Abstract

BACKGROUND:

Elevated systematic inflammation is a hallmark of aging, but the association of long-term inflammation trajectories with subsequent aging phenotypes has been little examined. We assessed inflammatory marker C-reactive protein (CRP) repeatedly over time and examined whether long-term changes predicted aging outcomes.

METHODS:

A total of 2,437 men and women aged 47-87 years at baseline (1998-2001) who were participants in the English Longitudinal Study of Ageing had CRP measured on two or three occasions between 1998 and 2009. Inflammation trajectories were computed using latent-class growth mixture modelling and were related to aging outcomes measured in 2012/2013: physical functioning, cardiometabolic, respiratory, mental health, and a composite "healthy aging" outcome.

RESULTS:

Four CRP trajectories were identified: 'stable-low' (71% of the sample) with baseline mean 1.33mg/L remaining <3mg/L; 'medium-to-high' (14%) with baseline 2.7mg/L rising to 5.3mg/L; 'high-to-medium' (10%) with baseline 6.6mg/L decreasing to 2.4mg/L; 'stable-high' (5%) with levels from 5.7 to 7.5mg/L. Relative to the stable-low trajectory, individuals in the medium-to-high had a higher risk of limitations in basic activities of daily living (ADL, Odds Ratio; 95% Confidence Interval: 2.09; 1.51,2.88), instrumental ADL (1.62; 1.15,2.30), impaired balance (1.59; 1.20,2.11) and walking speed (1.61; 1.15,2.24), arthritis (1.55; 1.16,2.06), hypertension (1.57; 1.21,2.04), obesity (1.95; 1.36,2.80), poor respiratory function (1.84; 1.36,2.50), and depression (1.55; 1.13,2.12). A lower odds of healthy aging was observed in people in the medium-to-high (0.57; 0.40,0.79) and stable-high (0.50; 0.27,0.91) trajectories.

CONCLUSIONS:

Older people who displayed an elevation in CRP levels over a decade experienced an increased risk of adverse aging outcomes.