also differences between experiencing cognitive and physical limitations in couples. Finally, mild health impairment sometimes shows stronger effects on social relationships than severe impairment, suggesting adaptation to health transition.
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Affiliation(s)
- Jaclyn S Wong
- NORC, Department of Sociology, University of Chicago, Illinois
| | - Ning Hsieh
- Department of Sociology, Michigan State University, East Lansing
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Associations of serum CRP levels with demographics, health behaviors, and risk of cancer among the Mexican American Mano A Mano Cohort. Cancer Epidemiol 2019; 60:1-7. [PMID: 30878797 DOI: 10.1016/j.canep.2019.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 02/08/2023]
Abstract
C-Reactive protein (CRP) is a well-known inflammatory marker, and elevated CRP levels has been reported to be associated with the risk of various cancers. To date, no study has investigated the association between elevated CRP and incidents of cancer among Mexican Americans. In the current prospective cohort study, we measured pre-diagnostic CRP levels in serum samples and evaluated their relationships with demographic characteristics and health behaviors associated with cancer risk among 2753 Mexican Americans selected from the Mano-A-Mano Mexican American Cohort Study. At baseline, median levels of serum CRP significantly differed by demographics (sex, age category, marital status, and education levels) and health behaviors (cigarette smoking status, alcohol drinking status, BMI category, and physical activity levels). In the multivariable analysis, the study participants who were women, older, never drinking alcohol, overweight or obese, and physically inactive had increased likelihood of having high CRP levels (≥ median levels among all study participants) compared to their counterparts. A total of 177 cancer cases were identified during the follow-up with a median follow-up time of 127 months. In the quartile analysis, study participants in the 4th quartile with highest CRP levels had significantly 1.88 fold increased risk of cancer (hazard ratio (HR) = 1.88, 95%CI: 1.12, 3.13) compared to those in the 1st quartile with lowest CRP levels. The association was further confirmed in analyses using clinical CRP levels. In summary, our findings suggested that serum CRP levels have potential to serve as a predictive marker of cancer risk in Mexican Americans.
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de Almeida Roediger M, de Fátima Nunes Marucci M, Duim EL, Santos JLF, de Oliveira Duarte YA, de Oliveira C. Inflammation and quality of life in later life: findings from the health, well-being and aging study (SABE). Health Qual Life Outcomes 2019; 17:26. [PMID: 30728031 PMCID: PMC6366117 DOI: 10.1186/s12955-019-1092-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 01/14/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Few studies have specifically investigated the inverse relationship between reduced quality of life in different domains and elevated C-reactive protein (CRP) serum levels in older adults. Therefore, this study investigates the cross-sectional association between quality of life and inflammation in older Brazilian adults. METHODS Data were collected from 1255 participants from the third wave (2010) of the Brazilian Health, Well-being and Aging study (SABE), a community-based cohort study of aging. Inflammation was assessed using CRP serum levels and quality of life (QoL) was measured using the 12-item Short-Form Health Survey (SF-12) questionnaire. The covariates included age, sex, education level, financial sufficiency, number of non-communicable diseases, self-reported doctor diagnosed diseases, Activity of Daily Living (ADL) difficulties, Body Mass Index (BMI), and waist circumference. RESULTS The fully adjusted models showed that older adults with low scores in the physical domain of the SF12 (OR 1.34, 95%CI 1.02;1.77) and high BMI values (> 30) (OR 2.05, 95%CI 1.50;2.81) were more likely to present high CRP serum levels. CONCLUSION Our findings suggest a significant association of lower scores in the physical domain of quality of life and the presence of obesity with high CRP serum levels.
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Affiliation(s)
- Manuela de Almeida Roediger
- School of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, Faculty of Public Health (FSP), University of Sao Paulo (USP), Avenida Doutor Arnaldo 715, Cerqueira César, São Paulo - SP CEP: 01246-904 Brazil
| | | | | | | | | | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
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Huang MH, Blackwood J, Godoshian M, Pfalzer L. Factors associated with self-reported falls, balance or walking difficulty in older survivors of breast, colorectal, lung, or prostate cancer: Results from Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey linkage. PLoS One 2018; 13:e0208573. [PMID: 30566443 PMCID: PMC6300321 DOI: 10.1371/journal.pone.0208573] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/20/2018] [Indexed: 01/19/2023] Open
Abstract
Background Cancer and its treatment affect body systems that are important in preventing falls and controlling balance/walking. This study examined factors associated with self-reported falls and balance/walking difficulty in the past 12 months in older survivors of four major cancers. Methods This was a cross-sectional study analyzing population-based data from Surveillance, Epidemiology, and End Results–Medicare Health Outcomes Survey (SEER-MHOS). Data from cohorts 9 to 14 (January 2006 to December 2013) were extracted. Inclusion criteria were: age ≥65 years at cancer diagnosis, first MHOS completed during years 1–5 post-cancer diagnosis, first primary breast (n = 2725), colorectal (n = 1646), lung (n = 752), and prostate (n = 4245) cancer, and availability of cancer staging information. Primary outcomes were self-reported falls and balance/walking difficulty in the past 12 months. Multivariable logistic regression was constructed for each cancer type to examine independent factors associated with falls and balance/walking difficulty. Results In all cancer types, advancing age at cancer diagnosis and dependence in activities of daily living were significant independent factors associated with increased odds of reporting falls and balance/walking difficulty in the past 12 months. Additionally, depression was independently associated with falls and sensory impairment in feet was independently linked to balance/walking difficulty in all cancer types. Other independent factors of falls and balance/walking difficulty varied across cancer types. In breast cancer only, localized or regional cancer stage was significantly associated with increased odds of reporting falls and balance/walking difficulty, whereas treatment with radiation decreased the odds of falling. No association between falls and balance/walking difficulty with time since cancer diagnosis, cancer stage, or cancer treatment was found in colorectal, lung, and prostate cancer. Conclusion There exists some heterogeneity in factors associated with self-reported falls and balance/walking difficulty between different cancer types. Future research is necessary to ascertain factors predictive of falls and balance/walking difficulty in older cancer survivors, particularly factors related to cancer diagnosis and treatment.
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Affiliation(s)
- Min H. Huang
- Physical Therapy Department, College of Health Sciences, University of Michigan–Flint, Flint, MI, United States of America
- * E-mail:
| | - Jennifer Blackwood
- Physical Therapy Department, College of Health Sciences, University of Michigan–Flint, Flint, MI, United States of America
| | - Monica Godoshian
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Lucinda Pfalzer
- Physical Therapy Department, College of Health Sciences, University of Michigan–Flint, Flint, MI, United States of America
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Anastasopoulos E, Haidich AB, Coleman AL, Wilson MR, Harris A, Yu F, Koskosas A, Pappas T, Keskini C, Kalouda P, Karkamanis G, Topouzis F. Risk factors for Age-related Macular Degeneration in a Greek population: The Thessaloniki Eye Study. Ophthalmic Epidemiol 2018; 25:457-469. [PMID: 30265203 DOI: 10.1080/09286586.2018.1512634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To assess the association of potential risk factors with early and late age-related macular degeneration (AMD) in the Thessaloniki Eye Study (TES) population Design: Population-based, cross-sectional study of subjects over age of 60 living in Thessaloniki, Greece Methods: Subjects without any AMD features and subjects with early and late AMD (neovascular AMD or geographic atrophy) were identified in the TES cohort using standardized procedures and masked grading of stereo color fundus photos. Demographic, lifestyle, systemic and other ophthalmic covariates were also collected during a detailed examination process. Their association with AMD was investigated using univariate and multivariate adjusted logistic regression models. RESULTS Among the 2108 participants with gradable photos, the grading process identified 1204 subjects with no AMD, 848 subjects with early AMD, and 56 subjects with late AMD (24 with geographic atrophy and 32 with neovascular AMD). In multivariate analysis, compared to no AMD, late AMD was positively associated with older age (OR:1.16; 95%CI:1.10-1.22 per year of age), current smoking (smoking vs. never smoking, OR:2.34; 95%CI:1.12-4.90), prior cataract surgery (cataract surgery vs. no cataract surgery OR:2.06; 95%CI:0.96-4.40), marital status (divorced/separated vs. married, OR:3.10; 95%CI:1.08-8.93) and with 60% lower odds when sleeping in the afternoon (yes vs. no, OR:0.40; 95%CI:0.22-0.72). Early AMD was positively associated with older age (OR: 1.03; 95%CI:1.01-1.05 per year of age) and negatively with higher pulse pressure (OR:0.99; 95%CI:0.98-0.99 per mmHg). CONCLUSIONS In TES, apart for well-known risk factors for AMD like age, smoking, and cataract surgery, two novel behavioral risk factors for prevalent late AMD were suggested. Sleeping in the afternoon was associated with 60% decreased odds for late AMD and 67% decreased odds for neovascular AMD. Being divorced/separated compared to married was associated with 3-fold higher odds for late AMD. Large longitudinal population-based studies will be necessary to further establish the potential late AMD risk effects of these two novel factors, to demonstrate potential implications of underlying pathogenetic mechanisms, and to explore preventive measures and therapeutic targets.
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Affiliation(s)
- Eleftherios Anastasopoulos
- a Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Anna Bettina Haidich
- b Department of Epidemiology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Anne Louise Coleman
- c Stein Eye Institute, David Geffen School of Medicine at UCLA , University of California Los Angeles , Los Angeles , CA , USA
| | | | - Alon Harris
- e Eugene and Marilyn Glick Eye Institute, Department of Ophthalmology , Indiana University School of Medicine , Indianapolis , Indiana , USA
| | - Fei Yu
- f Department of Biostatistics , UCLA Fielding School of Public Health , Los Angeles , CA , USA
| | - Archimides Koskosas
- a Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Theofanis Pappas
- a Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Christina Keskini
- a Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Pelagia Kalouda
- a Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Georgia Karkamanis
- a Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Fotis Topouzis
- a Laboratory of Research and Clinical Applications in Ophthalmology (LARCAO), Department of Ophthalmology, School of Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
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A multifaceted analysis of social stressors and chronic inflammation. SSM Popul Health 2018; 6:136-140. [PMID: 30263926 PMCID: PMC6156737 DOI: 10.1016/j.ssmph.2018.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 08/31/2018] [Accepted: 09/10/2018] [Indexed: 12/30/2022] Open
Abstract
Chronic stress has been linked to negative health outcomes, including increased inflammation, which can be measured by high-sensitivity C-reactive protein (CRP). Prior research has focused almost exclusively on relationships between individual social and demographic stressors and CRP. The objective of this study is to assess the role of multiple potential stressors simultaneously to determine which key stressors are related to risk of high CRP, given that sustained stress and resulting inflammation may have long-term health implications. We hypothesized that negative social and environmental factors would be associated with high CRP. Data from two waves of Midlife in the United States were used to predict high CRP with variable selection procedures and logistic regression. Results indicated females, those with greater BMI, those with improvements in family strain, and those with higher A1c had a greater risk of high CRP. There was limited evidence that negative social factors were associated with CRP to the extent seen in prior literature. A key advantage of the study was testing multiple potential determinants of chronic stress and inflammation simultaneously, advancing the existing literature. Results demonstrate the potential usefulness of a multifaceted approach to evaluating the risk of chronic inflammation and high CRP.
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Jaremka LM, Lebed O, Sunami N. Threats to Belonging, Immune Function, and Eating Behavior: an Examination of Sex and Gender Differences. Curr Psychiatry Rep 2018; 20:71. [PMID: 30094481 DOI: 10.1007/s11920-018-0939-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW The first goal of this review is to discuss the evidence linking belonging threats to immune function and food intake. The second goal is to evaluate whether the links among belonging threats, immune function, and eating behavior differ based on gender. RECENT FINDINGS Threats to belonging are linked to elevated herpesvirus antibody titers, dysregulated appetite-relevant hormones, and increased food consumption. Furthermore, these relationships are largely consistent for both men and women. Threats to belonging are also linked to elevated inflammation. However, some studies showed that these effects were stronger among women, others demonstrated that they were stronger among men, and others determined that the links were consistent for men and women. Understanding why belonging threats are inconsistently linked to inflammation across men and women is an important next step. We conclude the review with four concrete recommendations for researchers studying belonging threats, immune function, and eating behavior.
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Affiliation(s)
- Lisa M Jaremka
- Department of Psychological and Brain Sciences, University of Delaware, 212 Wolf Hall, Newark, DE, 19716, USA.
| | - Olga Lebed
- Department of Psychological and Brain Sciences, University of Delaware, 212 Wolf Hall, Newark, DE, 19716, USA
| | - Naoyuki Sunami
- Department of Psychological and Brain Sciences, University of Delaware, 212 Wolf Hall, Newark, DE, 19716, USA
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Predictors of falls in older survivors of breast and prostate cancer: A retrospective cohort study of surveillance, epidemiology and end results-Medicare health outcomes survey linkage. J Geriatr Oncol 2018; 10:89-97. [PMID: 29752141 DOI: 10.1016/j.jgo.2018.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 03/03/2018] [Accepted: 04/25/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To identify predictors of falls in older breast and prostate cancer survivors. METHODS This retrospective cohort study analyzed population-based Surveillance, Epidemiology and End Results-Medicare Health Outcomes Survey (SEER-MHOS) linkage. Inclusion criteria were age >65 years at cancer diagnosis, first primary female breast or prostate cancer, cancer staging information available, completion of baseline MHOS during years 2-3 and follow-up MHOS during years 4-5 post-diagnosis, and falls information available. Data from 437 breast and 660 prostate cancer survivors were analyzed. Multivariable logistic regression was constructed to evaluate variables from baseline MHOS with relation to falls from follow-up MHOS. Model accuracy was assessed using area under receiver-operating-characteristic curve (AUC). RESULTS At follow-up MHOS, 26% of breast and 22% of prostate cancer survivors reported falls in the past 12 months. In breast cancer, a history of falls (odds ratio (OR) = 4.95, 95% confidence interval (CI) = 2.44-10.04) and sensory impairment in feet (OR = 3.33, 95%CI = 1.51-7.32) were significant predictors of falls. In prostate cancer, a history of falls (OR = 3.04, 95%CI = 1.79-5.15), unmarried (OR = 1.82, 95%CI = 1.12-2.95), lower physical summary score of quality-of-life(OR = 0.96, 95%CI = 0.94-0.98), urinary incontinence (OR = 1.69, 95%CI = 1.08-2.65), older age at diagnosis (OR = 1.05, 95%CI = 1.01-1.09), and shorter time post-diagnosis (OR = 0.96, 95%CI = 0.93-0.99) were significant predictors of falls. AUC was 0.67 and 0.77 for breast and prostate cancer, respectively, indicating moderate accuracy of models in detecting fallers. CONCLUSIONS Asking older breast and prostate cancer survivors about falls in the past 12 months is imperative in fall prevention. Further examination of deficits specific to each cancer is necessary to assess fall risks.
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Osimo EF, Cardinal RN, Jones PB, Khandaker GM. Prevalence and correlates of low-grade systemic inflammation in adult psychiatric inpatients: An electronic health record-based study. Psychoneuroendocrinology 2018; 91:226-234. [PMID: 29544672 PMCID: PMC5910056 DOI: 10.1016/j.psyneuen.2018.02.031] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/19/2018] [Accepted: 02/27/2018] [Indexed: 12/16/2022]
Abstract
Low-grade inflammation is a risk factor for depression, psychosis and other major psychiatric disorders. It is associated with poor response to antidepressant and antipsychotics, and could potentially be a treatment target. However, there is limited data on the prevalence of low-grade inflammation in major psychiatric disorders, and on the characteristics of patients who show evidence of inflammation. We examined the prevalence of low-grade inflammation and associated socio-demographic and clinical factors in acute psychiatric inpatients. An anonymised search of the electronic patient records of Cambridgeshire and Peterborough NHS Foundation Trust was used to identify patients aged 18-65 years who were hospitalised between 2013 and 2016 (inclusive). We excluded patients on antibiotics or oral steroids, or with missing data. Inflammation was defined using serum C-reactive protein (>3 mg/L) or total white cell count (>9.4 × 109/L) as measured within 14 days of admission. Out of all 599 admissions, the prevalence of inflammation (serum CRP >3 mg/L) in the ICD-10 diagnostic groups of psychotic disorders (F20-29), mood disorders (F30-39), neurotic disorders (F40-48) and personality disorders (F60-69) was 32%, 21%, 22% and 42%, respectively. In multivariable analyses, low-grade inflammation was associated with older age, black ethnicity, being single, self-harm, diagnoses of schizophrenia, bipolar disorder, current treatments with antidepressants, benzodiazepines, and with current treatment for medical comorbidities. A notable proportion of acutely unwell psychiatric patients from all ICD-10 major diagnostic groups show evidence of low-grade inflammation, suggesting inflammation may be relevant for all psychiatric disorders.
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Affiliation(s)
- Emanuele F. Osimo
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, UK,Corresponding author at: Department of Psychiatry, University of Cambridge, Herchel Smith Building Cambridge Biomedical Campus, Cambridge CB2 0SZ, UK.
| | - Rudolf N. Cardinal
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, UK
| | - Golam M. Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, England, UK
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Abstract
Family relationships are enduring and consequential for well-being across the life course. We discuss several types of family relationships—marital, intergenerational, and sibling ties—that have an important influence on well-being. We highlight the quality of family relationships as well as diversity of family relationships in explaining their impact on well-being across the adult life course. We discuss directions for future research, such as better understanding the complexities of these relationships with greater attention to diverse family structures, unexpected benefits of relationship strain, and unique intersections of social statuses.
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Affiliation(s)
- Patricia A Thomas
- Department of Sociology and Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana
| | - Hui Liu
- Department of Sociology, Michigan State University, East Lansing
| | - Debra Umberson
- Department of Sociology and Population Research Center, University of Texas at Austin
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Gunn HE, Buysse DJ, Matthews KA, Kline CE, Cribbet MR, Troxel WM. Sleep-Wake Concordance in Couples Is Inversely Associated With Cardiovascular Disease Risk Markers. Sleep 2017; 40:2661822. [PMID: 28364457 DOI: 10.1093/sleep/zsw028] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 11/13/2022] Open
Abstract
Aim To determine whether interdependence in couples' sleep (sleep-wake concordance i.e., whether couples are awake or asleep at the same time throughout the night) is associated with two markers of cardiovascular disease (CVD) risk, ambulatory blood pressure (BP) and systemic inflammation. Methods This community-based study is a cross-sectional analysis of 46 adult couples, aged 18-45 years, without known sleep disorders. Percent sleep-wake concordance, the independent variable, was calculated for each individual using actigraphy. Ambulatory BP monitors measured BP across 48 h. Dependent variables included mean sleep systolic BP (SBP) and diastolic BP (DBP), mean wake SBP and DBP, sleep-wake SBP and DBP ratios, and C-reactive protein (CRP). Mixed models were used and were adjusted for age, sex, education, race, and body mass index. Results Higher sleep-wake concordance was associated with lower sleep SBP (b = -.35, SE = .01) and DBP (b = -.22, SE = .10) and lower wake SBP (b = -.26, SE = .12; all p values < .05). Results were moderated by sex; for women, high concordance was associated with lower BP. Men and women with higher sleep-wake concordance also had lower CRP values (b = -.15, SE = .03, p < .05). Sleep-wake concordance was not associated with wake DBP or sleep/wake BP ratios. Significant findings remained after controlling for individual sleep quality, duration, and wake after sleep onset. Conclusions Sleep-wake concordance was associated with sleep BP, and this association was stronger for women. Higher sleep-wake concordance was associated with lower systemic inflammation for men and women. Sleep-wake concordance may be a novel mechanism by which marital relationships are associated with long-term CVD outcomes.
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Affiliation(s)
- Heather E Gunn
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Daniel J Buysse
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Karen A Matthews
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Christopher E Kline
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | - Matthew R Cribbet
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA
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Grinberg AM, O'Hara KL, Sbarra DA. Preliminary evidence of attenuated blood pressure reactivity to acute stress in adults following a recent marital separation. Psychol Health 2017; 33:430-444. [PMID: 28880686 DOI: 10.1080/08870446.2017.1373111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study explores cardiovascular reactivity during an acute-stress task in a sample of recently separated adults. DESIGN In a cross-sectional design, we examined the association between adults' subjective separation-related distress and changes in heart rate and blood pressure across the acute-stress laboratory paradigm in a sample of 133 (n = 49 men) recently separated adults. MAIN OUTCOME MEASURES Heart rate (HR) and Blood pressure (BP) were recorded across a resting baseline period, a math stressor task, and a recovery period. RESULTS Multilevel analyses revealed that adults who reported greater separation-related distress exhibited higher initial BP and a slower linear increase in BP across the study period. In addition, adults reporting greater separation-related distress evidenced significantly slower declines in diastolic blood pressure (DBP) following the acute-stress task. HR reactivity was not moderated by separation-related distress. CONCLUSIONS In recently separated adults, preliminary evidence suggests that the context of the stressors may reveal differential patterns of problematic reactivity (exaggerated or blunted responding). Greater emotional intrusion and hyperactivity symptoms may index increased risk for blunted cardiovascular reactivity to general stressors. This pattern of reactivity is consistent with models of allostatic load that emphasise the deleterious effect of hyporesponsivity to environmental demands.
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Affiliation(s)
- Austin M Grinberg
- a Department of Psychology , University of Arizona , Tucson , AZ , USA
| | - Karey L O'Hara
- a Department of Psychology , University of Arizona , Tucson , AZ , USA
| | - David A Sbarra
- a Department of Psychology , University of Arizona , Tucson , AZ , USA
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Manfredini R, De Giorgi A, Tiseo R, Boari B, Cappadona R, Salmi R, Gallerani M, Signani F, Manfredini F, Mikhailidis DP, Fabbian F. Marital Status, Cardiovascular Diseases, and Cardiovascular Risk Factors: A Review of the Evidence. J Womens Health (Larchmt) 2017; 26:624-632. [PMID: 28128671 DOI: 10.1089/jwh.2016.6103] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is evidence showing that marital status (MS) and marital disruption (i.e., separation, divorce, and being widowed) are associated with poor physical health outcomes, including for all-cause mortality. We checked for the available evidence on the association between MS and cardiovascular (CV) diseases, outcomes, and CV risk factors. METHODS A search across the PubMed database of all articles, including the term "marital status" in their title, was performed. All articles were then manually checked for the presence of the following terms or topic: CV diseases, acute myocardial infarction, acute coronary syndrome, coronary artery disease, cardiac arrest, heart failure, heart diseases, and CV mortality. Moreover, other search terms were: CV risk factors, hypertension, cholesterol, obesity, smoking, alcohol, fitness and/or physical activity, and health. Systematic reviews, meta-analyses, controlled trials, cohort studies, and case-control studies were potentially considered pertinent for inclusion. Case reports, comments, discussion letters, abstracts of scientific conferences, articles in other than English language, and conference abstracts or proceedings were excluded. RESULTS In total, 817 references containing the title words "marital status" were found. After elimination of articles dealing with other topics, 70 records were considered pertinent. Twenty-two were eliminated for several reasons, such as old articles, no abstract, full text unavailable, other than English language, comments, and letters. Out of the remaining 48 articles, 13 were suitable for the discussion, and 35 (accounting for 1,245,967 subjects) were included in this study. CONCLUSIONS Most studies showed better outcomes for married persons, and men who were single generally had the poorest results. Moreover, being married was associated with lower risk factors and better health status, even in the presence of many confounding effects.
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Affiliation(s)
- Roberto Manfredini
- 1 University of Ferrara , Ferrara, Italy .,2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
| | - Alfredo De Giorgi
- 1 University of Ferrara , Ferrara, Italy .,2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
| | - Ruana Tiseo
- 2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
| | | | | | | | | | | | - Fabio Manfredini
- 1 University of Ferrara , Ferrara, Italy .,2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
| | | | - Fabio Fabbian
- 1 University of Ferrara , Ferrara, Italy .,2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
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Work-family life courses and BMI trajectories in three British birth cohorts. Int J Obes (Lond) 2016; 41:332-339. [PMID: 27811951 PMCID: PMC5309340 DOI: 10.1038/ijo.2016.197] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 09/27/2016] [Accepted: 10/16/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND/OBJECTIVES: Combining work and family responsibilities has previously been associated with improved health in mid-life, yet little is known about how these associations change over time (both biographical and historical) and whether this extends to body mass index (BMI) trajectories for British men and women. The purpose of this study was to investigate relationships between work-family life courses and BMI trajectories across adulthood (16–42 years) for men and women in three British birth cohorts. SUBJECTS/METHODS: Multiply imputed data from three nationally representative British birth cohorts were used—the MRC National Survey of Health and Development (NSHD; 1946 birth cohort, n=3012), the National Child Development Study (NCDS; 1958 birth cohort, n=9614) and the British Cohort Study (BCS; 1970 birth cohort, n=8140). A typology of work-family life course types was developed using multi-channel sequence analysis, linking annual information on work, partnerships and parenthood from 16 to 42 years. Work-family life courses were related to BMI trajectories using multi-level growth models. Analyses adjusted for indicators of prior health, birthweight, child BMI, educational attainment and socioeconomic position across the life course, and were stratified by gender and cohort. RESULTS: Work-family life courses characterised by earlier transitions to parenthood and weaker long-term links to employment were associated with greater increases in BMI across adulthood. Some of these differences, particularly for work-family groups, which are becoming increasingly non-normative, became more pronounced across cohorts (for example, increases in BMI between 16 and 42 years in long-term homemaking women: NSHD: 4.35 kg m–2, 95% confidence interval (CI): 3.44, 5.26; NCDS: 5.53 kg m–2, 95% CI: 5.18, 5.88; BCS: 6.69 kg m–2, 95% CI: 6.36, 7.02). CONCLUSIONS: Becoming a parent earlier and weaker long-term ties to employment are associated with greater increases in BMI across adulthood in British men and women.
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Goldman AW. All in the family: The link between kin network bridging and cardiovascular risk among older adults. Soc Sci Med 2016; 166:137-149. [PMID: 27566043 DOI: 10.1016/j.socscimed.2016.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 07/24/2016] [Accepted: 07/26/2016] [Indexed: 11/19/2022]
Abstract
While considerable work has examined the association between social relationships and health, most of this research focuses on the relevance of social network composition and the quality of dyadic ties. In this study, I consider how the social network structure of ties among older adults' close family members may affect cardiovascular health in later life. Using data from 938 older adults that participated in Waves 1 and 2 of the National Social Life, Health, and Aging Project (NSHAP), I test whether older adults who occupy bridging positions among otherwise disconnected or poorly connected kin in their personal social network are more likely to present elevated levels of C-reactive protein (CRP), a biomarker for cardiovascular risk. Results indicate that occupying a bridging position among family members is significantly associated with elevated CRP. This effect is unique to bridging kin network members. These findings suggest that ties among one's closest kin may generate important resources and norms that influence older adults' health, such that bridging kin network members may compromise physical wellbeing. I discuss these results in the context of prior work on social support, family solidarity, and health in later life.
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Affiliation(s)
- Alyssa W Goldman
- Department of Sociology, Cornell University, 345 Uris Hall, Ithaca, NY 14853, USA.
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Does disorder get "into the head" and "under the skin"? Layered contexts and bi-directional associations. Health Place 2016; 39:131-41. [PMID: 27086267 DOI: 10.1016/j.healthplace.2016.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 11/21/2022]
Abstract
This paper utilizes a layered context approach to examine how neighborhood and household conditions are associated with the objective and subjective well-being of older adults. Using two waves of data from the National Social Life, Health, and Aging Project (n=2261), we assess subjective mental health through self-reported measures of perceived stress and distress and objective physical health through C-reactive protein (CRP). Environmental disorder was measured by independent, trained interviewers. Cross-sectional results indicate that household disorder is positively associated with perceived stress and distress, overwhelming the association between neighborhood disorder and mental health outcomes. Yet longitudinal findings point to a reverse process, whereby highly stressed women experience deterioration in their home environment across the two waves. Few significant findings surfaced for CRP. Taken together, our findings illustrate the complex interplay between health and proximal environments and underscore how feedback cycles operate between "health" and "place" across multiple outcomes.
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Abstract
OBJECTIVE This study examines the link between marital disruption and biological risk, and asks whether the association of this precarious life event with health is contingent on marital loss duration and history. METHOD Data are drawn from the National Social Life, Health, and Aging Project ( N = 1,414), and Poisson regressions are presented for allostatic load and logistic regressions for individual biomarkers. RESULTS The currently unmarried with more distant marital disruptions exhibit higher levels of allostatic load than the currently married, which is primarily driven by dysregulation of cardiovascular and metabolic indicators. Results also reveal the differing ways marital disruption "gets under the skin" with widowhood associated with compromised inflammatory, metabolic, and cardiovascular functioning, and divorce with cardiovascular and neuroendocrine markers. DISCUSSION Findings lend support for both the crisis and chronic strain models, and likely reflect normative expectations of the timing of life events, decrements in marital resources, and selection processes.
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Chen JH, Waite LJ, Lauderdale DS. Marriage, Relationship Quality, and Sleep among U.S. Older Adults. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2015; 56:356-77. [PMID: 26272988 PMCID: PMC4677485 DOI: 10.1177/0022146515594631] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Sleep is a restorative behavior essential for health. Poor sleep has been linked to adverse health outcomes among older adults; however, we know little about the social processes that affect sleep. Using innovative actigraphy data from the National Social Life, Health, and Aging Project (N = 727), we considered the role of marriage, positive marital relationship support, and negative marital relationship strain on older adults' (ages 62-90) self-reported and actigraph-measured sleep characteristics. We found that married older adults had better actigraph-estimated but not self-reported sleep characteristics than the unmarried. However, among the married, those who reported more negative aspects of their marital relationship reported more insomnia symptoms, with the association reduced when psychosocial characteristics were added to the model. The married who reported more positive aspects of their marital relationship showed better actigraph-estimated sleep characteristics; taking characteristics of the physical and mental health and home environment into account reduced this association.
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Affiliation(s)
- Jen-Hao Chen
- University of Missouri-Columbia, Columbia, MO, USA
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Inoue Y, Stickley A, Yazawa A, Li D, Du J, Jin Y, Chen Y, Watanabe C. The association between economic development, lifestyle differentiation, and C-reactive protein concentration within rural communities in Hainan Island, China. Am J Hum Biol 2015; 28:186-96. [DOI: 10.1002/ajhb.22771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 05/01/2015] [Accepted: 07/19/2015] [Indexed: 02/06/2023] Open
Affiliation(s)
- Yosuke Inoue
- Department of Human Ecology; Graduate School of Medicine, The University of Tokyo; Bunkyo-Ku Tokyo 113-0033 Japan
| | - Andrew Stickley
- Department of Human Ecology; Graduate School of Medicine, The University of Tokyo; Bunkyo-Ku Tokyo 113-0033 Japan
- Department of Sociology, Stockholm Center for Health and Social Change (Scohost); Södertörn University; Huddinge 141 89 Sweden
| | - Aki Yazawa
- Department of Human Ecology; Graduate School of Medicine, The University of Tokyo; Bunkyo-Ku Tokyo 113-0033 Japan
| | - Dandan Li
- Hainan Provincial Center for Disease Control and Prevention; Haikou Hainan 57023 China
| | - Jianwei Du
- Hainan Provincial Center for Disease Control and Prevention; Haikou Hainan 57023 China
| | - Yuming Jin
- Hainan Provincial Center for Disease Control and Prevention; Haikou Hainan 57023 China
| | - Yan Chen
- Hainan Provincial Center for Disease Control and Prevention; Haikou Hainan 57023 China
| | - Chiho Watanabe
- Department of Human Ecology; Graduate School of Medicine, The University of Tokyo; Bunkyo-Ku Tokyo 113-0033 Japan
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Li A, Tu MT, Sousa AC, Alvarado B, Kone GK, Guralnik J, Zunzunegui MV. Early life adversity and C-reactive protein in diverse populations of older adults: a cross-sectional analysis from the International Mobility in Aging Study (IMIAS). BMC Geriatr 2015; 15:102. [PMID: 26286183 PMCID: PMC4544803 DOI: 10.1186/s12877-015-0104-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 08/06/2015] [Indexed: 12/15/2022] Open
Abstract
Background Recent studies suggest potential associations between childhood adversity and chronic inflammation at older ages. Our aim is to compare associations between childhood health, social and economic adversity and high sensitivity C-reactive protein (hsCRP) in populations of older adults living in different countries. Methods We used the 2012 baseline data (n = 1340) from the International Mobility in Aging Study (IMIAS) of community-dwelling people aged 65–74 years in Natal (Brazil), Manizales (Colombia) and Canada (Kingston, Ontario; Saint-Hyacinthe, Quebec). Multiple linear and Poisson regressions with robust covariance were fitted to examine the associations between early life health, social, and economic adversity and hsCRP, controlling for age, sex, financial strain, marital status, physical activity, smoking and chronic conditions both in the Canadian and in the Latin American samples. Results Participants from Canadian cities have less adverse childhood conditions and better childhood self-reported health. Inflammation was lower in the Canadian cities than in Manizales and Natal. Significant associations were found between hsCRP and childhood social adversity in the Canadian but not in the Latin American samples. Among Canadian older adults, the fully-adjusted mean hsCRP was 2.2 (95 % CI 1.7; 2.8) among those with none or one childhood social adversity compared with 2.8 (95 % CI 2.1; 3.8) for those with two or more childhood social adversities (p = 0.053). Similarly, the prevalence of hsCRP > 3 mg/dL was 40 % higher among those with higher childhood social adversity but after adjustment by health behaviors and chronic conditions the association was attenuated. No associations were observed between hsCRP and childhood poor health or childhood economic adversity. Conclusions Inflammation was higher in older participants living in the Latin American cities compared with their Canadian counterparts. Childhood social adversity, not childhood economic adversity or poor health during childhood, was an independent predictor of chronic inflammation in old age in the Canadian sample. Selective survival could possibly explain the lack of association between social adversity and hsCRP in the Latin American samples.
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Affiliation(s)
- Annie Li
- Department of Family Medicine, McGill University, 5858, chemin de la Côte-des-Neiges, 3rd floor, Montreal, QC, H3S 1Z1, Canada.
| | - Mai Thanh Tu
- Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101 avenue du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3 J7, Canada.
| | - Ana Carolina Sousa
- CNPQ Programa de Pós Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
| | - Beatriz Alvarado
- Department of Public Health Sciences, 2nd and 3rd Floors, Carruthers Hall, Kingston, ON, K7L 3 N6, Canada.
| | - Georges Karna Kone
- Centre de recherche du CHUM (CRCHUM), 900, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.
| | - Jack Guralnik
- Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD, 21201, USA.
| | - Maria Victoria Zunzunegui
- Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101 avenue du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3 J7, Canada.
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Faugere M, Micoulaud-Franchi JA, Alessandrini M, Richieri R, Faget-Agius C, Auquier P, Lançon C, Boyer L. Quality of life is associated with chronic inflammation in schizophrenia: a cross-sectional study. Sci Rep 2015; 5:10793. [PMID: 26041435 PMCID: PMC4455112 DOI: 10.1038/srep10793] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 04/23/2015] [Indexed: 12/13/2022] Open
Abstract
Inflammation may play a crucial role in the pathogenesis of schizophrenia. However, the association between chronic inflammation and health outcomes in schizophrenia remains unclear, particularly for patient-reported outcomes. The aim of this study was to investigate the relationship between quality of life (QoL) and chronic inflammation assessed using C -Reactive Protein (CRP) in patients with schizophrenia. Two hundred and fifty six patients with schizophrenia were enrolled in this study. After adjusting for key socio-demographic and clinical confounding factors, patients with high levels of CRP (>3.0 mg/l) had a lower QoL than patients with normal CRP levels (OR = 0.97, 95% CI = 0.94–0.99). An investigation of the dimensions of QoL revealed that psychological well-being, physical well-being and sentimental life were the most salient features of QoL associated with CRP. Significant associations were found between lower educational level (OR = 4.15, 95% CI = 1.55–11.07), higher body mass index (OR = 1.16, 95% CI = 1.06–1.28), higher Fagerström score (OR = 1.22, 95% CI = 1.01–1.47) and high levels of CRP. After replications with longitudinal approaches, the association between QoL and chronic inflammation may offer interesting interventional prospects to act both on inflammation and QoL in patients with schizophrenia.
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Affiliation(s)
- M Faugere
- 1] Department of Psychiatry, La Conception University Hospital, 13009 Marseille, France [2] Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - J A Micoulaud-Franchi
- 1] Department of Clinical Neurophysiology, Sleep Clinique, Pellegrin University Hospital, 33076 Bordeaux, France [2] Bordeaux University, USR CNRS 3413 SANPSY, Research Unit, 33000 Bordeaux, France
| | - M Alessandrini
- Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - R Richieri
- 1] Department of Psychiatry, La Conception University Hospital, 13009 Marseille, France [2] Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - C Faget-Agius
- 1] Department of Psychiatry, La Conception University Hospital, 13009 Marseille, France [2] Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - P Auquier
- Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - C Lançon
- 1] Department of Psychiatry, La Conception University Hospital, 13009 Marseille, France [2] Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - L Boyer
- Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
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43
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Wong JS, Waite LJ. Marriage, Social Networks, and Health at Older Ages. JOURNAL OF POPULATION AGEING 2015; 8:7-25. [PMID: 26279707 DOI: 10.1007/s12062-014-9110-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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44
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Liu H, Waite L. Bad marriage, broken heart? Age and gender differences in the link between marital quality and cardiovascular risks among older adults. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2014; 55:403-23. [PMID: 25413802 PMCID: PMC4325990 DOI: 10.1177/0022146514556893] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Working from a life course perspective, we develop hypotheses about age and gender differences in the link between marital quality and cardiovascular risk and test them using data from the first two waves of the National Social Life, Health, and Aging Project. The analytic sample includes 459 married women and 739 married men (aged 57-85 in the first wave) who were interviewed in both waves. We apply Heckman-type corrections for selection bias due to mortality and marriage. Cardiovascular risk is measured as hypertension, rapid heart rate, C-reactive protein, and general cardiovascular events. Results suggest that changes in marital quality and cardiovascular risk are more closely related for older married people than for their younger counterparts and that the link between marital quality and cardiovascular risk is more pronounced among women than among men at older ages. These findings fit with the gendered life course perspective and cumulative disadvantage framework.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State University, East Lansing, MI, USA
| | - Linda Waite
- Department of Sociology & NORC, University of Chicago, Chicago, IL, USA
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45
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Lapate RC, van Reekum CM, Schaefer SM, Greischar LL, Norris CJ, Bachhuber DRW, Ryff CD, Davidson RJ. Prolonged marital stress is associated with short-lived responses to positive stimuli. Psychophysiology 2014; 51:499-509. [PMID: 24660957 DOI: 10.1111/psyp.12203] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 01/31/2014] [Indexed: 11/27/2022]
Abstract
Marital stress is associated with a higher incidence of psychiatric disorders, in particular major depression. One pathway through which marital stress may impact emotional health is by compromising emotion-responding processes. We examined a longitudinal sample of adults (N = 116; 59 males; 39-84 years) to verify how marital stress predicts reactivity to, and recovery from, emotional provocation. Individuals watched positive, neutral, and negative pictures while an objective measure of affective state, corrugator supercilii muscle activity, was recorded continuously. Our results indicate that marital stress is associated with short-lived responses to positive pictures, indexed by a less persistent decrease in corrugator activity after picture offset. Extending beyond the prior focus on negative emotional processes, these results suggest that social stress may impact health by influencing the time course of responding to positive events.
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Affiliation(s)
- Regina C Lapate
- Psychology Department, Waisman Laboratory for Brain Imaging and Behavior and Center for Investigating Healthy Minds, University of Wisconsin-Madison, Madison, Wisconsin, USA
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McFarland MJ, Hayward MD, Brown D. I've Got You Under My Skin: Marital Biography and Biological Risk. JOURNAL OF MARRIAGE AND THE FAMILY 2013; 75:363-380. [PMID: 26078480 PMCID: PMC4465275 DOI: 10.1111/jomf.12015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Social relationships shape adult health in profound ways. This study informs our understanding of this association by investigating how the transitions, timing, and exposures to marriage are associated with types of biological risk presumed to serve as pathways to disease and disability. Drawing on the 2005 - 2006 National Social Health and Aging Project (N = 1,062), the authors evaluated how marital biography was associated with cardiovascular, metabolic, and chronic inflammation risk. The results showed that the effects of marital biography were highly sensitive to gender, the dimension of marital biography, and type of biological risk. For example, marital exposure was protective of cardiovascular risk for women, but not men, whereas an earlier age at first marriage had a pernicious effect on chronic inflammation among men, but not women. Health behaviors did not explain these associations. The implications of these findings are discussed as they pertain to under-the-skin risk processes and chronic morbidity.
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Affiliation(s)
- Michael J McFarland
- Center for Research on Child Wellbeing and Office of Population Research, 280 Wallace Hall, Princeton, NJ 08544 ( )
| | - Mark D Hayward
- Department of Sociology and Population Research Center, 110 Inner Campus Drive G1800, Austin, TX 78712-1699
| | - Dustin Brown
- Department of Sociology and Population Research Center, 110 Inner Campus Drive G1800, Austin, TX 78712-1699
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Abstract
Background: telomere length has been used to represent biological ageing and is found to be associated with various physiological, psychological and social factors. Objective: to explore the effects of income and marriage on leucocyte telomere length in a representative sample of older adults. Design and subjects: cross-sectional analysis among 298 adults, aged 65–74, randomly selected from the community by census. Methods: telomere length was measured by quantitative PCR. Participants provided information on sociodemographics, physical illness and completed questionnaires rating mental state and perceived neighbourhood experience. Results: telomere length was negatively associated with lower income [coefficient −0.141 (95% CI: −0.244 to −0.020), P = 0.021] and positively associated with the marital status [coefficient 0.111 (95% CI: −0.008 to 0.234), P = 0.067] when controlling for gender, age, educational level, physical diseases (including diabetes, hypertension, cardiovascular diseases, cerebrovascular disease and Parkinson's disease), depressive symptoms, minor mental symptoms, cognitive impairment and perceived neighbourhood experience (including social support, perceived security and public facilities). Conclusions: these results indicate that older adults with higher income or being married have longer telomeres when other sociodemographics, physical diseases, mental status and neighbourhood experience are adjusted.
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Affiliation(s)
- Yung-Chieh Yen
- Department of Psychiatry, E-Da Hospital, 1 Yi-Da Road, Yan-Chau District, Kaohsiung 824, Taiwan.
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Buchwald S, Kocher T, Biffar R, Harb A, Holtfreter B, Meisel P. Tooth loss and periodontitis by socio-economic status and inflammation in a longitudinal population-based study. J Clin Periodontol 2013; 40:203-11. [DOI: 10.1111/jcpe.12056] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2012] [Indexed: 12/20/2022]
Affiliation(s)
- Sabine Buchwald
- Unit of Periodontology; Centre of Oral Health; University of Greifswald; Greifswald Germany
| | - Thomas Kocher
- Unit of Periodontology; Centre of Oral Health; University of Greifswald; Greifswald Germany
| | - Reiner Biffar
- Unit of Prosthodontics; Gerodontology and Biomaterials; Centre of Oral Health; University of Greifswald; Greifswald Germany
| | - Ali Harb
- Institute of Community Medicine; University of Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Unit of Periodontology; Centre of Oral Health; University of Greifswald; Greifswald Germany
| | - Peter Meisel
- Unit of Periodontology; Centre of Oral Health; University of Greifswald; Greifswald Germany
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49
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Donoho CJ, Crimmins EM, Seeman TE. Marital Quality, Gender, and Markers of Inflammation in the MIDUS Cohort. JOURNAL OF MARRIAGE AND THE FAMILY 2013; 75:127-141. [PMID: 24700968 PMCID: PMC3971932 DOI: 10.1111/j.1741-3737.2012.01023.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Marital quality is an important factor for understanding the relationship between marriage and health. Low-quality relationships may not have the same health benefits as high-quality relationships. To understand the association between marital quality and health, we examined associations between two indicators of marital quality (marital support and marital strain) and two biomarkers of inflammation (interleukin-6 and C-reactive protein) among men and women in long-term marriages using data from the Survey of Midlife in the United States (N = 542). Lower levels of spousal support were associated with higher levels of inflammation among women but not men. Higher levels of spousal strain were weakly and inconsistently associated with higher levels of inflammation among women and men; the effects were diminished with the addition of psychosocial and behavioral covariates. These findings suggest marital quality is an important predictor of inflammation, especially among women.
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50
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Donoho CJ, Crimmins EM, Seeman TE. Marital Quality, Gender, and Markers of Inflammation in the MIDUS Cohort. JOURNAL OF MARRIAGE AND THE FAMILY 2013. [PMID: 24700968 DOI: 10.1111/j.1741.3737.2012.01023.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Marital quality is an important factor for understanding the relationship between marriage and health. Low-quality relationships may not have the same health benefits as high-quality relationships. To understand the association between marital quality and health, we examined associations between two indicators of marital quality (marital support and marital strain) and two biomarkers of inflammation (interleukin-6 and C-reactive protein) among men and women in long-term marriages using data from the Survey of Midlife in the United States (N = 542). Lower levels of spousal support were associated with higher levels of inflammation among women but not men. Higher levels of spousal strain were weakly and inconsistently associated with higher levels of inflammation among women and men; the effects were diminished with the addition of psychosocial and behavioral covariates. These findings suggest marital quality is an important predictor of inflammation, especially among women.
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