Slow gait, white matter characteristics, and prior 10-year interleukin-6 levels in older adults

Neurology. 2016 Nov 8;87(19):1993-1999. doi: 10.1212/WNL.0000000000003304. Epub 2016 Oct 12.

Abstract

Objective: To examine the relationship between gait speed and prior 10 years interleukin-6 (IL-6) burden in older adults. We then assessed whether white matter characteristics influence this relationship.

Methods: In 179 community-dwelling older adults, gait speed was assessed on an automated walkway and serum IL-6 was assayed on ELISA. Concurrently, white matter characteristics were assessed on MRI by quantifying volume of white matter hyperintensities (WMH), a marker of small vessel disease, and normal-appearing white matter on fractional anisotropy (NAWM-FA), a marker of axonal integrity. IL-6 was assayed at regular intervals at gait assessment and over the prior 10 years and estimates of sustained 10-year IL-6 exposure and the rate of change in IL-6 over 10 years were obtained. Multivariate linear regressions were used to examine the relationships among sustained IL-6 exposure, rate of change in IL-6, gait speed, and white matter characteristics.

Results: In this sample (age 83 years, 58% female, 41% black, gait speed 0.9 m/s), higher sustained IL-6 levels, but not the rate of change in IL-6 or IL-6 at gait assessment, was significantly related to slower gait (β = -0.27, p < 0.001) and to higher WMH (β = 0.23, p = 0.002), but not NAWM-FA, withstanding covariate adjustments. WMH accounted for 30% attenuation in the relationship between higher sustained IL-6 levels and slower gait speed (p = 0.043) in the mediation analyses.

Conclusions: Sustained exposure to high IL-6 over 10 years rather than the rate of change in IL-6 or an isolated high IL-6 level may adversely affect gait speed by influencing cerebral WMH.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Enzyme-Linked Immunosorbent Assay
  • Fasting / blood
  • Female
  • Gait Disorders, Neurologic / blood*
  • Gait Disorders, Neurologic / physiopathology*
  • Humans
  • Independent Living
  • Interleukin-6 / blood*
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Neurologic Examination
  • White Matter / diagnostic imaging
  • White Matter / pathology*

Substances

  • IL6 protein, human
  • Interleukin-6