Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

Abstract

The present study was undertaken to evaluate serum levels of pro-inflammatory cytokines in Tunisian older adults and to examine the relationships between inflammatory marker levels, geriatric, and biochemical parameters. A cross-sectional study was conducted in a population of Tunisian older adults (N = 141, aged 65 and over). Patients were recruited from the Department of Internal Medicine, Fattouma Bourguiba University Hospital (Monastir, Tunisia) and from a nursing home (Sousse, Tunisia). Comprehensive geriatric assessment, history taking and examination including functional and nutritional assessment were done for each participant. Enzyme-linked immunosorbent assay (ELISA) test was used to measure serum cytokine (TNF-α, IL-8, IL-6) levels. The modified Short Emergency Geriatric Assessment score (SEGAm) were used to classify patients as 51 very-frail, 40 frail, and 50 non-frail. The age of the participants (80 men, 61 women) ranged from 65 to 97 years. Serum levels of TNF-α, IL-8 and C-reactive protein (CRP) were significantly higher in very-frail participants compared to frail and non-frail ones. However, no significant differences in IL-6 levels were detected among frailty groups. After adjustment for age, CRP and IL-8 levels remained significantly associated with frailty. Analysis of the receiver operating characteristic (ROC) curve corresponding to IL-8 showed an area under the curve of 0.7 (p = 0.003; 95% CI [0.58–0.81]) and a predictive threshold of 5.27 pg/ml. Positive correlations were found between frailty score, IL-6, and IL-8 levels. In addition, a significant positive correlation was observed between IL-8 levels and Timed Up and Go test results. However, a negative correlation was observed between Mini Nutritional Assessment Short-Form score, IL-6 and CRP levels, as well as between Activities of Daily Living score and serum levels of TNF-α, IL-6, and CRP. In conclusion, the key findings of this study collectively support a role of pro-inflammatory cytokines, TNF-α, CRP, and especially IL-8 in the development of frailty in older adults.

Inflammation and Oxidative Stress in Frailty and Metabolic Syndromes—Two Sides of the Same Coin

“…In the randomized PolSenior study, which investigated 4979 elderly participants from Poland, a relationship between markers of inflammation (IL6 and CRP) and frailty were shown [94]. What is more, Hammami et al showed positive associations between frailty score and pro-inflammatory markers: CRP, IL-6, IL-8 and TNF-α [95]. Moreover, in this study, the relationship between CRP and frailty was still strong and significant after adjusting for age.…”

Socio-Demographic, Clinical and Psychological Profile of Frailty Patients Living in the Home Environment and Nursing Homes: A Cross-Sectional Study

“…The present study confirmed the relationship between the incidence of frailty syndrome and a greater mean number of diseases, represented by the medications taken, and the duration of the diseases. Cognitive impairment and depression symptoms have been shown in a study conducted in Turkey by Hammami et al ( 36 ) to be a factor that increases the occurrence of frailty syndrome. A study by Lenardt et al showed that physical disability, loss of independence, and increased frequency of hospitalization and institutionalization are all consequences of frailty syndrome that reduce the quality of life of older people ( 37 ).…”

Nutritional Assessment in Older Adults: MNA® 25 years of a Screening Tool & a Reference Standard for Care and Research; What Next?

“…Further, the MNA ® appears useful to measure frail older persons, especially when the MNA ® is between 17 and 23.5 (27,286,303,335,336). Malnutrition and physical frailty seem to be strongly related, however, they should be assessed separately within the geriatric assessment (313,317,326,(337)(338)(339)(340)(341).…”