title: Peripheral blood markers of inflammation predict mortality and functional decline in high-functioning community-dwelling older persons.
abstract: 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.
authors: Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, Los Angeles, California 90095, USA. dreuben@mednetucla.edu
authors: David B
authors: DB
authors: Reuben
authors: Anna I
authors: AI
authors: Cheh
authors: Tamara B
authors: TB
authors: Harris
authors: Luigi
authors: L
authors: Ferrucci
authors: John W
authors: JW
authors: Rowe
authors: Russell P
authors: RP
authors: Tracy
authors: Teresa E
authors: TE
authors: Seeman
mesh_terms: 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
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D012709:Serum Albumin; D002097:C-Reactive Protein; D002784:Cholesterol