Abstract
BackgroundThe complex physiology underpinning the frailty syndrome is responsible for the absence of robust biomarkers that can be used for screening, diagnostic and/or prognostic purposes and has made clinical implementation difficult. Considering socially vulnerable populations, who have poor health status and increased morbidity and mortality, this scenario is even more complex. However, to the best of our knowledge, there are no studies available to investigate frailty biomarkers in socially vulnerable populations. Thus, the aim of this cross-sectional study was to identify potential blood-based biomarkers of frailty in a socially vulnerable population.MethodsA sample consisting of 347 community-dwelling older people living in a context of high social vulnerability was divided into non-frail (robust), pre-frail and frail groups, according to modified Fried frailty phenotype criteria. Blood samples were collected and analyzed for basic metabolic parameters and for inflammatory cytokines.ResultsLevels of Interleukin-1α (IL-1α) and Tumor Necrosis Factor α (TNF-α) were significantly higher in pre-frail subjects, compared to non-frail ones. Tumor Necrosis Factor β (TNF-β) levels presented higher values in the frail compared to non-frail individuals. Interleukin-6 (IL-6) levels in pre-frail and frail subjects were significantly higher compared to the levels of non-frail subjects. Using an ordinal regression analysis, we observed that socially vulnerable older people at higher risk of developing frailty were subjects above 80 years old (OR: 2.5; 95% CI: 1.1–5.6) and who presented higher levels of TNF-β (≥0.81 pg/mL, OR: 2.53; 95% CI: 1.3–4.9).ConclusionAs vulnerable populations continue to age, it is imperative to have a greater understanding of the frailty condition, identifying novel potential blood-based biomarkers. The results presented here could help to implement preventive healthcare strategies by evaluating frailty and at the same time measuring a set of inflammatory biomarkers, paying special attention to TNF-β plasmatic levels.
Highlights
The complex physiology underpinning the frailty syndrome is responsible for the absence of robust biomarkers that can be used for screening, diagnostic and/or prognostic purposes and has made clinical implementation difficult
Frailty is an age-related state characterized as a syndrome in which individuals may become more vulnerable to adverse health outcomes with a higher risk for mortality when exposed to stressors [1,2,3]
Nascimento et al BMC Geriatrics (2018) 18:268 are characterized by a low-grade, controlled, asymptomatic, systemic, and chronic progressive increase in the pro-inflammatory status, called inflammaging [10]. This pro-inflammatory state generated by age, sex, lifestyle, socioeconomic background, comorbidities and affective, cognitive or sensory impairments has been postulated as a potential driver of frailty pathogenesis, producing even higher levels of systemic inflammatory markers [11, 12]
Summary
The complex physiology underpinning the frailty syndrome is responsible for the absence of robust biomarkers that can be used for screening, diagnostic and/or prognostic purposes and has made clinical implementation difficult. Considering socially vulnerable populations, who have poor health status and increased morbidity and mortality, this scenario is even more complex. Changes related to the immune-endocrine axis are extensively described during aging and are frequently associated to increases in morbidity and mortality [9]. Nascimento et al BMC Geriatrics (2018) 18:268 are characterized by a low-grade, controlled, asymptomatic, systemic, and chronic progressive increase in the pro-inflammatory status, called inflammaging [10] This pro-inflammatory state generated by age, sex, lifestyle, socioeconomic background, comorbidities and affective, cognitive or sensory impairments has been postulated as a potential driver of frailty pathogenesis, producing even higher levels of systemic inflammatory markers [11, 12]. Considering that frailty is characterized by the loss of resilience, poor social conditions may reflect chronic stressors, which increase risk of disturbances in metabolic and immunological parameters, leading to a higher risk of developing frailty [15,16,17]
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