Associations Between Frailty and Inflammation, Physical, and Psycho-Social Health in Older Adults: A Systematic Review

Abstract

Frailty is a complex geriatric syndrome with multifactorial associated mechanisms that need to be examined more deeply to help reverse the adverse health-related outcomes. Specific inflammatory and physical health markers have been associated with the onset of frailty, but the associations between these factors and psycho-social health outcomes seem less studied. This systematic review aimed to identify, in the same study design, the potential associations between frailty and markers of inflammation, and physical or psycho-social health. A literature search was performed from inception until March 2021 using Medline, Psycinfo, and EMBASE. Three raters evaluated the articles and selected 22 studies, using inclusion and exclusion criteria (n = 17,373; 91.6% from community-dwelling samples). Regarding biomarkers, 95% of the included studies showed significant links between inflammation [especially the higher levels of C-reactive protein (CRP) and interleukin-6 (IL-6)], and frailty status. Approximately 86% of the included studies showed strong links between physical health decline (such as lower levels of hemoglobin, presence of comorbidities, or lower physical performance), and frailty status. At most, 13 studies among the 22 included ones evaluated psycho-social variables and mixed results were observed regarding the relationships with frailty. Results are discussed in terms of questioning the medical perception of global health, centering mostly on the physical dimension. Therefore, the development of future research studies involving a more exhaustive view of frailty and global (bio-psycho-social) health is strongly encouraged.

Relationship Between Preoperative Nutritional Indices and Sarcopenia in Patients With Stage III Colorectal Cancer

“…(P = .30, P = .56, P = .57; Fisher's exact test). Among 19 men with sarcopenia and 58 men without sarcopenia, there were no differences in diabetes (2, 13), heart disease (5,11), and hypertension (8, 33), (P = .51, P = .55, P = .65, respectively, Fisher's exact test).…”

“… 10 Increased blood inflammatory markers were reported in patients with sarcopenia and frailty. 11 Thus, sarcopenia could be associated with cancer via the inflammation pathway.…”

The association between chronic heart failure and frailty index: A study based on the National Health and Nutrition Examination Survey from 1999 to 2018

“…Multiple studies have shown that low self-efficacy always results in a higher incidence of frailty, poor self-management, medication compliance, and quality of life ( 25 , 26 ). The self-efficacy of patients, especially female patients, can be improved using goal setting, peer education, and incentive mechanism ( 27 ).…”

“…According to a meta-analysis ( 27 ), more than 50% of the studies showed that frail individuals had lower levels of red blood cells, especially Hb, compared with non-frail adults. In our study, we drew a similar conclusion.…”

Association between Perceived Health-Related Quality of Life and Depression with Frailty in the FRASNET Study

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