Interleukin-6, C-reactive protein, and tumor necrosis factor-alpha as predictors of mortality in frail, community-living elderly individuals

Academic Article


  • OBJECTIVES: To investigate whether interleukin-6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α) protein levels predict all-cause mortality in older persons living in the community. DESIGN: Prospective cohort study. SETTING: Data were from the Aging and Longevity Study in the Sirente Geographic Area, a prospective cohort study. PARTICIPANTS: Individuals aged 80 and older living in an Italian mountain community (N=362). MEASUREMENTS: Participants were classified according to the median value of the three inflammation markers (IL-6, 2.08 pg/mL; TNF-α, 1.43 pg/mL; CRP, 3.08 mg/L). A composite summary score of inflammation was also created. The main outcome was risk of death after 4 years of follow-up. RESULTS: One hundred fifty deaths occurred during 4 years of follow-up. In the unadjusted model, high levels of each of the three markers were associated with greater mortality. After adjusting for potential confounders, high levels of IL-6 (hazard ratio (HR)=2.18, 95% confidence interval (CI)=1.29-3.69) and CRP (HR=2.58, 95% CI = 1.52-4.40) were associated with a significantly greater risk of death, whereas the association between TNF-α protein levels and mortality was no longer significant (HR=1.26, 95% CI=0.74-2.15). The composite summary score of inflammation was strongly associated with mortality, with the highest risk estimated for individuals with all three inflammatory markers above the median. CONCLUSION: Low levels of inflammatory markers are associated with better survival in older adults, independent of age and other clinical and functional variables. © 2011, Copyright the Authors.
  • Authors

    Digital Object Identifier (doi)

    Author List

  • Giovannini S; Onder G; Liperoti R; Russo A; Carter C; Capoluongo E; Pahor M; Bernabei R; Landi F
  • Start Page

  • 1679
  • End Page

  • 1685
  • Volume

  • 59
  • Issue

  • 9