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Leveraging naturally occurring variation in financial stress to examine associations with inflammatory burden among older adults.

Abstract：

BACKGROUND:Financial strain is associated with earlier disability and mortality, but causal links are underexplored, partly because it is unethical to randomise people to financial stress. This study leverages naturally occurring random variation in days since monthly Social Security payment arrival among older adults to test associations with inflammatory biomarkers. METHODS:Biomarker data, including tumour necrosis factor (TNF)-α, interleukin (IL)-6 and C reactive protein (CRP), was collected from 2155 non-working healthy adults aged 70-79 years, participating in the Health, Aging and Body Composition Study. Days since payment arrival was independent of all demographic, socioeconomic or health characteristics measured in this study. Restricted cubic spline models estimated associations separately for each week of the month, stratified by financial strain status (interaction term p value for TNF-α model <0.05). RESULTS:Among financially strained older adults, more days since payment arrival was associated with higher TNF-α levels during the first week of the month (coefficient=0.102). Associations with IL-6 and CRP differed depending on the degree of financial strain (interaction term p values <0.05). Those with low, but not high, strain had lower levels of IL-6 (coefficient=-0.152) and CRP (coefficient=-0.179) during the first week. CONCLUSIONS:Days since monthly payments were associated with inflammatory cytokines among older adults who have difficulty making ends meet financially and associations depended on financial strain severity, suggesting that results are attributable to monthly variation in financial stress. Future research should examine whether more frequent Social Security disbursement would modify financial strain and inflammatory biomarkers.

journal_name

J Epidemiol Community Health

journal_title

Journal of epidemiology and community health

authors

Samuel L,Szanton SL,Fedarko NS,Simonsick EM

doi

10.1136/jech-2020-213807

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

892-897

issue

eissn

0143-005X

issn

1470-2738

pii

jech-2020-213807

journal_volume

pub_type

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Leveraging naturally occurring variation in financial stress to examine associations with inflammatory burden among older adults.