Living alone and divorce linked to inflammation in men

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• Divorce or relationship breakups are associated with poorer health in men.
• A new study looking at middle-aged adults in Denmark found that living alone and experiencing more relationship breakdowns are linked to higher levels of inflammation in men.
• The study found no such link in women.

Scientists have already shown that for men, divorce or the breakup of a relationship often leads to a decline in health and is associated with increased mortality.

The breakup of a relationship often leads to living alone, which is also linked to health issues.

Previous studies have found an association between social isolation and higher levels of inflammation, suggesting a potential physiological pathway. However, there is little prior research looking at how this association might work over a longer course of time.

As the number of people living alone increases in Western populations, scientists are keen to understand the ties between personal relationships and disease states.

A recent, large study in Denmark adds to our growing understanding. The authors identified a significant association between partnership breakups or years lived alone and increased inflammation levels in men. The study appears in the Journal of Epidemiology & Community Health.

Prof. Rikke Lund from the University of Copenhagen in Denmark, one of the study’s lead authors, explained to Medical News Today:

“[S]ince heightened inflammatory levels are associated with increased mortality and morbidity from a number of chronic diseases, our study contributes […] a potential linking mechanism.”

The study used data from middle-aged people covering 26 years of adult life. It is the first study to investigate the effects of living alone for a shorter or longer period and experiencing zero, one, or several divorces or breakups from cohabiting relationships.

Inflammation is the body’s way of defending itself against toxins, injury, and infection. Acute inflammation lasts a few hours or days, for example, after a cut on a knee.

Chronic inflammation is the persistence of the inflammation reaction. White blood cells can flood the system and attack healthy tissues.

Interleukin 6 (IL-6) and C-reactive protein (CRP) are two molecules involved in the inflammation response. Elevated IL-6 and CRP are associated with many adverse health outcomes, such as the increased risk of cardiovascular events, decreased physical and cognitive performance, and a higher risk of death.

The study team, based at the University of Copenhagen, analyzed data from the Copenhagen Aging and Midlife Biobank.

In total, they used data from 4,835 participants, all aged 48–62 years old. The data spanned 26 years, from 1986 to 2011.

For 4,612 individuals (3,170 men and 1,442 women), the data included information on the number of breakups. For 4,835 individuals (3,336 men and 1,499 women), records included information about the number of years lived alone.

The researchers also collected information on factors that might influence the results of the study. These included education level, weight, medical conditions, early major life events, medicines that might influence inflammation, personality traits, and any recent inflammation episodes.

Participants provided blood samples to assess levels of IL-6 and CRP as an indication of inflammation levels.

After adjusting for a range of potentially confounding variables, the scientists found that in men, more relationship breakups or years lived alone were associated with increased inflammatory markers compared with a reference group of men who had not experienced a relationship breakup or had lived alone for 0–1 years.

The most profound increase in levels of inflammation occurred in the group of men who had experienced the most breakups — two or more. Compared with the reference group, they had 17% higher levels of inflammatory markers.

Similarly, men who had lived alone for the longest time — 7 years or more — had 12% higher levels of inflammation than the reference group.

The study found no such effect in women.

These findings suggest that men and not women are significantly disadvantaged by relationship breakdowns or living alone.

A few years living alone or a few breakups are not health risk factors in themselves, but a combination of many years living alone and several breakups does create an increased risk of raised inflammatory markers in men.

“Our study has identified middle-aged men living alone for many years or who have experienced several partnership breakups as a vulnerable group — social policy development but also healthcare professionals should take that into account when new initiatives are being planned or when they come into contact with the healthcare system.”

– Prof. Lund

The authors suggest a number of possible explanations for why women were not affected in the same way as men.

Firstly, it could be that women have fewer health gains from being in a marriage. If so, a breakup would cause less risk of declining health. Secondly, there is evidence that young men have a greater inflammatory response than women, which may persist into later life.

They also note that there was a relatively small group of female participants in the study, which might mean that it missed a true association.

The main strength of this study is the large sample size, with data across 26 years.

One limitation the authors noted is the possible selection bias due to participant dropout. The people who did not complete all the questionnaires and blood samples might represent people with less stable lives — those with more frequent histories of divorce or partnership breakups.

Another limitation might be that the full consequences of the events the researchers were studying might not have reached the peak, as the mean age of the participants was only 54.5 years.

Also, the men included in the study had a higher body mass index (BMI) than the women. Individuals with a higher BMI can experience increased systemic inflammation.

Prof. Lund told MNT that she would like to investigate how having children impacts the associations.

“There is a potential that having children may be protective of living alone for many years, but that is probably given that there is a meaningful and positive contact between the child and the single living parent. There is also a potential that having children may further aggravate the negative effects of partnership dissolution, as they often tend to become [part of] the conflict.”

“Furthermore,” she continued, “studies involving a larger group of women may shed light on if subgroups of women are also at risk of increased inflammatory levels when exposed.”