Pothier Kristell, Gana Wassim, Bailly Nathalie, Fougère Bertrand
Département de Psychologie, Université de Tours, Tours, France.
EA2114, Psychologie des Ages de la Vie et Adaptation, Tours, France.
Front Psychol. 2022 Mar 14;13:805501. doi: 10.3389/fpsyg.2022.805501. eCollection 2022.
Frailty is a complex geriatric syndrome with multifactorial associated mechanisms that need to be examined more deeply to help reverse the adverse health-related outcomes. Specific inflammatory and physical health markers have been associated with the onset of frailty, but the associations between these factors and psycho-social health outcomes seem less studied. This systematic review aimed to identify, in the same study design, the potential associations between frailty and markers of inflammation, and physical or psycho-social health. A literature search was performed from inception until March 2021 using Medline, Psycinfo, and EMBASE. Three raters evaluated the articles and selected 22 studies, using inclusion and exclusion criteria ( = 17,373; 91.6% from community-dwelling samples). Regarding biomarkers, 95% of the included studies showed significant links between inflammation [especially the higher levels of C-reactive protein (CRP) and interleukin-6 (IL-6)], and frailty status. Approximately 86% of the included studies showed strong links between physical health decline (such as lower levels of hemoglobin, presence of comorbidities, or lower physical performance), and frailty status. At most, 13 studies among the 22 included ones evaluated psycho-social variables and mixed results were observed regarding the relationships with frailty. Results are discussed in terms of questioning the medical perception of global health, centering mostly on the physical dimension. Therefore, the development of future research studies involving a more exhaustive view of frailty and global (bio-psycho-social) health is strongly encouraged.
衰弱是一种复杂的老年综合征,其相关机制具有多因素性,需要更深入地研究以帮助扭转与健康相关的不良后果。特定的炎症和身体健康标志物与衰弱的发生有关,但这些因素与心理社会健康结果之间的关联似乎研究较少。本系统评价旨在在同一研究设计中确定衰弱与炎症标志物以及身体或心理社会健康之间的潜在关联。使用Medline、Psycinfo和EMBASE进行了从创刊到2021年3月的文献检索。三名评估者对文章进行了评估,并根据纳入和排除标准选择了22项研究(n = 17,373;91.6%来自社区居住样本)。关于生物标志物,95%的纳入研究表明炎症[尤其是较高水平的C反应蛋白(CRP)和白细胞介素-6(IL-6)]与衰弱状态之间存在显著联系。约86%的纳入研究表明身体健康下降(如血红蛋白水平较低、存在合并症或身体表现较差)与衰弱状态之间存在密切联系。在纳入的22项研究中,最多有13项研究评估了心理社会变量,并且在与衰弱的关系方面观察到了混合结果。从质疑主要集中在身体层面的全球健康医学观念的角度对结果进行了讨论。因此,强烈鼓励开展未来的研究,以更全面地看待衰弱和全球(生物心理社会)健康。