Inflammatory Markers and Frailty in Long-Term Care Residents

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.