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Journal of the American Geriatrics Society v.65 no.1, 2017년, pp.153 - 159   SCI SCIE SSCI
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T‐Cell Phenotypes Predictive of Frailty and Mortality in Elderly Nursing Home Residents

Johnstone, Jennie (Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada ) ; Parsons, Robin (McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada ) ; Botelho, Fernando (McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada ) ; Millar, Jamie (McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada ) ; McNeil, Shelly (Canadian Center for Vaccinology, IWK Health Center and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada ) ; Fulop, Tamas (Department of Medicine, Geriatrics Division, Research Center on Aging, University of Sherbrooke, Sherbrooke, Quebec, Canada ) ; McElhaney, Janet E. (Health Sciences North Research Institute, Sudbury, Ontario, Canada ) ; Andrew, Melissa K. (Department of Medicine, Dalhousie University, ) ; Walter, Stephen D. ; Devereaux, P.J. ; Malek, Mehrnoush ; Brinkman, Ryan R. ; Bramson, Jonathan ; Loeb, Mark ;
  • 초록  

    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.


  • 주제어

    immunosenescence .   immune biomarker .   frailty .   mortality .   nursing home.  

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