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LETTER

Anticardiolipin Antibodies and Physical Disability in the Elderly

right arrow Jean-Yves Cesbron, MD; Ph Amouyel, MD, PhD; and Eric Masy, MD

15 June 1997 | Volume 126 Issue 12 | Page 1003


TO THE EDITOR:

Anticardiolipin antibodies (aCL) are associated with an increased risk for vascular thromboses in cerebral, retinal, coronary, and peripheral venous and arterial vessels in young populations [1, 2]. Serum levels of aCL increase significantly with age [3], but the impact of these higher concentrations is largely unknown [4].

We addressed this question in a random sample of 1042 French men and women older than 60 years of age [5] who were recruited from the retirement homes in the Nord department (an administrative region of France). For each study participant, disabilities were assessed and classified as "none" (when the participant's abilities allowed him or her to perform routine activities), "some" (when abilities were impaired and the participant needed occasional help), or "disabled" (when a third party was necessary). The Mini-Mental State Examination was administered to all participants to estimate cognitive status. Disease diagnoses were collected during examination and confirmed from relevant inpatient and outpatient medical records. The serum levels of IgG and IgM aCL were measured (BioMed Diagnostic, Marnes La Vallee, France) and were considered to be positive when both levels were greater than 15 UP, negative when both levels were less than 10 UP, and intermediate otherwise (1 UP = the concentration of aCL able to detect 1 µg of cardiolipin coated onto the plates).

As expected [3], the proportion of participants negative for aCL tended to decrease significantly as age increased (Table 1). Disabled participants had positive levels of aCL more frequently than the rest of the sample (Table 1). Multivariate logistic regression analysis showed that this association was independent of age, sex, level of education, visual and aural disabilities, Mini-Mental State Examination scores, and history of cardiovascular or vascular cerebral diseases (adjusted odds ratio, 2.24 [95% CI, 1.43 to 3.51]; P < 0.001). According to these results, high aCL levels seem to be associated with physical disability at older ages. This association suggests that aCL may have a pathogenic role in older persons.


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Table 1. Anticardiolipin Antibody Status according to Age and Physical Disability

 


Author and Article Information
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Institute Pasteur de Lille, 59019 Lille, France
Faculte de Medecine de Lille, 59019 Lille, France


References
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1. Shapiro SS. The lupus antigoagulant/antiphospholipid syndrome. Annu Rev Med. 1996; 47:533-53.

2. Hughes GR. The antiphospholipid syndrome: ten years on. Lancet. 1993; 342:341-4.

3. Mannoussakis MN, Tzioufas AG, Silis AG, Pange PJ, Goudevenous J, Moutsopoulos HM. High prevalence of anticardiolipin antibody and other autoantibodies in healthy population. Clin Exp Immunol. 1987; 69:557-65.

4. Tohgi H, Takahashi H, Kashiwaya M, Watanabe K, Hayama K. The anticardiolipin antibody in elderly stroke patients: its effects on stroke types, recurrence, and the coagulation-fibrinolysis system. Acta Neurol Scand. 1994; 90:86-90.

5. Amouyel P, Cottel D, Berr C, Vidal O, Brousseau T. {epsilon}4 allele of the apolipoprotein E gene is a potent risk factor for cognitive impairment. Neurobiol Aging. 1994; 15:S43.

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