Cross-linked fibrin degradation products (D-dimer), plasma cytokines, and cognitive decline in community-dwelling elderly persons.
OBJECTIVE
To investigate the effect of coagulation and inflammatory pathway activation on future cognitive decline in older persons.


METHODS
Prospective cohort study.


METHODS
Rural and urban communities in North Carolina.


METHODS
Community-dwelling older people enrolled in the Duke Established Populations for Epidemiologic Studies of the Elderly in 1986.


METHODS
In 1992, blood was drawn for assay of D-dimer (1,723 subjects), Interleukin-6 (1,726 subjects), and other cytokines (1,551 subjects). Cognitive and functional assessments were performed in 1986, 1989, 1992, and 1996. Cognition was measured using the Short Portable Mental Status Questionnaire.


RESULTS
Cognitive decline over a 4-year period was significantly correlated (P<.001) with D-dimer, age, race, and physical performance status as measured using the Rosow-Breslau and Nagi instruments. After controlling for demographics, functional status, and comorbidities, D-dimer remained predictive of cognitive decline. Proinflammatory cytokines were not associated with current cognitive status in cross-sectional analyses or with incident cognitive decline in prospective analyses.


CONCLUSIONS
In a large sample of community-dwelling elders, higher levels of D-dimer were predictive of cognitive decline over a 4-year period. No clinically significant associations were found between age-related peripheral cytokine dysregulation and cognition.
D000368:Aged; D000375:Aging / Q000097:blood*; D003072:Cognition Disorders / Q000097:blood* / Q000453:epidemiology; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
D016207:Cytokines; D005338:Fibrin Fibrinogen Degradation Products