Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study
Abstract Background Inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and cognitive impairment (CI) are associated with mortality; CRP is related to the deterioration of CI. However, it is still unknown whether these two indices predict mortality independent of each other....
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2019-11-01
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Series: | Immunity & Ageing |
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Online Access: | http://link.springer.com/article/10.1186/s12979-019-0170-y |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chen Chen Yingchun Liu Zhaojin Cao Zhaoxue Yin Feng Zhao Yuebin Lv Zuyun Liu Chen Mao Shixun Song Ling Liu Yingli Qu Saisai Ji Jun Duan Jiaonan Wang Virginia Byers Kraus Yi Zeng Xiaoming Shi |
spellingShingle |
Chen Chen Yingchun Liu Zhaojin Cao Zhaoxue Yin Feng Zhao Yuebin Lv Zuyun Liu Chen Mao Shixun Song Ling Liu Yingli Qu Saisai Ji Jun Duan Jiaonan Wang Virginia Byers Kraus Yi Zeng Xiaoming Shi Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study Immunity & Ageing Hs-CRP Cognition Mortality Oldest-old |
author_facet |
Chen Chen Yingchun Liu Zhaojin Cao Zhaoxue Yin Feng Zhao Yuebin Lv Zuyun Liu Chen Mao Shixun Song Ling Liu Yingli Qu Saisai Ji Jun Duan Jiaonan Wang Virginia Byers Kraus Yi Zeng Xiaoming Shi |
author_sort |
Chen Chen |
title |
Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study |
title_short |
Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study |
title_full |
Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study |
title_fullStr |
Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study |
title_full_unstemmed |
Combined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort study |
title_sort |
combined associations of hs-crp and cognitive function with all-cause mortality among oldest-old adults in chinese longevity areas: a prospective cohort study |
publisher |
BMC |
series |
Immunity & Ageing |
issn |
1742-4933 |
publishDate |
2019-11-01 |
description |
Abstract Background Inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and cognitive impairment (CI) are associated with mortality; CRP is related to the deterioration of CI. However, it is still unknown whether these two indices predict mortality independent of each other. Furthermore, their joint effect on all-cause mortality has not been well established, especially in oldest-old adults. Methods Based on data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we included 1447 oldest-old adults (mean age 84.7 years and 58.7% were female, weighted) with information on hs-CRP (stratified by a cutoff value of 3.0 mg/L) and cognition (quantified by Mini-Mental Status Examination (MMSE) scored according to the personal educational level) at baseline. Mortality was assessed in followed 2014 and 2017 waves. Cox proportional hazards regression models were used, with adjustment for hs-CRP and cognition (mutually controlled) and several traditional mortality risk factors. Results During a median follow-up period of 32.8 months (Q1-Q3, 9.7–59.0 months), 826 participants died. Hs-CRP [HR > 3.0 mg/L vs ≤ 3.0 mg/L: 1.64 (95% CI, 1.17, 2.30)] and cognition [HR CI vs normal: 2.30 (95% CI, 1.64, 3.21)] each was independent predictor of all-cause mortality, even after accounting for each other and other covariates. Monotonic and positive associations were observed in combined analyses, in which the highest mortality risk was obtained in elders with both high hs-CRP> 3.0 mg/L and CI [HR: 3.56 (95% CI, 2.35, 5.38)].The combined effects were stronger in male and younger oldest-old (aged 80–89 years). Conclusion High hs-CRP and CI, both individually and jointly, were associated with increased all-cause mortality risks in Chinese oldest-old. Intervention strategies for preventing inflammation and maintaining adequate cognitive function may be more important in male and younger oldest-old for reducing mortality risk. |
topic |
Hs-CRP Cognition Mortality Oldest-old |
url |
http://link.springer.com/article/10.1186/s12979-019-0170-y |
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doaj-33bbd84e80b641fcb56380047d052a932020-11-25T04:03:17ZengBMCImmunity & Ageing1742-49332019-11-011611910.1186/s12979-019-0170-yCombined associations of hs-CRP and cognitive function with all-cause mortality among oldest-old adults in Chinese longevity areas: a prospective cohort studyChen Chen0Yingchun Liu1Zhaojin Cao2Zhaoxue Yin3Feng Zhao4Yuebin Lv5Zuyun Liu6Chen Mao7Shixun Song8Ling Liu9Yingli Qu10Saisai Ji11Jun Duan12Jiaonan Wang13Virginia Byers Kraus14Yi Zeng15Xiaoming Shi16National Institute of Environmental and Health, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionDivision of Non-communicable Disease and Healthy Ageing Management, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionDepartment of Pathology, Yale School of MedicineDivision of Epidemiology, School of Public Health, Southern Medical UniversityNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionDuke Molecular Physiology Institute and Department of Medicine, Duke University School of MedicineCenter for the study of Aging and Human Development and the Geriatric Division, School of Medicine, Duke UniversityNational Institute of Environmental and Health, Chinese Center for Disease Control and PreventionAbstract Background Inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), and cognitive impairment (CI) are associated with mortality; CRP is related to the deterioration of CI. However, it is still unknown whether these two indices predict mortality independent of each other. Furthermore, their joint effect on all-cause mortality has not been well established, especially in oldest-old adults. Methods Based on data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we included 1447 oldest-old adults (mean age 84.7 years and 58.7% were female, weighted) with information on hs-CRP (stratified by a cutoff value of 3.0 mg/L) and cognition (quantified by Mini-Mental Status Examination (MMSE) scored according to the personal educational level) at baseline. Mortality was assessed in followed 2014 and 2017 waves. Cox proportional hazards regression models were used, with adjustment for hs-CRP and cognition (mutually controlled) and several traditional mortality risk factors. Results During a median follow-up period of 32.8 months (Q1-Q3, 9.7–59.0 months), 826 participants died. Hs-CRP [HR > 3.0 mg/L vs ≤ 3.0 mg/L: 1.64 (95% CI, 1.17, 2.30)] and cognition [HR CI vs normal: 2.30 (95% CI, 1.64, 3.21)] each was independent predictor of all-cause mortality, even after accounting for each other and other covariates. Monotonic and positive associations were observed in combined analyses, in which the highest mortality risk was obtained in elders with both high hs-CRP> 3.0 mg/L and CI [HR: 3.56 (95% CI, 2.35, 5.38)].The combined effects were stronger in male and younger oldest-old (aged 80–89 years). Conclusion High hs-CRP and CI, both individually and jointly, were associated with increased all-cause mortality risks in Chinese oldest-old. Intervention strategies for preventing inflammation and maintaining adequate cognitive function may be more important in male and younger oldest-old for reducing mortality risk.http://link.springer.com/article/10.1186/s12979-019-0170-yHs-CRPCognitionMortalityOldest-old |