Rheumatoid arthritis in a population of persons aged 85 years and over.

A Dutch urban population of 977 persons aged 85 years and over was examined for the presence of rheumatoid arthritis (RA). Prevalence rates for definite RA, past polyarthritis with joint deformation and past polyarthritis without joint deformation were 0.3%, 0.

The prevalence of morbidity in the oldest old, aged 85 and over: a population-based survey in Leiden, The Netherlands.

The Leiden 85-plus study has investigated the prevalence of morbidity in the total population of the Dutch community of Leiden (population 105 000) aged 85 and over, including both independently living and institutionalized elderly. The participation rate of 94% of all living elderly (n = 1037) and 78% of the initial cohort (n = 1259) was exceptionally high. Information was obtained on past and present diseases by taking a medical history.

Serum immunoglobulin class and IgG subclass levels and the occurrence of homogeneous immunoglobulins during the course of ageing in humans.

Serum levels of IgM and IgA classes and of IgG subclasses were determined and related to the presence of homogeneous immunoglobulin components (H-Ig) in volunteers equally distributed in age groups from 25 to 98 years, who all met the Senieur admission criteria for immunogerontological studies. In addition, sera of non-Senieur volunteers aged 75 years and older were included. Furthermore, the amount of IgD was determined in sera of Senieur individuals equally distributed in age groups from 15 to 98 years.

Influence of ageing on antibody formation in vivo after immunisation with the primary T-cell dependent antigen Helix pomatia haemocyanin.

The in vivo antibody response to the primary T-cell dependent antigen Helix pomatia Haemocyanin (HPH) was studied, in order to detect the possible presence of a humoral immune deficiency in ageing. The IgG subclass distribution of the specific antibodies was also determined. In order to define a dose of HPH which could be used to discriminate between the responsiveness of healthy and immunocompromised individuals, we first established a dose-response curve for this antigen in 60 healthy young volunteers.

Age-related changes of the antigen-specific antibody formation in vitro and PHA-induced T-cell proliferation in individuals who met the health criteria of the Senieur protocol.

The antigen-specific antibody secretion in vitro after immunisation with the primary T-cell dependent antigen Helix pomatia Haemocyanin (HPH) was investigated in both young and elderly individuals, who all met the health admission criteria for immunogerontological studies as detailed in the SENIEUR protocol. In addition, elderly non-Senieur persons were incorporated in this study. Young and elderly Senieur volunteers were fully comparable in terms of the occurrence of anti-HPH antibody secreting cells after in vitro simulation of peripheral blood mononuclear cells with variable doses of the antigen.

Prevalence of dementia in the 'oldest old' of a Dutch community.

Objective: To estimate the prevalence rate of dementia in subjects 85 years of age and over.

Design: A two-phase design with the Mini-Mental State Examination (MMSE) in the screening phase and the Geriatric Mental State Schedule (GMS) in the diagnostic phase.

Setting: Community survey including subjects in residential care.

Longevity and heredity in humans. Association with the human leucocyte antigen phenotype.

Several arguments support the idea of a link between longevity and heredity, both in experimental animals and in the human species. In mice, genes in the major histocompatibility complex (MHC) are associated with a significant effect on life span. Results of analogous studies in man are confusing and contradictory.

Gating of the so-called 'lymphocytic' cell population for the quantification of natural killer cells (CD16+) by flow cytometry causes loss of CD16 positive cells.

Natural killer cells can phenotypically be identified as CD16 positive with a specific monoclonal antibody (B73.1 = Leu-11c) by either immunofluorescence microscopy or by flow cytometry. The standard procedure in flow cytometry is to set a window or gate around the so called lymphocytic population, based on scatter characteristics.

Reference values for the Mini-Mental State Examination (MMSE) in octo- and nonagenarians.

The Mini-Mental State Examination (MMSE) was used in a population survey of all inhabitants of Leiden, the Netherlands, over 85 years (n = 1258). In this paper we report on 532 subjects without neurological or psychiatric disease. Results show that the median score and lowest quartile cut-off score remain high until the tenth decade (median score = 28, lowest quartile cut-off score = 26).

Necessity of the assessment of health status in human immunogerontological studies: evaluation of the SENIEUR protocol.

Disease is frequent in ageing, and the many conflicting results in studies of the ageing process can be due to the presence of factors such as underlying disease or the use of medication. For immunogerontology, a solution to this problem was initiated in 1984 by a working party of EURAGE, the European Community's Concerted Action Programme on Ageing and Diseases. A protocol defining strict admission criteria to studies of ageing, the SENIEUR protocol, was elaborated.

Monoclonal gammopathies in human aging: increased occurrence with age and correlation with health status.

To determine the incidence of monoclonal gammopathies (MG) in relation to the aging process as such, and to evaluate the influence of disease on the occurrence of MG, we studied 439 elderly subjects aged 75-84 years. These individuals were categorized into 4 groups on the basis of their health status. There was a group of "optimally healthy" elderly, a group of "apparently healthy" residents of homes for the aged, a group of geriatric outpatients and a group of randomly chosen inpatients from a general hospital.

Natural killer cell function is not diminished in the healthy aged and is proportional to the number of NK cells in the peripheral blood.

We studied natural killer (NK) cell subsets and NK function in young (25-35 years) and aged (75-84 years) persons by means of the single-cell assay. The subjects admitted to the study all fulfilled the SENIEUR health criteria in order to avoid confounding factors such as underlying disease or the influence of medication. We found no significant difference in the NK function between healthy young and aged persons on a per cell basis.

The expanded null cell compartment in ageing: increase in the number of natural killer cells and changes in T-cell and NK-cell subsets in human blood.

Analysis of the subpopulations of mononuclear cells in human blood in ageing has revealed a striking increase in the number of null cells, defined as non-T, non-B, non-monocyte cells, and a decrease in the number of T and B cells. By using recently developed monoclonal antibodies against natural killer cells in combination with T-cell markers in two-wavelength immunofluorescence, we were able to define 13 subpopulations of mononuclear cells and compare them in two groups of persons, respectively aged 25-34 and 75-84 years, all fulfilling the stringent admission criteria for immunogerontological studies described in the SENIEUR protocol, and thus all to be considered as optimally healthy and immunologically uncompromised. We found that the increased null cell population in the aged is a result of an increase in the numbers of NK cells, mostly the CD16+Leu7+ subset.

Intracellular immunoglobulin G 'pseudocrystals' in a patient with chronic B-cell leukemia.

A patient with chronic B-cell leukemia in whom the malignant lymphocytes showed intracellular inclusions of immunoglobulin (Ig) G kappa molecules is described. Electron microscopy revealed filamentous material in the nuclear envelopes and in the cisternae of the rough endoplasmic reticulum. These in vivo surface Ig-negative, nonexcreting cells could be stimulated in vitro to excrete immunoglobulin-free light chain molecules into the supernatant, which were not found in the cytoplasm after stimulation.

[Problems of aging in China].

A WHO consultancy to the 'National Seminar on Geriatrics' in Beijing provided an opportunity to get some ideas about the problems of ageing in China. Since 1949 life expectancy has doubled and it has been estimated that between now and the end of the century the 65+ group will double to a total of approximately 100 million people. This will be the fastest growing ageing population in history.

Subpopulations of mononuclear cells in ageing: expansion of the null cell compartment and decrease in the number of T and B cells in human blood.

Study of the immune system in ageing has yielded conflicting results. These controversies are mainly due to the selection of the subjects studied. We investigated the mononuclear cell subpopulations in the peripheral blood of subjects fulfilling strict admission criteria meant to exclude persons with diseases that influence the immune system.

Chronic B-cell leukemias: relation between morphological and immunological features.

To better understand the heterogeneity of chronic B-cell leukemias we correlated morphological and immunological features by studying the peripheral blood from 80 patients with a panel of anti-immunoglobulin and fourteen monoclonal antibodies, which hitherto were studied separately or with respect to one single morphological entity only. Of these the surface immunoglobulins (sIg) and monoclonal antibodies (McAb) BA-1, BA-2, FMC7, OKM1, and anti-T65 allowed a fair distinction between five cytological subtypes: chronic lymphocytic (CLL), "lymphoplasmacytoid" (LPL), centrocytic (CL), prolymphocytic (PLL), and hairy cell leukemia (HCL). In that order the sIg showed a decreasing number of cases of mu +/- delta class and an increase of alpha or gamma positivity.

Light and electron microscopic studies of the rat hyalocyte after perfusion fixation.

The characteristic morphology of a not intentionally stimulated hyalocyte is described, using TEM and perfusion fixation. The best results were obtained by retrograde perfusion via the abdominal aorta with a glutaraldehyde- and formaldehyde-containing fixative. The cells, situated in the cortical area of the vitreous body, show mostly an indented nucleus, primary and secondary lysosomes, mitochondria, cisterna, clusters of free ribosomes and a Golgi apparatus.

Hairy cell leukemia: its place among the chronic B cell leukemias.

Hairy cell leukemia is a chronic B cell leukemia. The presence of surface Ig (SIg) of gamma or multiple isotypes on the cells locates HCL at a rather mature stage of B cell differentiation. The reactivity of HC with McAb is in accordance with this concept (T65-, OKM1+, FMC7+, BA-1-).

Admission criteria for immunogerontological studies in man: the SENIEUR protocol.

Immunogerontological studies in man have often led to conflicting results. One of the main reasons is the selection of the subjects to be studied. Admission criteria such as "apparently healthy" or "without overt disease" seem insufficient to exclude underlying disease which might influence the immune system and thereby the results.

Autoantibodies in highly aged humans.

The presence of 14 different autoantibodies was determined in 65 persons, aged 95 years and older, without overt disease. The prevalence of positive anti-immunoglobulin latex tests, of autoantibodies against nuclear components and against thyroid microsomes was significantly increased. This selective increase of autoantibodies of low titre and without cluster formation is considered to be the result of a loss of control within the immune system due to ageing, rather than as a sign of latent disease.