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. 2017 Aug;65(8):1777-1783.
doi: 10.1111/jgs.14876. Epub 2017 Mar 21.

Inflammatory Markers and Frailty in Long-Term Care Residents

Gabrielle A Langmann  1 , Subashan Perera  1   2 , Mary A Ferchak  1 , David A Nace  1 , Neil M Resnick  1 , Susan L Greenspan  1   3
Affiliations

Inflammatory Markers and Frailty in Long-Term Care Residents

Gabrielle A Langmann et al. J Am Geriatr Soc. 2017 Aug.

Abstract

Objectives: To determine whether proinflammatory biomarkers are associated with frailty assessed according to functional status, mobility, mental health, and falls over 24 months.

Design: Secondary analysis of a 2-year double-blind clinical trial for osteoporosis.

Setting: Nursing homes and assisted living facilities.

Participants: Women aged 65 and older with osteoporosis in long-term care (LTC) (N = 178).

Measurements: Baseline serum concentrations of proinflammatory cytokines and soluble receptors (high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNFα) and its two receptors (TNFα-R1 and TNFα-R2), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), IL-10), functional status assessed according to activities of daily living, the Nursing Home Physical Performance Test, gait speed, cognitive status, mental health, and falls.

Results: At baseline, older age was moderately associated with higher serum concentrations of hs-CRP (correlation coefficient (r) = 0.22), TNFα-R1 (r = 0.36), TNFα-R2 (r = 0.34), and IL-10 (r = 0.16) (all P < .05). Frail participants had significantly higher hs-CRP, TNFα-R1, TNFα-R2, IL-6, and IL-6-sR levels (all P < .05) than those nonfrail participants. Higher baseline hs-CRP and IL-6 levels were associated with worse physical performance and gait speed at 12 months independent of age, zoledronic acid use, and comorbidity (|r| = 0.25-0.30; all P < .05). Inflammatory markers were not significantly associated with incident falls.

Conclusions: Higher proinflammatory biomarker levels are associated with frailty and poorer function and mobility in older women residing in LTC facilities.

Keywords: cytokines; falls; frailty; gait speed; inflammation; long-term care; zoledronic acid.

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Figures

Figure 1
Figure 1
Baseline log-transformed inflammatory markers (mean ± SD) for (A) HS-CRP (high sensitivity C-reactive protein), (B) IL-6-sR (interleukin-6 soluble receptor), (C) tumor necrosis factor alpha receptor 1 (TNFα-R1) and (D) tumor necrosis factor alpha receptor 2 (TNFα-R2) by frailty category ap<0.05 for frail vs. non-frail bp<0.05 for pre-frail vs. non-frail cp<0.05 for frail vs. pre-frail
See this image and copyright information in PMC

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