Elevated Levels of High-Sensitivity C-Reactive Protein are Associated with Mild Cognitive Impairment and its Subtypes: Results of a Population-Based Case-Control Study

Article type: Research Article

Authors: Dlugaj, Martha^{a; *} | Gerwig, Marcus^a | Wege, Natalia^b | Siegrist, Johannes^b | Mann, Klaus^c | Bröcker-Preuß, Martina^d | Dragano, Nico^e | Moebus, Susanne^e | Jöckel, Karl-Heinz^e | Bokhof, Beate^e | Möhlenkamp, Stefan^f | Erbel, Raimund^f | Weimar, Christian^a | on behalf of the Heinz Nixdorf Recall Study Investigative Group

Affiliations: [a] Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany | [b] Department of Medical Sociology, University of Düsseldorf, Düsseldorf, Germany | [c] Department of Endocrinology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany | [d] Department of Endocrinology, Division of Laboratory Research, University Hospital of Essen, University Duisburg-Essen, Essen, Germany | [e] Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany | [f] Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Essen, Germany

Correspondence: [*] Correspondence to: Martha Dlugaj, Dipl.-Psych., University Hospital Essen, Department of Neurology, Hufelandstr. 55, 45147 Essen, Germany. Tel.: +49 201 723 2588; Fax: +49 201 723 5953; E-mail: [email protected].

Abstract: As high-sensitivity C-reactive protein (hsCRP) seems to be associated with an increased risk of cognitive decline, this nested case-control study examined the relation of hsCRP and mild cognitive impairment (MCI) at different time points. 148 MCI cases (106 amnestic, 42 non-amnestic (aMCI/naMCI)) and 148 matched controls were identified from a prospective population based cohort study of 4,359 participants (aged 50–80). HsCRP levels were measured 5 years before (baseline) and at the time of neuropsychological testing (follow-up). Odds ratios (OR) for hsCRP quartiles serum levels were calculated for the two time points using logistic regression analyses and were adjusted for cardiovascular covariates. In the fully adjusted model, baseline hsCRP levels were significantly associated with both MCI and aMCI (OR = 2.29, 95% confidence interval (CI), 1.01–5.15, first versus fourth quartile, respective OR = 2.73, 95% CI, 1.09–6.84). At follow-up, the fourth hsCRP quartile was associated with MCI (OR = 3.60, 95% CI, 1.55–8.33), aMCI (OR = 3.73, 95% CI, 1.52–9.17) and naMCI (OR = 3.66, 95% CI, 1.00–13.77). Elevated hsCRP levels, even detected five years before diagnosis, are associated with an at least twofold increased probability of MCI. These findings suggest that inflammation plays an important role in the development and presence of cognitive impairment.

Keywords: Case-control study, high-sensitivity C-reactive protein (hsCRP), inflammation, mild cognitive impairment (MCI)

DOI: 10.3233/JAD-2011-111352

Journal: Journal of Alzheimer's Disease, vol. 28, no. 3, pp. 503-514, 2012