Inflammation and frailty in the elderly: A systematic review and meta-analysis.
The pathogenesis of frailty and the role of inflammation is poorly understood. We examined the evidence considering the relationship between inflammation and frailty through a systematic review and meta-analysis. A systematic literature search of papers providing data on inflammatory biomarkers and frailty was carried out in major electronic databases from inception until May 2016. From 1856 initial hits, 35 studies (32 cross-sectional studies n=3232 frail, n=11,483 pre-frail and n=8522 robust, and 563 pre-frail+robust; 3 longitudinal studies n=3402 participants without frailty at baseline) were meta-analyzed. Cross-sectional studies reported that compared to 6757 robust participants, both 1698 frail (SMD=1.00, 95%CI: 0.40-1.61) and 8568 pre-frail (SMD=0.33, 95%CI: 0.04-0.62) participants had significantly higher levels of C-reactive protein (CRP). Frailty (n=1057; SMD=1.12, 95%CI: 0.27-2.13) and pre-frailty (n=4467; SMD=0.56, 95%CI: 0.00-1.11) were associated with higher serum levels of interleukin-6 compared to people who were robust (n=2392). Frailty and pre-frailty were also significantly associated with elevated white blood cell and fibrinogen levels. In three longitudinal studies, higher serum CRP (OR=1.06, 95%CI: 0.78-1.44,) and IL-6 (OR=1.19, 95%CI: 0.87-1.62) were not associated with frailty. In conclusion, frailty and pre-frailty are associated with higher inflammatory parameters and in particular CRP and IL-6. Further longitudinal studies are needed.
Center for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Pinar
P
Soysal
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; United Kingdom and Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom; Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK.
Brendon
B
Stubbs
Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Paola
P
Lucato
Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy.
Claudio
C
Luchini
Department of Neurosciences, University of Padova, Padova, Italy; Local Health Unit 17, Mental Health Department, Padova, Italy; Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy.
Marco
M
Solmi
Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Roberto
R
Peluso
Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Giuseppe
G
Sergi
Center for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Ahmet Turan
AT
Isik
Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy.
Enzo
E
Manzato
Aging Branch, Institute of Neuroscience, National Research Council-CNR, Padova, Italy.
Stefania
S
Maggi
Geriatric Clinic and Laboratory of Movement Analysis, Geriatric and Rehabilitation Department, University Hospital of Parma, Via Gramsci 14, I-431126 Parma, Italy.
Marcello
M
Maggio
King's College London, Centre for Global Mental Health, Health Service and Population Department, Institute of Psychiatry, Pscyhology and Neuroscience, De Crespigny Park, SE5 8AF London, United Kingdom.
A Matthew
AM
Prina
MRC Unit for Lifelong Health & Ageing, University College London, 33 Bedford Place, London WC1B 5JU, United Kingdom.
Theodore D
TD
Cosco
REACH: The Centre for Research in Aging and Cognitive Health, College of Life and Environmental Sciences-Psychology, University of Exeter, Exeter EX4 4QG, United Kingdom.
Yu-Tzu
YT
Wu
Nicola Veronese, Geriatrics Section, Department of Medicine (DIMED), University of Padova, Padova, Italy; Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy. Electronic address: ilmannato@gmail.com.
Nicola
N
Veronese
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D016207:Cytokines / Q000097:blood; D005260:Female; D016330:Frail Elderly; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000276:immunology; D008297:Male
D015415:Biomarkers; D016207:Cytokines
Aging; C-Reactive protein; Frailty; Inflammation; Interleukin-6; Pre-frailty