Nutritional and inflammation factors associated with current frailty level and effect of comorbidities on the progression of frailty

Abstract

Abstract Objective Frailty is defined as the extreme vulnerability of an organism, a syndrome that exposes the individual to a higher risk of disability. While risk factors for frailty have been gradually uncovered, the full identification of biochemical factors or comorbidities influencing frailty remains incomplete. Design: Cross-sectional and longitudinal analyses were performed to elucidate the risk factors for the prevalence and progression of frailty. Setting and participants: Peri- or post-menopausal Japanese female outpatients (n = 1035). Measurements: At baseline, biochemical markers such as serum levels of interleukin-6 (IL-6), adiponectin, high-sensitivity C-reactive protein, leptin, and branched-chain amino acids (BCAA) were measured. Comorbidities included diabetes mellitus, dyslipidemia, hypertension, vertebral osteoarthritis, and osteoporosis. Frailty levels were assessed using frailty scores ranging from 0 to 5. Prevalence of frailty was judged by a score of 3 and above, and progression was judged by an increase of the frail score during observation period. Multiple regression analysis was used for the cross-sectional analysis, and the Cox hazard model was used for the longitudinal analysis. Results Of the 1035 selected participants, 212 were diagnosed with frailty. Advanced age and log IL-6 and BCAA levels were significant independent risk factors for frailty. Subjects were followed for 7.7 ± 5.9 years and progression was observed on 130 subjects. Higher age, the absence of hyperlipidemia, presence of osteoporosis, and lower frailty scores were identified as significant risk factors for frailty progression. Conclusions Energy metabolism markers, IL-6 and BCAA, were significantly associated with the current frailty status, while hyperlipidemia and osteoporosis acted as negative and positive predictors, respectively, of future frailty progression. Improved energy-related conditions and treating osteoporosis in the older adults may be useful in preventing of frailty or its progression.