F Formiga1, A Ferrer, G Padros, A Cintra, R Pujol. 1. F. Formiga, MD, PhD, Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat 08907, Barcelona, Spain. E-mail: fformiga@bellvitgehospital.cat, Phone: (+34) 93 260 74 19; Fax: (+34) 93 260 74 20.
Abstract
BACKGROUND: The presence of an immune risk phenotype (IRP) has been correlated with survival rates in elderly people. OBJECTIVE: To determine whether an inverted CD4:CD8 ratio might be a marker of IRP in a sample of oldest old by assessing its relationship with mortality. DESIGN: Prospective cohort study. SETTING: Community-based survey study of seven primary healthcare centres. PARTICIPANTS: 328 people born in 1924 and registered with primary healthcare centres. MEASUREMENTS: Chronic drug prescription, functional status (Barthel and Lawton indexes) and cognitive status (Spanish version of the Mini-Mental State Examination) were recorded. CD4:CD8 ratios were determined, with a ratio of 1.00 or less being used to define IRP. RESULTS: The CD4:CD8 ratio was 1.00 or less in 47 subjects (15.6%). After three years, 51 subjects had died (16.3%); 9 were from among the 47 (19.1%) with an inverted CD4:CD8 ratio and 42 (15.8%) from the remainder (P=0.52). Multivariate analysis identified two significant clinical variables (Lawton Index scores and the number of chronic drugs prescribed) as being independent predictors of three-year mortality risk in this cohort of octogenarians. This risk profile did not change when introducing the CD4:CD8 ratio into the calculation. CONCLUSION: In this community-dwelling population of oldest old (85 years old at baseline) an inverted CD4:CD8 ratio was not associated with three-year mortality.
BACKGROUND: The presence of an immune risk phenotype (IRP) has been correlated with survival rates in elderly people. OBJECTIVE: To determine whether an inverted CD4:CD8 ratio might be a marker of IRP in a sample of oldest old by assessing its relationship with mortality. DESIGN: Prospective cohort study. SETTING: Community-based survey study of seven primary healthcare centres. PARTICIPANTS: 328 people born in 1924 and registered with primary healthcare centres. MEASUREMENTS: Chronic drug prescription, functional status (Barthel and Lawton indexes) and cognitive status (Spanish version of the Mini-Mental State Examination) were recorded. CD4:CD8 ratios were determined, with a ratio of 1.00 or less being used to define IRP. RESULTS: The CD4:CD8 ratio was 1.00 or less in 47 subjects (15.6%). After three years, 51 subjects had died (16.3%); 9 were from among the 47 (19.1%) with an inverted CD4:CD8 ratio and 42 (15.8%) from the remainder (P=0.52). Multivariate analysis identified two significant clinical variables (Lawton Index scores and the number of chronic drugs prescribed) as being independent predictors of three-year mortality risk in this cohort of octogenarians. This risk profile did not change when introducing the CD4:CD8 ratio into the calculation. CONCLUSION: In this community-dwelling population of oldest old (85 years old at baseline) an inverted CD4:CD8 ratio was not associated with three-year mortality.
Authors: Anders Wikby; Bengt-Olof Nilsson; Rosalyn Forsey; Julie Thompson; Jan Strindhall; Sture Löfgren; Jan Ernerudh; Graham Pawelec; Frederick Ferguson; Boo Johansson Journal: Mech Ageing Dev Date: 2006-06-05 Impact factor: 5.432