Frailty, inflammation and the elderly

Abstract

Frailty is a term used as a marker of vulnerability, identifying individuals with a diminished capacity to respond to external stressors. Those who are frail are at increased risk of death, institutionalisation and worsening disability. While the associations of frailty with increasing chronological age, female gender, functional dependence and chronic disease are now well described, the aetiology of frailty remains less clearly understood. The growing body of evidence linking inflammation and frailty in older people, an association that seems consistent across different frailty definitions, is therefore of great interest to research gerontologists. However, further studies are needed to establish the exact nature of this relationship. Inflammation may be primarily causal, a compensatory response to viral antigens or subclinical disease or an epi-phenomenon, merely a marker of another key pathophysiological process such as excessive oxidative stress. Furthermore, it has recently been recognised that frailty is most strongly associated with a combination of immunological and physiological impairments rather than a single biomarker. This supports the conceptualisation of ageing as the progressive accumulation of damage to a complex system resulting in aggregate loss of system redundancy. The frail older person is analogous to a complex system without redundancy: capacity to respond to external stressors is reduced. A critical mass of abnormalities across different systems may therefore be a more important determinant of frailty than any individual pathway.

The association between frailty, the metabolic syndrome, and mortality over the lifespan

“…Common pathophysiological pathways such as inflammation (Cesari et al 2006;Barzilay et al 2007;Hubbard and Woodhouse 2010;Collerton et al 2012) and changes in body composition could help explain the link between frailty and metabolic syndrome in younger adults. The FI quantifies health deficit accumulation across a range of systems, so it seems likely if someone has the metabolic syndrome then they will have more health-related deficits.…”

Effect of Pioglitazone on Sciatic Nerve Ischemia/Reperfusion Injury in Rats

“…The protective role of NO in these conditions is more due to its action as a chain-breaking antioxidant during lipid peroxidation rather than that of other macromolecules [26, 27]. Since NO is more persistent than O 2 and more rapidly generated in a biological setting, it may exhibit striking antioxidant properties in peripheral nerve I/R injury where lipid peroxidation is implicated owing to the high lipid content of the nerve tissue [17, 28].…”

The Concept of Frailty in Geriatric Chronic Kidney Disease (CKD) Patients

“…Taken together, the effects of even minor illnesses, such as a common cold, lead to maladaptive processes leaving the body vulnerable to any new external or internal stressor [18]. Advances in biological and molecular research have shown that metabolic changes are seen in blood clotting and hormonal levels, with elevated cytokine levels, immunomodulatory abnormalities, and markers of chronic inflammation being common [12,19,20,21]. …”