An immune risk phenotype, cognitive impairment, and survival in very late life: impact of allostatic load in Swedish octogenarian and nonagenarian humans.
In the previous OCTO longitudinal study, we identified an immune risk phenotype (IRP) of high CD8 and low CD4 numbers and poor proliferative response. We also demonstrated that cognitive impairment constitutes a major predictor of nonsurvival. In the present NONA longitudinal study, we simultaneously examine in a model of allostatic load IRP and compromised cognition in 4-year survival in a population-based sample (n = 138, 86-94 years). Immune system measurements consisted of determinations of T-cell subsets, plasma interleukin 6 and cytomegalovirus and Epstein-Barr virus serology. Interleukin 2 responsiveness to concanavalin A, using data from the previous OCTO (octogenarians) immune study, hereafter OCTO immune, was also examined. Cognitive status was rated using a battery of neuropsychological tests. Logistic regression indicated that the IRP and cognitive impairment together predicted 58% of observed deaths. IRP was associated with late differentiated CD8+CD28-CD27- cells (p < .001), decreased interleukin 2 responsiveness (p < .05) and persistent viral infection (p < .01). Cognitive impairment was associated with increased plasma interleukin 6 (p < .001). IRP individuals with cognitive impairment were all deceased at the follow-up, indicating an allostatic overload.
Department of Natural Science and Biomedicine, School of Health sciences, Jönköping University, Sweden.
Anders
A
Wikby
Frederick
F
Ferguson
Rosalyn
R
Forsey
Julie
J
Thompson
Jan
J
Strindhall
Sture
S
Löfgren
Bengt-Olof
BO
Nilsson
Jan
J
Ernerudh
Graham
G
Pawelec
Boo
B
Johansson
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000276:immunology*; D000704:Analysis of Variance; D015703:Antigens, CD / Q000276:immunology*; D016516:CD4-CD8 Ratio; D003072:Cognition Disorders / Q000276:immunology* / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D016867:Immunocompromised Host; D007376:Interleukin-2 / Q000235:genetics / Q000276:immunology; D015850:Interleukin-6 / Q000235:genetics / Q000276:immunology; D008017:Life Expectancy; D008136:Longevity; D008137:Longitudinal Studies; D008297:Male; D010641:Phenotype; D011336:Probability; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013548:Sweden
D015703:Antigens, CD; D007376:Interleukin-2; D015850:Interleukin-6