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Cross‐Linked Fibrin Degradation Products (D‐Dimer), Plasma Cytokines, and Cognitive Decline in Community‐Dwelling Elderly Persons
Author(s) -
Wilson Craig J.,
Cohen Harvey Jay,
Pieper Carl F.
Publication year - 2003
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1532-5415.2003.51454.x
Subject(s) - medicine , cognitive decline , cognition , gerontology , prospective cohort study , proinflammatory cytokine , cohort , demography , cohort study , dementia , psychiatry , inflammation , disease , sociology
Objectives: To investigate the effect of coagulation and inflammatory pathway activation on future cognitive decline in older persons. Design: Prospective cohort study. Setting: Rural and urban communities in North Carolina. Participants: Community‐dwelling older people enrolled in the Duke Established Populations for Epidemiologic Studies of the Elderly in 1986. Measurements: 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. Conclusion: 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.