Cell-mediated immunity as a predictor of morbidity and mortality in subjects over 60.
Previous studies have suggested an association between depressed cell-mediated immunity and increased mortality in elderly persons. However, the effects of age and existing disease on this association have not been adequately addressed. We studied the association between cell-mediated immunity and subsequent morbidity and mortality in 273 initially healthy persons 60 years of age and older. In 1979, two tests of cell-mediated immunity were conducted--mitogen stimulation with phytohaemagglutinin, and delayed hypersensitivity skin testing. The study group was followed annually for development of pneumonia, cancer, and death. Anergy was associated with all-cause mortality (hazard ratio of 2.16; 95% confidence interval [1.10,4.28]). When the results were adjusted for age, the resulting hazard ratio was 1.89;[0.94,3.79]. A relationship was also suggested between anergy and cancer mortality although this association was not statistically significant. Response to phytohaemagglutinin was a poorer predictor of mortality than was response to delayed hypersensitivity skin testing. The results show that anergy may be a good indicator of subsequent all-cause mortality, and perhaps cancer mortality, in elderly who lack other indicators of poor health.
Wayne
S J
SJ
Department of Family, Community, and Emergency Medicine, University of New Mexico, School of Medicine, Albuquerque.
Rhyne
R L
RL
Garry
P J
PJ
Goodwin
J S
JS
D000368:Aged; D000375:Aging / Q000276:immunology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology; D007111:Immunity, Cellular / Q000502:physiology*; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008934:Mitogens; D009017:Morbidity; D009026:Mortality; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality; D010835:Phytohemagglutinins; D011336:Probability; D016016:Proportional Hazards Models; D012882:Skin Tests; D015996:Survival Rate
D008934:Mitogens; D010835:Phytohemagglutinins