title: Social isolation and adult mortality: the role of chronic inflammation and sex differences.
abstract: The health and survival benefits of social embeddedness have been widely documented across social species, but the underlying biophysiological mechanisms have not been elucidated in the general population. We assessed the process by which social isolation increases the risk for all-cause and chronic disease mortality through proinflammatory mechanisms. Using the 18-year mortality follow-up data (n = 6,729) from the National Health and Nutrition Examination Survey (1988-2006) on Social Network Index and multiple markers of chronic inflammation, we conducted survival analyses and found evidence that supports the mediation role of chronic inflammation in the link between social isolation and mortality. A high-risk fibrinogen level and cumulative inflammation burden may be particularly important in this link. There are notable sex differences in the mortality effects of social isolation in that they are greater for men and can be attributed in part to their heightened inflammatory responses.
authors: Department of Sociology, Lineberger Comprehensive Cancer Center, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA. yangy@unc.edu
authors: Yang Claire
authors: YC
authors: Yang
authors: Martha K
authors: MK
authors: McClintock
authors: Michael
authors: M
authors: Kozloski
authors: Ting
authors: T
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007249:Inflammation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009749:Nutrition Surveys; D012727:Sex Characteristics; D012934:Social Isolation
keywords: cancer; chronic inflammation; heart disease; mortality; sex differences
references: Am J Cardiol. 2006 Apr 1;97(7):1010-6
references: 16563907
references: Cancer. 2002 Aug 15;95(4):808-15
references: 12209725
references: Am J Public Health. 2008 Jul;98(7):1215-20
references: 18511736
references: Demography. 1999 May;36(2):273-85
references: 10332617
references: JAMA. 1998 Feb 25;279(8):585-92
references: 9486752
references: Psychol Aging. 2006 Mar;21(1):140-51
references: 16594799
references: Soc Sci Med. 2000 Sep;51(6):843-57
references: 10972429
references: Psychosom Med. 2000 Jul-Aug;62(4):524-34
references: 10949098
references: Psychol Rev. 2000 Jul;107(3):411-29
references: 10941275
references: Brain Behav Immun. 2005 Nov;19(6):521-5
references: 15890493
references: Psychosom Med. 2002 May-Jun;64(3):395-406
references: 12021414
references: Science. 1988 Jul 29;241(4865):540-5
references: 3399889
references: J Gerontol A Biol Sci Med Sci. 2009 Dec;64(12):1251-61
references: 19723772
references: J Gerontol B Psychol Sci Soc Sci. 1999 May;54(3):S173-80
references: 10363048
references: J Health Soc Behav. 2011 Jun;52(2):145-61
references: 21673143
references: Semin Immunopathol. 2012 Jan;34(1):43-62
references: 22037947
references: Health Psychol. 1991;10(2):102-11
references: 2055208
references: Psychooncology. 2012 Jun;21(6):588-93
references: 22438289
references: Proc Natl Acad Sci U S A. 2001 Apr 10;98(8):4770-5
references: 11287659
references: Ann Epidemiol. 2006 Feb;16(2):78-84
references: 16271297
references: Psychosom Med. 2006 May-Jun;68(3):376-81
references: 16738067
references: Cancer. 2005 Jul 15;104(2):305-13
references: 15954082
references: Am J Physiol Regul Integr Comp Physiol. 2006 Feb;290(2):R273-82
references: 16210419
references: Am J Health Promot. 2000 Jul-Aug;14(6):362-70
references: 11067571
references: Annu Rev Clin Psychol. 2007;3:377-401
references: 17716061
references: Am J Epidemiol. 1979 Feb;109(2):186-204
references: 425958
references: J Health Soc Behav. 2009 Mar;50(1):31-48
references: 19413133
references: Annu Rev Sociol. 2010 Aug 1;36:139-157
references: 21921974
references: Med Sci Monit. 2002 May;8(5):HY1-9
references: 12011758
references: Gend Med. 2006 Jun;3(2):79-92
references: 16860268
references: J Health Soc Behav. 1981 Dec;22(4):337-56
references: 7320473
references: J Gerontol B Psychol Sci Soc Sci. 2005 Mar;60 Spec No 1:32-41
references: 15863708
references: J Gerontol A Biol Sci Med Sci. 2009 Feb;64(2):272-9
references: 19196638
references: Ann Med. 2000 May;32(4):274-8
references: 10852144
references: Am J Public Health. 1997 Jun;87(6):957-61
references: 9224176
references: Am J Epidemiol. 2012 Jun 15;175(12):1275-83
references: 22534202
references: J Gerontol A Biol Sci Med Sci. 2011 May;66(5):493-500
references: 21350248
references: Science. 2012 Oct 5;338(6103):79-82
references: 23042887
references: Psychol Rev. 1998 Jan;105(1):83-107
references: 9450372
references: Cancer Prev Res (Phila). 2009 Oct;2(10):850-861
references: 19789294
references: J Clin Oncol. 2005 Oct 1;23(28):7105-13
references: 16192594
references: Am J Epidemiol. 2002 Apr 15;155(8):700-9
references: 11943687
references: Ann Epidemiol. 2012 Feb;22(2):94-103
references: 22100543
references: Psychosom Med. 1993 Jan-Feb;55(1):37-43
references: 8446739
references: Am J Cardiol. 2003 Oct 15;92(8):984-7
references: 14556880
references: Am J Epidemiol. 1987 Oct;126(4):714-23
references: 3631060
references: Perspect Biol Med. 2003 Summer;46(3 Suppl):S39-52
references: 14563073