Science + Technology

Multiple Measures of Inflammation Predict Mortality and Functional Decline in Healthy Older Persons


Effortsto prevent or delay functional decline and premature death in older personshave increasingly focused on identification of risk factors with the hope thatinterventions — lifestyle modification or early detection and treatment ofdisease — would delay disability or death.

Researchersfrom UCLA, Mt. Sinai School of Medicine, the University of Vermont, the ItalianNational Research Council on Aging and the National Institute on Aging havepublished findings from their analysis of a combination of blood markers ofinflammation that may help in early identification of at-risk older persons.

Theinflammatory response is the body's integrated and diverse reaction and defenseagainst biological disturbances such as injury and infection. Althoughinflammation begins at the local cellular level, a series of biological stepsfollows, including the release of markers of inflammation into the bloodstream.

For thisstudy, investigators looked at the value of four blood measures of inflammationin identifying those older persons who may be at higher risk of mortality orfunctional decline. Blood levels of these markers — cholesterol, serum albumin,interleukin (IL-6) and C-reactive protein — are biological indicators ofunderlying pathologic processes that contribute to functional decline ormortality.

Individually,these blood markers are known to be associated with functional status declineand increased mortality risk in select conditions such as rheumatoid arthritis.In healthy people, abnormal blood markers could indicate subclinicalinflammation not yet detectable by older persons or their physicians. Becauseregulation of markers and inflammatory response is complex, researchers soughtto determine whether simultaneous measurement of all these markers wouldprovide improved prognostic ability for mortality and functional decline inotherwise healthy older persons.

Usinglongitudinal data from the MacArthur Research Network on Successful AgingCommunity Study, researchers analyzed blood samples of 870 high-functioningpeople aged 70–79 with no reported functional disability at baseline. Follow-upsubject contacts and measurements were done at three and seven years.

Resultsindicate that among high-functioning older persons, these measures can identifysubstantially increased risk of mortality and possibly increased risk offunctional decline.

Moreover,those with greater numbers of abnormal inflammatory markers had progressivelyhigher risk. For example, nearly 25 percent of those with three or four of theinflammatory markers had died by the three-year follow-up, compared to only 4percent of those with no markers. This group with three or four markers ofinflammation (5 percent of the total sample) was at a more than six-foldincreased risk of dying within the three years, independent of other healthstatus measures.

Riskidentification in persons with no visible clinical problems may indicate theneed for closer observation for the development of inflammatory diseases. Theauthors suggest future research to identify possible dietary or otherinterventions that may reduce inflammation. However, whether inflammationreduction would then lead to a reduced risk of future illness remains anunanswered question.

"Peripheralblood markers of inflammation predict mortality and functional decline inhigh-functioning community-dwelling older persons" appears in the April issueof the Journal of the American Geriatrics Society.

Thearticle's lead author is principal investigator David B. Reuben, chief of UCLAgeriatrics.

The UCLAClaude D. Pepper Older Americans Independence Center and John A. HartfordFoundation provided support for this study.

UCLA's division of geriatrics providescontinuing medical education opportunities for health professionals, conductsmedical and non-medical research activities aimed at promoting the health andindependence of older persons, and provides inpatient and community-basedclinical care for older patients in the Los Angeles area.

For the last ten years, UCLA's geriatricsprogram has ranked the best in the nation, according to U.S. News & WorldReport's annual listing of top hospitals and specialties.



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