Bereavement and marriage are associated with antibody response to influenza vaccination in the elderly

Abstract

Stressful life events exposure including bereavement, an event commonly experienced by elderly people, social support, marital status and satisfaction were examined in relation to antibody response to the annual trivalent influenza vaccination in an elderly community sample (N = 184). Antibody response was assessed at baseline, and at one and 12 months following vaccination. Taking into account baseline antibody titer, overall life events exposure and social support were not associated with response to any of the influenza strains.However, bereavement in the year prior to vaccination was negatively associated with the one-month response to the A/Panama and B/Shangdong strains. Being married and having higher marital satisfaction was also associated with higher peak responses to the A/Panama influenza strain at one month. The positive association between marital satisfaction and A/Panama response was particularly evident in the younger half of the married sample. These associations largely withstood adjustment for potential confounders. Thus, in the elderly, peak antibody response was associated with bereavement and marriage, and not the more general factors, life events and social support, related to antibody response in student samples.This suggests the importance of taking a life course approach to examining relationships between psychosocial factors and immunity, and that interventions to modify the impact of these factors should address those most salient for each age group.

Ageing, depression, anxiety, social support and the diurnal rhythm and awakening response of salivary cortisol

“…Social support may be interpreted differently by these age cohorts and the relevance of different domains of support may differ. Other aspects of social support not measured in this study, such as marriage, may be more important for older adults, as suggested previously (Phillips et al, 2006).…”

“…It could be speculated that social support has differing relationships with physiological variables depending on age. For example social support has been associated with vaccination response in students (Gallagher et al, 2008) but not an older adult sample (Phillips et al, 2006). Social support may be interpreted differently by these age cohorts and the relevance of different domains of support may differ.…”

Stress, ageing and their influence on functional, cellular and molecular aspects of the immune system

“…This detriment in neutrophil immunity was also accompanied by a higher cortisol/DHEAS ratio in the bereaved older adults relative to age-matched nonbereaved controls (Khanfer et al 2011). Bereavement in older adults has also previously been associated with a poorer antibody response to vaccination against the influenza virus (Phillips et al 2006). Changes in cortisol/DHEAS ratio with diminished immune function again suggest a potential mechanism through which stress could influence the body's defence mechanism against infection.…”

“…An inadequate response and failure to provide required protection after vaccination, measured in terms of antibody titre, is indicative of a poorer immune response in the recipient. Unmarried older adults and those who had poor marital quality had a weaker antibody response to the influenza vaccination than happily married older adults (Phillips et al 2006). Life events stress and perceived stress were also related to a lower antibody response after vaccination against flu and meningitis in students (Burns et al 2002(Burns et al , 2003Phillips et al 2005), while greater social support enhanced antibody titres for some vaccine strains (Phillips et al 2005).…”

“…The majority of chronic stressors, on the other hand, are associated with global immunosuppression and have an impact on both innate and adaptive components of the immune system (Kiecolt- Glaser et al 1991a;Phillips et al 2006;Segerstrom and Miller 2004;Thaker et al 2006) to mention a few.…”