Inverted CD4:CD8 ratio is not associated with three-year mortality in a sample of community-dwelling oldest old: The octabaix immune study

摘要

Background: The presence of an immune risk phenotype (IRP) has been correlated with survival rates in elderly people. Objective: To determine whether an inverted CD4:CD8 ratio might be a marker of IRP in a sample of oldest old by assessing its relationship with mortality. Design: Prospective cohort study. Setting: Community-based survey study of seven primary healthcare centres. Participants: 328 people bom in 1924 and registered with primary healthcare centres. Measurements: Chronic drug prescription, functional status (Barthel and Lawton indexes) and cognitive status (Spanish version of the Mini-Mental State Examination) were recorded. CD4:CD8 ratios were determined, with a ratio of 1.00 or less being used to define IRP. Results: The CD4:CD8 ratio was 1.00 or less in 47 subjects (15.6%). After three years, 51 subjects had died (16.3%); 9 were from among the 47 (19.1%) with an inverted CD4:CD8 ratio and 42 (15.8%) from the remainder (P=0.52). Multivariate analysis identified two significant clinical variables (Lawton Index scores and the number of chronic drugs prescribed) as being independent predictors of three-year mortality risk in this cohort of octogenarians. This risk profile did not change when introducing the CD4:CD8 ratio into the calculation. Conclusion: In this community-dwelling population of oldest old (85 years old at baseline) an inverted CD4:CD8 ratio was not associated with three-year mortality.