title: Frailty has a stronger association with inflammation than age in older veterans.
abstract: BACKGROUND
  Upregulation of pro-inflammatory cytokines has not only been associated with increased morbidity and mortality in older adults but also has been linked to frailty. In the current study we aimed to compare the relative relationship of age and frailty on inflammation and thrombosis in older veterans.
  
  
  RESULTS
  We analyzed 117 subjects (age range 62-95 years; median 81) divided into 3 cohorts: non-frail, pre-frail and frail based on the Fried phenotype of frailty. Serum inflammatory markers were determined using commercially available ELISA kits. Frail and pre-frail (PF) subjects had higher levels than non-frail (NF) subjects of IL-6 (NF vs. PF:p= 0.002; NF vs. F:p< 0.001), TNFR1 (NF vs. F:p= 0.012), TNFRII (NF vs. F: 0.002; NF vs. PF:p= 0.005) and inflammatory index: = 0.333*log(IL-6) + 0.666*log(sTNFR1) (NF vs. F:p= 0.009; NF vs. PF:p< 0.001). Frailty status explained a greater percent of variability in markers of inflammation than age: IL-6 (12 % vs. 0.3 %), TNFR1 (5 % vs. 4 %), TNFR2 (11 % vs. 6 %), inflammatory index (16 % vs. 8 %). Aging was significantly associated with higher fibrinogen (p= 0.04) and D-dimer levels (p= 0.01) but only among NF subjects.
  
  
  CONCLUSIONS
  In conclusion, these data suggest that among older veterans, frailty status has a stronger association with inflammation and the inflammatory index than age does. Larger studies, in more diverse populations are needed to confirm these findings.
authors: Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH USA ; Division of Infectious Disease, Case Western Reserve University, Cleveland, OH USA.
authors: P
authors: P
authors: Van Epps
authors: Division of Infectious Disease, Case Western Reserve University, Cleveland, OH USA.
authors: D
authors: D
authors: Oswald
authors: Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH USA ; School of Nursing, Case Western Reserve University, Cleveland, OH USA.
authors: P A
authors: PA
authors: Higgins
authors: Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH USA ; Division of Geriatrics, Department of Medicine, Case Western Reserve University, Cleveland, OH USA.
authors: T R
authors: TR
authors: Hornick
authors: Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH USA ; Division of Infectious Disease, Case Western Reserve University, Cleveland, OH USA.
authors: H
authors: H
authors: Aung
authors: Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH USA.
authors: R E
authors: RE
authors: Banks
authors: Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH USA.
authors: B M
authors: BM
authors: Wilson
authors: Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH USA ; School of Nursing, Case Western Reserve University, Cleveland, OH USA.
authors: C
authors: C
authors: Burant
authors: Division of Geriatrics, Department of Medicine, Case Western Reserve University, Cleveland, OH USA.
authors: S
authors: S
authors: Graventstein
authors: Geriatric Research, Education, and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH USA ; Division of Infectious Disease, Case Western Reserve University, Cleveland, OH USA.
authors: D H
authors: DH
authors: Canaday
keywords: Cytokines; Functional decline and coagulation; Inflammatory index