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Anticardiolipin Antibodies and Physical Disability in the Elderly
- Jean-Yves Cesbron, MD;
- Ph Amouyel, MD, PhD; and
- Eric Masy, MD
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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.
Jean-Yves Cesbron, MD
Ph. Amouyel, MD, PhD
Institute Pasteur de Lille; 59019 Lille, France
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
