Inflammatory Markers and Frailty in Long-Term Care Residents.

OBJECTIVES

To determine whether proinflammatory biomarkers are associated with frailty assessed according to functional status, mobility, mental health, and falls over 24 months.

DESIGN

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

SETTING

Nursing homes and assisted living facilities.

PARTICIPANTS

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

MEASUREMENTS

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.