title: Inflammatory markers and physical performance in middle-aged and older people in Indonesia.
abstract: BACKGROUND
  although recent studies have suggested that inflammation may play an important role in the process of ageing and in the development of disabilities, knowledge about the role of inflammation in physical performance decline among middle-aged and older people in the context of developing countries is limited.
  
  
  OBJECTIVE
  to examine the association between C-reactive protein (CRP) and the activities of daily living (ADL) among middle-aged (40-54 years old) and older (55-96 years old) people in Indonesia.
  
  
  METHODS
  data from a population-based sample, the Indonesia Family Life Survey (IFLS) 2007, were analysed. The data consist of 1,702 respondents of middle age (40-54 years old) and 2,017 older respondents who had completed information on ADL and CRP.
  
  
  METHODS
  CRP concentrations in Dried Blood Spot (DBS) specimens were measured, using the validated enzyme-linked immunosorbent assay (ELISA) method. Thirteen items of ADL were used to measure physical performance. A three-level linear model was applied to take advantage of the nested structure of data at the individual level within the household and community levels.
  
  
  RESULTS
  high levels of CRP were significantly associated with lower ADL for middle-aged and older people (P < 0.001). The model was adjusted for co-morbid conditions, health risk factors, medications, depressive symptoms and sociodemographic characteristics.
  
  
  CONCLUSIONS
  the significant association between the high level of CRP and lower ADL among older people in Indonesia is in line with earlier studies in the context of developed countries. This study provides an extension in which the significant association was also found in middle-aged people (40-54 years old).
authors.affiliation: Faculty of Public Administration, University of Brawijaya, Malang, Indonesia.
authors.forename: Sujarwoto
authors.initials: S
authors.lastname: Sujarwoto
authors.affiliation: Cathie Marsh Institute for Social Research, Manchester, Lancashire, UK.
authors.forename: Gindo
authors.initials: G
authors.lastname: Tampubolon
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007249:Inflammation / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Indonesia; inflammatory markers; middle age; older people; physical performance