Cross-linked fibrin degradation products (D-dimer), plasma cytokines, and cognitive decline in community-dwelling elderly persons

J Am Geriatr Soc. 2003 Oct;51(10):1374-81. doi: 10.1046/j.1532-5415.2003.51454.x.


Objectives: To investigate the effect of coagulation and inflammatory pathway activation on future cognitive decline in older persons.

Design: Prospective cohort study.

Setting: Rural and urban communities in North Carolina.

Participants: Community-dwelling older people enrolled in the Duke Established Populations for Epidemiologic Studies of the Elderly in 1986.

Measurements: In 1992, blood was drawn for assay of D-dimer (1,723 subjects), Interleukin-6 (1,726 subjects), and other cytokines (1,551 subjects). Cognitive and functional assessments were performed in 1986, 1989, 1992, and 1996. Cognition was measured using the Short Portable Mental Status Questionnaire.

Results: Cognitive decline over a 4-year period was significantly correlated (P<.001) with D-dimer, age, race, and physical performance status as measured using the Rosow-Breslau and Nagi instruments. After controlling for demographics, functional status, and comorbidities, D-dimer remained predictive of cognitive decline. Proinflammatory cytokines were not associated with current cognitive status in cross-sectional analyses or with incident cognitive decline in prospective analyses.

Conclusion: In a large sample of community-dwelling elders, higher levels of D-dimer were predictive of cognitive decline over a 4-year period. No clinically significant associations were found between age-related peripheral cytokine dysregulation and cognition.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aging / blood*
  • Cognition Disorders / blood*
  • Cognition Disorders / epidemiology
  • Cytokines / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Humans
  • Male
  • North Carolina / epidemiology
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Statistics, Nonparametric
  • Surveys and Questionnaires


  • Cytokines
  • Fibrin Fibrinogen Degradation Products