Merchant Reshma Aziz, Chan Yiong Huak, Anbarasan Denishkrshna, Vellas Bruno
Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Front Med (Lausanne). 2024 Mar 6;11:1374197. doi: 10.3389/fmed.2024.1374197. eCollection 2024.
Decline in intrinsic capacity (IC) has been shown to accelerate progression to disability. The study aims to explore association of IC composite score with functional ability, sarcopenia and systemic inflammation in pre-frail older adults.
Cross-sectional study of pre-frail older adults ≥60 years old recruited from the community and primary care centers. Composite scores of four domains of IC were measured: locomotion, vitality, cognition and psychological. FRAIL scale was used to define pre-frailty. Muscle mass was measured using the bioelectrical impedance analysis. Systemic inflammation biomarkers [Interleukin-6 (IL-6), Interleukin-10 (IL-10), Tumor Necrosis Factor Alpha (TNF-α), and Growth differentiated factor 15 (GDF-15)] were measured. Participants in the lowest tertile (T1) exhibited greater decline in IC.
A total of 398 pre-frail older adults were recruited, mean age was 72.7 ± 5.8 years, 60.1% female, education level 7.8 years, and 85.2% were of Chinese ethnicity. A total of 75.1% had decline in locomotion, 40.5% in vitality, 53.2% in cognition and 41.7% in psychological domain. A total of 95% had decline in at least one domain. T1 was significantly associated with ADL impairment (aOR 3.36, 95% CI 1.78-6.32), IADL impairment (aOR 2.37, 95% CI 1.36-4.13), poor perceived health (aOR 0.96, 95% CI 0.95-0.98), fall (aOR 1.63, 95% CI 1.05-2.84), cognitive impairment (aOR 8.21, 95% CI 4.69-14.39), depression (aOR 101.82, 95% CI 33.62-308.37), and sarcopenia (aOR 2.40, 95% CI 1.60-5.45). T1 had significant associations with GDF-15, IL-10, and IL-10 to TNF-α ratio.
Decline in IC composite score among pre-frail older adults was associated with functional limitation, sarcopenia, and systemic inflammation.
已有研究表明，内在能力（IC）下降会加速残疾进展。本研究旨在探讨IC综合评分与脆弱前期老年人的功能能力、肌肉减少症和全身炎症之间的关联。
对从社区和初级保健中心招募的60岁及以上的脆弱前期老年人进行横断面研究。测量IC四个领域的综合评分：运动、活力、认知和心理。使用FRAIL量表定义脆弱前期。采用生物电阻抗分析测量肌肉量。测量全身炎症生物标志物[白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）和生长分化因子15（GDF-15）]。处于最低三分位数（T1）的参与者IC下降更为明显。
共招募了398名脆弱前期老年人，平均年龄为72.7±5.8岁，女性占60.1%，受教育年限为7.8年，85.2%为华裔。共有75.1%的人运动能力下降，40.5%的人活力下降，53.2%的人认知能力下降，41.7%的人心理领域下降。共有95%的人至少在一个领域出现下降。T1与日常生活活动（ADL）受损（调整后比值比[aOR]3.36，95%置信区间[CI]1.78 - 6.32）、工具性日常生活活动（IADL）受损（aOR 2.37，95% CI 1.36 - 4.13）、健康感知差（aOR 0.96，95% CI 0.95 - 0.98）、跌倒（aOR 1.63，95% CI 1.05 - 2.84）、认知障碍（aOR 8.21，95% CI 4.69 - 14.39）、抑郁（aOR 101.82，95% CI 33.62 - 308.37）和肌肉减少症（aOR 2.40，95% CI 1.60 - 5.45）显著相关。T1与GDF-15、IL-10以及IL-10与TNF-α的比值显著相关。
脆弱前期老年人IC综合评分下降与功能受限、肌肉减少症和全身炎症相关。
