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High Levels of Serum C‐Reactive Protein Are Associated with Greater Risk of All‐Cause Mortality, but Not Dementia, in the Oldest‐Old: Results from The 90+ Study
Author(s) -
Kravitz B. Adar,
Corrada Maria M.,
Kawas Claudia H.
Publication year - 2009
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 - 10.1111/j.1532-5415.2009.02169.x
Subject(s) - medicine , dementia , hazard ratio , proportional hazards model , c reactive protein , confidence interval , prospective cohort study , cohort study , relative risk , population , cohort , gerontology , disease , environmental health , inflammation
OBJECTIVES: To evaluate whether high levels of C‐reactive protein (CRP) in serum are associated with greater risk of all‐cause dementia or mortality in the oldest‐old. DESIGN: Prospective. SETTING: Research clinic and in‐home visits. PARTICIPANTS: Population‐based sample of adults (N=227; aged 93.9±2.8) from The 90+ Study, a longitudinal cohort study of people aged 90 and older. MEASUREMENTS: CRP levels were divided into three groups according to the assay detection limit: undetectable (<0.5 mg/dL), detectable (0.5–0.7 mg/dL), and elevated (≥0.8 mg/dL). Neurological examination was used to determine dementia diagnosis ( Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , criteria). Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using Cox regression, and results were stratified according to and apolipoprotein E4 (APOE4) genotype. RESULTS: Subjects with detectable CRP levels had significantly greater risk of mortality (HR=1.7, 95% CI=1.0–2.9), but not dementia (HR=1.2, 95% CI=0.6–2.1), 0.4 to 4.5 years later than subjects with undetectable CRP. The highest relative risk for dementia and mortality was in APOE4 carriers with detectable CRP (dementia HR=4.5, 95% CI=0.9–23.3; mortality HR=5.6, 95% CI=1.0–30.7). CONCLUSION: High levels of CRP are associated with greater risk of mortality in people aged 90 and older, particularly in APOE4 carriers. There was a trend toward greater risk of dementia in APOE4 carriers with high CRP levels, although this relationship did not reach significance. High levels of CRP in the oldest‐old represent a risk factor for negative outcomes.