Inflammatory Markers and Frailty in Long-Term Care Residents.
OBJECTIVE
To determine whether proinflammatory biomarkers are associated with frailty assessed according to functional status, mobility, mental health, and falls over 24 months.


METHODS
Secondary analysis of a 2-year double-blind clinical trial for osteoporosis.


METHODS
Nursing homes and assisted living facilities.


METHODS
Women aged 65 and older with osteoporosis in long-term care (LTC) (N = 178).


METHODS
Baseline serum concentrations of proinflammatory cytokines and soluble receptors (high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNFα) and its two receptors (TNFα-R1 and TNFα-R2), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), IL-10), functional status assessed according to activities of daily living, the Nursing Home Physical Performance Test, gait speed, cognitive status, mental health, and falls.


RESULTS
At baseline, older age was moderately associated with higher serum concentrations of hs-CRP (correlation coefficient (r) = 0.22), TNFα-R1 (r = 0.36), TNFα-R2 (r = 0.34), and IL-10 (r = 0.16) (all P < .05). Frail participants had significantly higher hs-CRP, TNFα-R1, TNFα-R2, IL-6, and IL-6-sR levels (all P < .05) than those nonfrail participants. Higher baseline hs-CRP and IL-6 levels were associated with worse physical performance and gait speed at 12 months independent of age, zoledronic acid use, and comorbidity (|r| = 0.25-0.30; all P < .05). Inflammatory markers were not significantly associated with incident falls.


CONCLUSIONS
Higher proinflammatory biomarker levels are associated with frailty and poorer function and mobility in older women residing in LTC facilities.
Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Gabrielle A
GA
Langmann
Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.|Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania.
Subashan
S
Perera
Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Mary A
MA
Ferchak
Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
David A
DA
Nace
Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Neil M
NM
Resnick
Division of Geriatric Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.|Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Susan L
SL
Greenspan
D000203:Activities of Daily Living; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D016207:Cytokines; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D016330:Frail Elderly; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D007249:Inflammation / Q000097:blood* / Q000150:complications; D008134:Long-Term Care; D010024:Osteoporosis; D000077211:Zoledronic Acid
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D016207:Cytokines; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid
cytokines; falls; frailty; gait speed; inflammation; long-term care; zoledronic acid