Resumen de Inflammatory Markers and Frailty in Long-Term Care Residents

Gabrielle A. Langmann, Subashan Perera, Mary A. Ferchak, David A. Nace, Neil M. Resnick, Susan L. Greenspan

• 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.