Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 1:139:111055.
doi: 10.1016/j.exger.2020.111055. Epub 2020 Aug 11.

Inflammation as a risk factor for the development of frailty in the Lothian Birth Cohort 1936

Miles Welstead  1 , Graciela Muniz-Terrera  2 , Tom C Russ  3 , Janie Corley  4 , Adele M Taylor  4 , Catharine R Gale  5 , Michelle Luciano  4
Affiliations

Inflammation as a risk factor for the development of frailty in the Lothian Birth Cohort 1936

Miles Welstead et al. Exp Gerontol. .

Abstract

Background: Research suggests that frailty is associated with higher inflammation levels. We investigated the longitudinal association between chronic inflammation and frailty progression.

Methods: Participants of the Lothian Birth Cohort 1936, aged 70 at baseline were tested four times over 12 years (wave 1: n = 1091, wave 4: n = 550). Frailty was assessed by; the Frailty Index at waves 1-4 and Fried phenotype at waves 1, 3 and 4. Two blood-based inflammatory biomarkers were measured at wave 1: Fibrinogen and C-reactive protein (CRP).

Results: Fully-adjusted, linear mixed effects models showed higher Fibrinogen was significantly associated with higher wave 1 Frailty Index score (β = 0.011, 95% CI[0.002,0.020], p < .05). Over 12 year follow-up, higher wave 1 CRP (β = 0.001, 95% CI[0.000,0.002], p < .05) and Fibrinogen (β = 0.004, 95% CI[0.001,0.007], p < .05) were significantly associated with increased Frailty Index change. For the Fried phenotype, wave 1 Pre-frail and Frail participants had higher CRP and Fibrinogen than Non-frail participants (p < .001). Logistic regression models calculated risk of worsening frailty over follow-up and we observed no significant association of CRP or Fibrinogen in minimally-adjusted nor fully-adjusted models.

Conclusions: Findings showed a longitudinal association of higher wave 1 CRP and Fibrinogen on worsening frailty in the Frailty Index, but not Fried Phenotype. A possible explanation for this disparity may lie in the conceptual differences between frailty measures (a biopsychosocial vs physical approach). Future research, which further explores different domains of frailty, as well the associations between improving frailty and inflammation levels, may elucidate the pathway through which inflammation influences frailty progression. This may improve earlier identification of those at high frailty risk.

Keywords: Healthy ageing; Longitudinal; Risk factor; Trajectory.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors have no competing interests to declare. Age UK and MRC are involved in funding the recruitment and data collection for the Lothian Birth Cohort 1936. The sponsor had no role in the design, methods, analysis and preparation of paper.

Figures

Fig. 1
Fig. 1
A plot of Frailty Index trajectories and estimated mean over the course of follow-up.
Fig. A1
Fig. A1
A plot of CRP levels the course of follow-up.
Fig. A2
Fig. A2
A plot of Fibrinogen levels over the course of follow-up.
See this image and copyright information in PMC

References

    1. Aguayo G.A., Donneau A.-F., Vaillant M.T., Schritz A., Franco O.H., Stranges S., Malisoux L., Guillaume M., Witte D.R. Agreement between 35 published frailty scores in the general population. Am. J. Epidemiol. 2017;186:420–434. - PMC - PubMed
    1. Baylis D., Bartlett D.B., Syddall H.E., Ntani G., Gale C.R., Cooper C., Lord J.M., Sayer A.A. Immune-endocrine biomarkers as predictors of frailty and mortality: a 10-year longitudinal study in community-dwelling older people. Age. 2013;35:963–971. - PMC - PubMed
    1. Buuren Sv, Groothuis-Oudshoorn K. Mice: multivariate imputation by chained equations in R. J. Stat. Softw. 2010:1–68.
    1. Chamberlain A.M., Sauver J.L.S., Jacobson D.J., Manemann S.M., Fan C., Roger V.L., Yawn B.P., Rutten L.J.F. Social and behavioural factors associated with frailty trajectories in a population-based cohort of older adults. BMJ Open. 2016;6 - PMC - PubMed
    1. Corley J., Kyle J.A., Starr J.M., McNeill G., Deary I.J. Dietary factors and biomarkers of systemic inflammation in older people: the Lothian Birth Cohort 1936. Br. J. Nutr. 2015;114:1088–1098. - PMC - PubMed

Publication types