title: Poorer self-rated health is associated with elevated inflammatory markers among older adults.
abstract: OBJECTIVE
  Self-rated health is a strong independent predictor of mortality after accounting for objective health status, behavioral risk factors, and sociodemographic characteristics. However, mechanisms underlying this association are largely unexplained. Inflammation has been associated with increased risk of morbidity and mortality in the elderly. The current study aimed to: (1) examine associations between self-rated health and serum inflammatory markers in older adults; (2) examine the relative strength of these associations for self-rated health versus self-rated change in recent health; (3) examine components of self-rated health that may underlie the association between inflammation and global self-rated health.
  
  
  METHODS
  Self-rated health, as measured by the RAND health survey, and serum interleukin (IL)-6 and C-reactive protein (CRP) were assessed among 250 generally healthy older adults (185 women, 65 men; average age=63.8±13.7 years).
  
  
  RESULTS
  A series of linear regression analyses demonstrated that poorer self-rated health was significantly associated with higher IL-6 and CRP. These relationships remained after controlling for age, body mass index, gender, and objective health conditions. These associations also remained after controlling for depressive symptoms, neuroticism, perceived change in health over the past year, and health behaviors (smoking, sleep quality, and physical activity). Analyses of RAND component measures demonstrated that poorer physical functioning was significantly associated with IL-6; the relationship between global self-rated health and both IL-6 and CRP remained after accounting for perceived physical functioning.
  
  
  CONCLUSIONS
  Poorer self-rated health is associated with elevated serum inflammatory markers among generally healthy older adults. The relationship of self-rated health with inflammatory markers is not secondary to depressive symptoms, neuroticism, or recent changes in perceived health. Subjective ratings of health provide important clinical information regarding inflammatory status, beyond traditional objective risk factors, even among generally healthy individuals.
authors: Department of Psychiatry, The Ohio State University Medical Center, Columbus, OH 43210, USA. Lisa.Christian@osumc.edu
authors: Lisa M
authors: LM
authors: Christian
authors: Ronald
authors: R
authors: Glaser
authors: Kyle
authors: K
authors: Porter
authors: William B
authors: WB
authors: Malarkey
authors: David
authors: D
authors: Beversdorf
authors: Janice K
authors: JK
authors: Kiecolt-Glaser
references: Annu Rev Med. 2000;51:245-70
references: 10774463
references: Viral Immunol. 2003;16(2):141-57
references: 12828866
references: Ann N Y Acad Sci. 2001 Mar;933:222-34
references: 12000023
references: J Health Soc Behav. 1997 Mar;38(1):21-37
references: 9097506
references: Trends Neurosci. 2002 Mar;25(3):154-9
references: 11852148
references: Cytokine Growth Factor Rev. 2002 Aug-Oct;13(4-5):357-68
references: 12220549
references: Int J Geriatr Psychiatry. 2009 Dec;24(12):1453-62
references: 19548267
references: Am J Kidney Dis. 2008 Jul;52(1):111-7
references: 18511166
references: Med Sci Sports Exerc. 2001 Jul;33(7):1126-41
references: 11445760
references: J Am Geriatr Soc. 1999 Aug;47(8):1016-25
references: 10443865
references: Gerontologist. 1995 Dec;35(6):771-91
references: 8557205
references: Curr Opin Hematol. 2001 May;8(3):131-6
references: 11303144
references: Soc Sci Med. 2003 Jun;56(12):2505-14
references: 12742613
references: Psychosom Med. 2004 Jul-Aug;66(4):559-63
references: 15272103
references: J Gerontol A Biol Sci Med Sci. 2006 Jun;61(6):575-84
references: 16799139
references: J Clin Endocrinol Metab. 2003 May;88(5):2019-25
references: 12727948
references: Int J Sports Med. 2000 May;21 Suppl 1:S4-9
references: 10893017
references: Am J Med. 2003 Sep;115(4):278-83
references: 12967692
references: Med Care. 1999 Dec;37(12):1226-36
references: 10599604
references: Arch Gen Psychiatry. 2003 Oct;60(10):1009-14
references: 14557146
references: J Gerontol B Psychol Sci Soc Sci. 2003 Mar;58(2):P112-28
references: 12646594
references: J Clin Epidemiol. 2006 May;59(5):465-71
references: 16632134
references: Psychiatry Res. 1989 May;28(2):193-213
references: 2748771
references: Gerontologist. 2003 Jun;43(3):396-405; discussion 372-5
references: 12810904
references: Psychosom Med. 2011 Feb-Mar;73(2):142-50
references: 21097658
references: Clin Sci (Lond). 2007 Jun;112(6):363-73
references: 17094770
references: J Gerontol. 1992 Nov;47(6):S304-12
references: 1430868
references: Brain Behav Immun. 2007 Feb;21(2):153-60
references: 17088043
references: Psychosom Med. 2007 Feb-Mar;69(2):138-43
references: 17289825
references: Am J Med. 1999 May;106(5):506-12
references: 10335721
references: J Gerontol A Biol Sci Med Sci. 1997 Jul;52(4):M201-8
references: 9224431
references: Trends Immunol. 2006 Jan;27(1):24-31
references: 16316783
references: Proc Natl Acad Sci U S A. 2003 Jul 22;100(15):9090-5
references: 12840146
references: J Gerontol. 1981 Jul;36(4):428-34
references: 7252074
references: J Gerontol. 1993 May;48(3):S94-101
references: 8482831
references: Med Care. 1992 Jun;30(6):473-83
references: 1593914
references: J Gerontol. 1992 Mar;47(2):S80-7
references: 1538079
references: Am J Public Health. 1994 Nov;84(11):1775-9
references: 7977916
references: J Pers. 1987 Jun;55(2):299-316
references: 3612472
references: Brain Behav Immun. 2005 Nov;19(6):555-63
references: 16214026
references: Am J Epidemiol. 1986 Sep;124(3):372-88
references: 3740038
references: Soc Sci Med. 2003 Apr;56(7):1447-52
references: 12614696
references: J Clin Oncol. 2009 Jun 20;27(18):2894-5
references: 19433678
references: Brain Behav Immun. 2002 Dec;16(6):622-53
references: 12480495
references: Am J Prev Med. 2005 Apr;28(3):298-304
references: 15766620
references: Am J Med. 2003 Oct 15;115(6):429-35
references: 14563498