Peripheral blood markers of inflammation predict mortality and functional decline in high-functioning community-dwelling older persons.
OBJECTIVE
Several peripheral blood markers of inflammation have demonstrated prognostic ability, but the value of combining multiple markers as a measure of inflammatory burden remains unknown. The objective of this study was to determine the prognostic value of combining four peripheral blood measures of inflammation in healthy older persons.


METHODS
Inception cohort study with 7 years of follow-up.


METHODS
Three communities.


METHODS
Eight hundred seventy high-functioning subjects aged 70 to 79 who had serum albumin, cholesterol, interleukin (IL)-6, and C-reactive protein (CRP) levels measured at baseline.


METHODS
Three- and 7-year mortality and Rosow- Breslau functional decline.


RESULTS
A summary score was created that assigned one point each for the following blood levels: albumin <3.8 g/dL, cholesterol <170 mg/dL (bottom decile), IL-6>3.8 pg/mL (top tertile), and CRP>2.65 mg/L (top tertile). By 3 years, 6% of subjects had died, and, by 7 years, 23% had died. In subjects with three or four markers of inflammation, the adjusted odds ratios (AORs) for 3- and 7-year mortality were 6.6 and 3.2, respectively, compared with those who had no abnormal markers. Subjects with one or two markers were at more moderate and statistically insignificant increased risk of 3- and 7-year mortality with AORs of 1.5 and 1.3, respectively. The risks for functional decline at 3- and 7-years were generally small (AOR = 1.1-1.9) and not statistically significant.


CONCLUSIONS
In high-functioning older persons, a measure of inflammation can identify those at a much higher risk of mortality and a possibly higher risk of functional decline. Whether therapies directed at reducing inflammation can attenuate such risk remains to be determined.
Reuben
David B
DB
Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, Los Angeles, California 90095, USA. dreuben@mednetucla.edu
Cheh
Anna I
AI
Harris
Tamara B
TB
Ferrucci
Luigi
L
Rowe
John W
JW
Tracy
Russell P
RP
Seeman
Teresa E
TE
D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism*; D002784:Cholesterol / Q000097:blood; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012709:Serum Albumin
D015415:Biomarkers; D015850:Interleukin-6; D012709:Serum Albumin; D002097:C-Reactive Protein; D002784:Cholesterol