Section of Geriatrics, Department of Internal Medicine, Yale University School of Medicine, P.O. Box 208025, 333 Cedar St., New Haven, CT 06520-8025, USA.
Arch Gerontol Geriatr. 2012 Jan-Feb;54(1):9-15. doi: 10.1016/j.archger.2011.05.020. Epub 2011 Jul 16.
Frailty is associated with a pro-inflammatory state, which has been characterized by elevated levels of systemic inflammatory biomarkers, but has not been related to the number of co-existing chronic diseases associated with inflammation. We sought to determine the extent to which a higher number of inflammatory-related diseases is associated with frailty and to identify the most common disease patterns associated with being frail in older adults. We performed binomial regression analyses to assess whether a higher count of inflammatory-related diseases increases the probability of frailty using data from the WHAS I and II, companion cohorts composed of 70-79-year-old community-dwelling older women in Baltimore, Maryland (n=620). An increase of one inflammatory-related disease was associated log-linearly with frailty (Prevalence Ratio (PR)=2.28, 95% Confidence Interval (CI)=1.81-2.87). After adjusting for age, race, education, and smoking status, the probability of frailty remained significant (PR=1.97, 95%CI=1.52-2.55). In the frail population, chronic kidney disease (CKD) and depressive symptoms (Prevalence=22.9%, 95%CI=14.2-34.8%); CVD and depressive symptoms (21.7%, 95%CI=13.2-33.5%); CKD and anemia (18.7%, 95%CI=11.1-29.7%); cardiovascular disease (CVD), CKD, and pulmonary disease (10.7%, 95%CI=5.2-21.0%); CKD, anemia, and depressive symptoms (8.7%, 95%CI=3.9-18.2%); and CVD, anemia, pulmonary disease, and depressive symptoms (5.0%, 95%CI=1.6-14.4%) were among the most frequent disease combinations. Their prevalence percentages were significantly higher in the frail versus non-frail women. A higher inflammatory-related disease count, perhaps reflecting a greater pro-inflammatory burden, increases the likelihood of frailty. Shared mechanisms among specific disease combinations may further contribute to this risk.
衰弱与炎症状态有关,其特征是全身炎症生物标志物水平升高,但与与炎症相关的慢性疾病数量无关。我们旨在确定更多的炎症相关疾病与衰弱的关系程度,并确定与老年人衰弱相关的最常见疾病模式。我们使用马里兰州巴尔的摩市 70-79 岁社区居住的老年女性的 WHAS I 和 II 及其配套队列的数据,进行二项式回归分析,以评估炎症相关疾病数量的增加是否会增加衰弱的可能性(n=620)。炎症相关疾病增加一种与衰弱呈对数线性相关(患病率比(PR)=2.28,95%置信区间(CI)=1.81-2.87)。在调整年龄、种族、教育程度和吸烟状况后,衰弱的可能性仍然显著(PR=1.97,95%CI=1.52-2.55)。在衰弱人群中,慢性肾脏病(CKD)和抑郁症状(患病率=22.9%,95%CI=14.2-34.8%);心血管疾病(CVD)和抑郁症状(21.7%,95%CI=13.2-33.5%);CKD 和贫血(18.7%,95%CI=11.1-29.7%);心血管疾病(CVD)、CKD 和肺部疾病(10.7%,95%CI=5.2-21.0%);CKD、贫血和抑郁症状(8.7%,95%CI=3.9-18.2%);以及 CVD、贫血、肺部疾病和抑郁症状(5.0%,95%CI=1.6-14.4%)是最常见的疾病组合。在衰弱女性中,这些疾病的患病率百分比明显高于非衰弱女性。炎症相关疾病数量的增加,可能反映了更大的促炎负担,增加了衰弱的可能性。特定疾病组合之间的共同机制可能进一步增加这种风险。