Background

Research suggests that frailty is associated with higher inflammation levels. We investigated the longitudinal association between chronic inflammation and frailty progression.

Methods

Participants of the Lothian Birth Cohort 1936, aged 70 at baseline were tested four times over 12 years (wave 1: n = 1091, wave 4: n = 550). Frailty was assessed by; the Frailty Index at waves 1–4 and Fried phenotype at waves 1, 3 and 4. Two blood-based inflammatory biomarkers were measured at wave 1: Fibrinogen and C-reactive protein (CRP).

Results

Fully-adjusted, linear mixed effects models showed higher Fibrinogen was significantly associated with higher wave 1 Frailty Index score (β = 0.011, 95% CI[0.002,0.020], p < .05). Over 12 year follow-up, higher wave 1 CRP (β = 0.001, 95% CI[0.000,0.002], p < .05) and Fibrinogen (β = 0.004, 95% CI[0.001,0.007], p < .05) were significantly associated with increased Frailty Index change. For the Fried phenotype, wave 1 Pre-frail and Frail participants had higher CRP and Fibrinogen than Non-frail participants (p < .001). Logistic regression models calculated risk of worsening frailty over follow-up and we observed no significant association of CRP or Fibrinogen in minimally-adjusted nor fully-adjusted models.

Conclusions

Findings showed a longitudinal association of higher wave 1 CRP and Fibrinogen on worsening frailty in the Frailty Index, but not Fried Phenotype. A possible explanation for this disparity may lie in the conceptual differences between frailty measures (a biopsychosocial vs physical approach). Future research, which further explores different domains of frailty, as well the associations between improving frailty and inflammation levels, may elucidate the pathway through which inflammation influences frailty progression. This may improve earlier identification of those at high frailty risk.

中文翻译：

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炎症是 1936 年洛锡安出生队列中衰弱发展的危险因素。

背景

研究表明，虚弱与较高的炎症水平有关。我们调查了慢性炎症和衰弱进展之间的纵向关联。

方法

Lothian Birth Cohort 1936 的参与者，基线年龄为 70 岁，在 12 年内接受了四次测试（第 1 波：n  = 1091，第 4 波：n  = 550）。脆弱性由以下人员评估；第 1-4 波的脆弱指数和第 1、3 和 4 波的 Fried 表型。在第 1 波测量了两种基于血液的炎症生物标志物：纤维蛋白原和 C 反应蛋白 (CRP)。

结果

完全调整的线性混合效应模型显示，较高的纤维蛋白原与较高的第 1 波虚弱指数评分显着相关（β = 0.011, 95% CI[0.002,0.020], p  < .05）。超过 12 年的随访，较高的第 1 波 CRP (β = 0.001, 95% CI[0.000,0.002], p  < .05) 和纤维蛋白原 (β = 0.004, 95% CI[0.001,0.007], p  < .05 ) ) 与虚弱指数变化增加显着相关。对于 Fried 表型，第 1 波衰弱前和衰弱参与者的 CRP 和纤维蛋白原高于非衰弱参与者 ( p  < .001)。逻辑回归模型计算了随访期间虚弱恶化的风险，我们在最小调整或完全调整模型中观察到 CRP 或纤维蛋白原没有显着关联。

结论

研究结果显示，较高的 1 波 CRP 和纤维蛋白原与衰弱指数中的衰弱恶化存在纵向关联，但与 Fried 表型无关。对这种差异的可能解释可能在于虚弱测量（生物心理社会与物理方法）之间的概念差异。未来的研究将进一步探索虚弱的不同领域，以及改善虚弱和炎症水平之间的关联，可能会阐明炎症影响虚弱进展的途径。这可能会提高早期识别那些处于高虚弱风险的人。