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D-dimer and Aging

Once again, Kim Kinney (Clarian, Indianapolis) drives me to the books.

Hi George,
Every article I have ever read talks about age and increased dimer levels but I never have seen a reason. Why do dimers increase with age? Acute phase proteins?

Kim, yes, I suggest that D-dimer is a marker of inflammation, and not necessarily of aging. After getting your message I did some PubMed work, and came up with several articles. Here are citations for two of them:

McDermott MM, Guralnik JM, Greenland P, Green D, et al. Inflammatory and thrombotic blood markers and walking-related disability in men and women with and without peripheral arterial disease. J Am Geriatr Soc 2004;52:1888-94.

Their abstract indicates a positive correlation between D-dimer and C-reactive protein with walking-related disability.
Walston J, McBurnie MA, Newman A, Tracy RP, et al. Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the Cardiovascular Health Study.Arch Intern Med 2002;162:2333-41.

They used clinical scores for “frailty” and associated frailty with C-reactive protein, factor VIII and D-dimer.
From these and others, I propose that it may be inappropriate to establish reference intervals for a geriatric population without first separating healthy people from those with chronic disorders.

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