T‐Cell Phenotypes Predictive of Frailty and Mortality in Elderly Nursing Home Residents
Objectives To determine whether immune phenotypes associated with immunosenescence are predictive of frailty and mortality within 1‐year in elderly nursing home residents. Design Cross sectional study of frailty; prospective cohort study of mortality. Setting Thirty‐two nursing homes in four Canadian cities between September 2009 and October 2011. Participants Nursing home residents aged 65 and older (N = 1,072, median age 86, 72% female). Measurements After enrollment, peripheral blood mononuclear cells were obtained and analyzed using flow cytometry for CD4 + and CD8 + T‐cell subsets (naIve, memory (central, effector, terminally differentiated, senescent), and regulatory T‐cells) and cytomegalovirus (CMV)‐reactive CD4 + and CD8 + T‐cells. Multilevel linear regression analysis was performed to determine the relationship between immune phenotypes and frailty; frailty was measured at the time of enrollment using the Frailty Index. A Cox proportional hazards model was used to determine the relationship between immune phenotypes and time to death (within 1 year). Results Mean Frailty Index was 0.44 ± 0.13. Multilevel regression analysis showed that higher percentages of naIve CD4 + T‐cells ( P = .001) and effector memory CD8 + T‐cells ( P = .02) were associated with a lower mean Frailty Index, whereas a higher percentage of CD8 + central memory T‐cells was associated with a higher mean Frailty Index score ( P = .02). One hundred fifty one (14%) members of the cohort died within 1 year. Multivariable analysis showed a significant negative multiplicative interaction between age and percentage of CMV‐reactive CD4 + T‐cells (hazard ratio = 0.87, 95% confidence interval = 0.79–0.96). No other significant factors were identified. Conclusion Immune phenotypes found to be predictive of frailty and mortality in this study can help further understanding of immunosenescence and may provide a rationale for future intervention studies designed to modulate immunity.
- 원문이 없습니다.
유료 다운로드의 경우 해당 사이트의 정책에 따라 신규 회원가입, 로그인, 유료 구매 등이 필요할 수 있습니다. 해당 사이트에서 발생하는 귀하의 모든 정보활동은 NDSL의 서비스 정책과 무관합니다.
NDSL에서는 해당 원문을 복사서비스하고 있습니다. 위의 원문복사신청 또는 장바구니 담기를 통하여 원문복사서비스 이용이 가능합니다.
- 이 논문과 함께 출판된 논문 + 더보기