title: Biochemical measures and frailty in people with intellectual disabilities.
abstract: BACKGROUND
  People with intellectual disabilities (ID) are earlier frail than people in the general population. Although this may be explained by lifelong unfavourable social, psychological and clinical causes, underlying physiological pathways might be considered too. Biological measures can help identify pathophysiological pathways. Therefore, we examined the association between frailty and a range of serum markers on inflammation, anaemia, the metabolic system, micronutrients and renal functioning.
  
  
  METHODS
  Participants (n = 757) with borderline to severe ID (50+) were recruited from three Dutch ID care and support services.
  
  
  RESULTS
  Frailty was measured with a frailty index, a measure based on the accumulation of deficits. Linear regression analyses were performed to identify associations between frailty and biochemical measures independent of age, gender, level of ID and the presence of Down syndrome. Frailty appears associated with inflammation (IL-6 and CRP), anaemia, metabolic markers (glucose, cholesterol and albumin) and renal functioning (cystatin-C and creatinine).
  
  
  CONCLUSIONS
  These results are in line with results observed in the general population. Future research needs to investigate the causal relation between biochemical measures and frailty, with a special focus on inflammation and nutrition. Furthermore, the possibility to screen for frailty using biochemical measures needs to be used.
authors.affiliation: Department of General Practice, Intellectual Disabilities Medicine, Erasmus University Medical Center, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Josje D
authors.initials: JD
authors.lastname: Schoufour
authors.affiliation: Department of General Practice, Intellectual Disabilities Medicine, Erasmus University Medical Center, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Echteld
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Andre
authors.initials: A
authors.lastname: Boonstra
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Zwier M A
authors.initials: ZM
authors.lastname: Groothuismink
authors.affiliation: Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Heleen M
authors.initials: HM
authors.lastname: Evenhuis
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000097:blood / Q000523:psychology; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000032:analysis; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008607:Intellectual Disability / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D007668:Kidney / Q000503:physiopathology; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015596:Nutrition Assessment; D009752:Nutritional Status; D019989:Persons with Intellectual Disabilities / Q000523:psychology*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human; D012720:Severity of Illness Index
chemical_list: C422455:ALB protein, human; D015415:Biomarkers; D001786:Blood Glucose; C525030:CST3 protein, human; D055316:Cystatin C; D018836:Inflammation Mediators; D008055:Lipids; D012709:Serum Albumin; D003404:Creatinine; D000075462:Serum Albumin, Human
keywords: frailty; inflammation; nutritional status; older people; people with intellectual disability; physiological measures