A Clinical Significance of High-Sensitivity C-reactive Protein Level in Alzheimer's Disease and Vascular Dementia

Min-Jeong Wang; Eun-Ye Lim; Young-Do Kim; In-Uk Song; Sung-Woo Chung; Young-Soon Yang

doi:10.12779/dnd.2012.11.4.131

Journal List > Dement Neurocogn Disord > v.11(4) > 1120793

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Wang, Lim, Kim, Song, Chung, and Yang: A Clinical Significance of High-Sensitivity C-reactive Protein Level in Alzheimer's Disease and Vascular Dementia

Original Article

Dementia and Neurocognitive Disorders

Dementia and Neurocognitive Disorders 2012; 11(4): 131-135.

Published online: 31 December 2012

DOI: https://doi.org/10.12779/dnd.2012.11.4.131

A Clinical Significance of High-Sensitivity C-reactive Protein Level in Alzheimer's Disease and Vascular Dementia

Min-Jeong Wang, M.D., Eun-Ye Lim, M.D., Young-Do Kim, M.D., In-Uk Song, M.D., Sung-Woo Chung, M.D., Young-Soon Yang, M.D.^*

Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

^*Department of Neurology, Veterans Hospital, Seoul Medical Center, Seoul, Korea.

Address for correspondence: In-Uk Song, M.D. Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon 403-720, Korea. Tel: +82-32-280-5010, Fax: +82-32-280-5244, siuy@cmcnu.or.kr

Received 9 October 2012 Revised 9 October 2012 Accepted 12 November 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

There is increasing evidence about inflammatory processes in the development of dementia. Therefore, inflammation has been believed to play a pivot role in cognitive decline, Alzheimer's disease (AD), and vascular dementia. High-sensitivity C-reactive protein (hs-CRP) is a sensitive systemic marker of inflammation, and increased levels of hs-CRP are associated with inflammatory reactions. It is important to identify modifiable risk factors, which could be used in preventing or delaying the onset of dementia. Therefore, we studied to clarify a clinical role of hs-CRP in AD and VaD.

Methods

This study population consisted of a sample of 102 patients with dementia (54 patients of AD and 48 patients of VaD) and 91 controls. We have investigated hs-CRP levels and cognitive function of each group. Cognitive function was evaluated with Mini-Mental State Examination (MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating (CDR) with Sum of Box and Activities of Daily Living (ADL).

Results

All subjects with dementia showed higher hs-CRP levels than subjects without dementia. But, there was no significant difference of hs-CRP levels between patients with AD and those with VaD. The odds ratio of patients with AD and VaD by hs-CRP is 2.250 (95% Cl 1.670-3.032) for Alzheimer's disease and 4.0 (95% Cl 2.451-6.529) for vascular dementia.

Conclusions

The result of our study suggests the presence of inflammatory activity is related with dementia, not only AD known to degenerative disease but also VaD associated with cerebrovascular disease. However, we could suggest that dementia with cerebrovascular lesions is more related with inflammatory activity than AD.

Keywords: Inflammation, High-sensitivity C-reactive protein, Alzheimer's disease, Vascular dementia

Figures and Tables

Fig. 1

Mean hs-CRP value of patients with Alzheimer's disease (AD) and Vascular dementia (VaD) compared with normal controls. Mean hs-CRP value of AD and VaD patients are higher than normal controls (AD: 2.53±7.42, VaD: 1.39±1.77, Normal control: 0.074±0.06). The differences of hs-CRP value between AD and VaD patients are not significant statistically (p=0.768).

Fig. 2

Odds Ratio and 95% confidence interval (CI) of patients with Alzheimer's disease (AD) and Vascular dementia (VaD) compared with normal controls for high-sensitivity C-reactive protein (hs-CRP). Values are expressed as odd ratio (95% CI). Rectangles indicate odds ratio and vertical lines represent 95% CIs.

Table 1

Clinical characteristics of patients with dementia and without dementia

Values were expressed mean±standard deviation. p values were measured by Mann-Witney U-test and Krusal-Wallis test. hs-CRP: AD=VaD>Control, MMSE: AD=VaD<control.

^*Kruskal-Wallis test was performed.

AD, Alzheimer's disease; VaD, Vascular dementia; ND, not done; hs-CRP, high sensitivity C-reactive protein; MMSE, Mini-mental state examination; GDS, Global Deterioration Scale; CDR, clinical dementia scale; SOB, sum of box of CDR; HIS, Hachinski ischemic scale.

Table 2

Relation between hs-CRP and variables in AD and VaD

Values are Spearman's rank order correlation coefficients and p value.

AD, Alzheimer's disease; VaD, Vascular dementia; hs-CRP, high sensitivity C-reactive protein; MMSE, Mini-mental state examination; GDS, Global Deterioration Scale; CDR, clinical dementia scale; SOB, sum of box of CDR; ADL, Activity of daily living.

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