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Observational Study
. 2014 Feb;36(1):457-67.
doi: 10.1007/s11357-013-9558-3. Epub 2013 Jul 3.

Significance of serum immune markers in identification of global functional impairment in the oldest old: cross-sectional results from the BELFRAIL study

Wim Adriaensen  1 , Catharina Matheï, Gijs van Pottelbergh, Bert Vaes, Delphine Legrand, Pierre Wallemacq, Jean-Marie Degryse
Affiliations
Observational Study

Significance of serum immune markers in identification of global functional impairment in the oldest old: cross-sectional results from the BELFRAIL study

Wim Adriaensen et al. Age (Dordr). 2014 Feb.

Abstract

The large burden and coexistence of physical disability, cognitive impairment, and depression in the oldest old makes summary markers of global functioning of great value, allowing for risk stratification. Inflammation may be a common underlying cause or represents a final common pathway. The present study investigated the association between elevated serum inflammatory markers and global functioning and its underlying aspects. A representative sample of 415 community-dwelling elderly subjects participating in the BELFRAIL study, with a mean age of 85 years, was included in the present analysis. Data on physical performance, dependence, and mental aspects of functioning and serum levels of 15 inflammatory proteins, including cytokines, chemokines, and acute-phase proteins, were assessed. Interleukin (IL)-6 was negatively associated with global functioning (odds ratio (OR) 4.35). The odds ratios for C-reactive protein (CRP) (OR 2.37) and the combined score of IL-6 and CRP (OR 2.59) were lower or not significant. IL-6 was significantly associated with physical dependence and cognitive function, and only a highly elevated serum level was associated with physical performance. Physical dependence was associated with a highly elevated CRP serum level. The proportion of functionally impaired older persons with elevated IL-6 was 81.93 %, giving a low positive predictive value (0.38), but a high negative predictive value (0.87). So, IL-6 is strongly associated with global functioning and all of the individual aspects of functioning, except suspected depression, in community-dwelling persons 80 years and older.

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Figures

Fig. 1
Fig. 1
Flow chart of study population
Fig. 2
Fig. 2
Proportions of older persons with high inflammatory protein levels. *p < 0.05, significant difference between good and impaired global functioning (chi-square test). Pre pretest probability, PPV positive predictive value, NPV negative predictive value
Fig. 3
Fig. 3
The most robust markers of inflammation for global functioning and the underlying physical and mental aspects
See this image and copyright information in PMC

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