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Objectives  To examine the independent relationships between fibrin  D ‐dimer, interleukin 6 ( IL ‐6),  C ‐reactive protein ( CRP ), and fibrinogen and incident mobility limitation and mortality.    Design  Prospective.    Setting  General practice in 24  B ritish towns.    Participants  Men aged 60 to 79 without prevalent heart failure followed up for an average of 11.5 years (N = 3,925).    Measurements  All‐cause mortality (n = 1,286) and self‐reported mobility disability obtained at examination in 1998 to 2000 and in a postal questionnaire 3 to 5 years later in 2003.    Results  High  D ‐dimer (top vs lowest tertile: adjusted odds ratio ( aOR ) = 1.46, 95% confidence interval = 1.02–2.05) and  IL ‐6 (a OR  = 1.43, 95%  CI  = 1.01–2.02) levels (but not  CRP  or fibrinogen) were associated with greater incident mobility limitation after adjustment for confounders and prevalent disease status. IL‐6,  CRP , fibrinogen, and  D ‐dimer were significantly associated with total mortality after adjustment for confounders. Only  D ‐dimer and  IL ‐6 predicted total mortality independent of each other and the other biomarkers. The adjusted hazard ratio ( aHR ) was 1.16 (95%  CI  = 1.10–1.22) for a standard deviation increase in log  D ‐dimer and 1.10 (95%  CI  = 1.04–1.18) for a standard deviation increase in log  IL ‐6.  D ‐dimer was independently related to vascular and nonvascular mortality, and  IL ‐6 was independently related to vascular mortality. Risks of mobility limitation and mortality were greatest in those with a combination of high  D ‐dimer and  IL ‐6 levels.    Conclusion   D ‐dimer and  IL ‐6 are associated with risk of mobility limitation and mortality in older men without heart failure. The findings suggest that coagulation leads to functional decline and mortality s that inflammation does not explain.

Associations Between Fibrin D ‐Dimer, Markers of Inflammation, Incident Self‐Reported Mobility Limitation, and All‐Cause Mortality in Older Men