Getting under the skin: Social isolation and biological markers in the National Health and Aging Trends Study

J Am Geriatr Soc. 2022 Feb;70(2):408-414. doi: 10.1111/jgs.17518. Epub 2021 Oct 26.

Abstract

Background: Social isolation is a risk factor for morbidity and mortality comparable to well-established risk factors including smoking, hypertension, and a sedentary lifestyle. The specific biological mechanisms that connect social isolation to morbidity and mortality remain unclear. Interleukin-6 (IL-6) and C-reactive protein (CRP) are biological markers that are upregulated during inflammation and can have long-term negative consequences for the health of individuals as they age.

Methods: Utilizing Round 7 (2017) data from the National Health and Aging Trends Study (NHATS), we examine the relationship between social isolation and two biological markers: IL-6 and high-sensitivity CRP. This study included a nationally representative sample of 4648 Medicare beneficiaries 65 years and older who provided samples using dried blood spot (DBS) techniques. We defined social isolation utilizing a multi-domained typology that considers living arrangement, core discussion network, religious attendance, and social participation. IL-6 and CRP were obtained via DBS that were collected in Round 7 of the NHATS. We performed linear regression to examine the association between social isolation and biological markers IL-6 and CRP.

Results: After adjusting for age, gender, race/ethnicity, income, tobacco use, body mass index, and chronic conditions, we found that severe social isolation and social isolation were significantly associated with higher levels of IL-6 and CRP values among older adults.

Conclusions: Social isolation is associated with higher levels of biological markers (IL-6 and CRP). Our findings inform the pathway between social isolation and morbidity and mortality among older adults. IL-6 or CRP could be a proximal outcome measures for future clinical and social interventions that seek to alter the trajectory of social isolation and its associated health outcomes.

Keywords: C-reactive protein; biological markers; interleukin-6.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood*
  • C-Reactive Protein / analysis
  • Female
  • Healthy Aging
  • Healthy Volunteers / statistics & numerical data
  • Humans
  • Inflammation / blood
  • Interleukin-6 / blood*
  • Male
  • Medicare
  • Residence Characteristics
  • Social Isolation*
  • Spirituality
  • Surveys and Questionnaires
  • United States

Substances

  • Biomarkers
  • Interleukin-6
  • C-Reactive Protein