title: Understanding red blood cell parameters in the context of the frailty phenotype: interpretations of the FIBRA (Frailty in Brazilian Seniors) study.
abstract: Frailty and anemia in the elderly appear to share a common pathophysiology associated with chronic inflammatory processes. This study uses an analytical, cross-sectional, population-based methodology to investigate the probable relationships between frailty, red blood cell parameters and inflammatory markers in 255 community-dwelling elders aged 65 years or older. The frailty phenotype was assessed by non-intentional weight loss, fatigue, low grip strength, low energy expenditure and reduced gait speed. Blood sample analyses were performed to determine hemoglobin level, hematocrit and reticulocyte count, as well as the inflammatory variables IL-6, IL-1ra and hsCRP. In the first multivariate analysis (model I), considering only the erythroid parameters, Hb concentration was a significant variable for both general frailty status and weight loss: a 1.0g/dL drop in serum Hb concentration represented a 2.02-fold increase (CI 1.12-3.63) in an individual's chance of being frail. In the second analysis (model II), which also included inflammatory cytokine levels, hsCRP was independently selected as a significant variable. Each additional year of age represented a 1.21-fold increase in the chance of being frail, and each 1-unit increase in serum hsCRP represented a 3.64-fold increase in the chance of having the frailty phenotype. In model II reticulocyte counts were associated with weight loss and reduced metabolic expenditure criteria. Our findings suggest that reduced Hb concentration, reduced RetAbs count and elevated serum hsCRP levels should be considered components of frailty, which in turn is correlated with sarcopenia, as evidenced by weight loss.
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University-Unicamp, Brazil.
authors.forename: João Carlos
authors.initials: JC
authors.lastname: Silva
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University-Unicamp, Brazil.
authors.forename: Zélia Vieira de
authors.initials: ZV
authors.lastname: Moraes
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University-Unicamp, Brazil.
authors.forename: Conceição
authors.initials: C
authors.lastname: Silva
authors.affiliation: Department of Clinical Pathology, Faculty of Medical Sciences, Campinas State University-Unicamp, Brazil.
authors.forename: Silvia de Barros
authors.initials: Sde B
authors.lastname: Mazon
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University-Unicamp, Brazil.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Guariento
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University-Unicamp, Brazil.
authors.forename: Anita Liberalesso
authors.initials: AL
authors.lastname: Neri
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University-Unicamp, Brazil. Electronic address: afattori@fcm.unicamp.br.
authors.forename: André
authors.initials: A
authors.lastname: Fattori
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004906:Erythrocyte Count; D005221:Fatigue / Q000097:blood; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D005684:Gait; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D018737:Hand Strength; D006400:Hematocrit / Q000379:methods; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D015999:Multivariate Analysis; D010641:Phenotype; D015995:Prevalence; D012111:Residence Characteristics; D055948:Sarcopenia / Q000097:blood*; D017678:Sex Distribution; D015431:Weight Loss / Q000502:physiology
chemical_list: D006454:Hemoglobins; D015850:Interleukin-6
keywords: (red blood cell distribution width) RDW; Anemia; Elderly; Frailty; Reticulocytes