Inflammatory biomarkers in older adults with frailty: a systematic review and meta-analysis of cross-sectional studies

Xu, Yushuang; Wang, Mengmeng; Chen, Di; Jiang, Xin; Xiong, Zhifan

doi:10.1007/s40520-021-02022-7

Cited by 57 publications

(28 citation statements)

References 77 publications

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“…In Germany's older patients, a higher risk GNRI was associated with increased CRP levels ( p < 0.05) and low lymphocyte counts ( p < 0.05) after multivariable adjustment ( 36 ). Subclinical catabolic and inflammatory states, which are associated with chronic disease, led to increased production of catabolic cytokines, increased muscle catabolism, and decreased appetite with a negative effect on albumin levels ( 38 – 40 ). A reduction in serum albumin can therefore be a consequence of poor nutritional status or inflammation/disease ( 38 – 40 ).…”

Section: Discussionmentioning

confidence: 99%

A nutritional assessment tool, GNRI, predicts sarcopenia and its components in type 2 diabetes mellitus: A Japanese cross-sectional study

et al. 2023

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BackgroundThere are few reports evaluating the relationship between undernutrition and the risk of sarcopenia in type 2 diabetes mellitus (T2DM) patients.ObjectiveWe investigated whether undernutritional status assessed by the geriatric nutritional risk index (GNRI) and controlling nutritional status (CONUT) were associated with the diagnosis of sarcopenia.MethodsThis was a cross-sectional study of Japanese individuals with T2DM. Univariate or multivariate logistic regression analysis was performed to assess the association of albumin, GNRI, and CONUT with the diagnosis of sarcopenia. The optimal cut-off values were determined by the receiver operating characteristic (ROC) curve to diagnose sarcopenia.ResultsIn 479 individuals with T2DM, the median age was 71 years [IQR 62, 77], including 264 (55.1%) men. The median duration of diabetes was 17 [11, 23] years. The prevalence of sarcopenia was 41 (8.6%) in all, 21/264 (8.0%) in men, and 20/215 (9.3%) in women. AUCs were ordered from largest to smallest as follows: GNRI > albumin > CONUT. The cut-off values of GNRI were associated with a diagnosis of sarcopenia in multiple logistic regression analysis (odds ratio 9.91, 95% confidential interval 5.72–17.2), P < 0.001. The superiority of GNRI as compared to albumin and CONUT for detecting sarcopenia was also observed in the subclasses of men, women, body mass index (BMI) < 22, and BMI ≥ 22.ConclusionsResults showed that GNRI shows a superior diagnostic power in the diagnosis of sarcopenia. Additionally, its optimal cut-off points were useful overall or in the subclasses. Future large and prospective studies will be required to confirm the utility of the GNRI cut-off for undernutrition individuals at risk for sarcopenia.

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Section: Discussionmentioning

confidence: 99%

A nutritional assessment tool, GNRI, predicts sarcopenia and its components in type 2 diabetes mellitus: A Japanese cross-sectional study

et al. 2023

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“…In terms of biomarkers, CRP, homocysteine, and TNFR‐1 were related to IC decline. CRP and TNFR‐1 are identified as biomarkers of aging and age‐related disease (Justice et al., 2018), as well as being associated with frailty status (Picca et al., 2022; Xu et al., 2022) and cognitive impairment (Stacey et al., 2017) in older adults. Homocysteine has been linked to gait speed decline, sarcopenia, and dementia in studies (Lee et al., 2020; Smith et al., 2018; Vidoni et al., 2017).…”

Section: Discussionmentioning

confidence: 99%

“…In terms of biomarkers, CRP, homocysteine, and TNFR-1 were related to IC decline. CRP and TNFR-1 are identified as biomarkers of aging and age-related disease (Justice et al, 2018), as well as being associated with frailty status (Picca et al, 2022;Xu et al, 2022) and cognitive impairment (Stacey et al, 2017) in older adults.…”

Section: Biomarkersmentioning

confidence: 99%

Factors associated with the intrinsic capacity in older adults: A scoping review

Wei,

Chen,

Qin

et al. 2024

Journal of Clinical Nursing

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IntroductionIn 2015, the term ‘intrinsic capacity’ (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain.AimWe aim to synthesise the factors connected with IC.MethodsThis scoping review followed the five‐stage framework of Arksey and O'Malley and was reported using PRISMA‐ScR guidelines.ResultsIn all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults.ConclusionsThis review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults.Relevance to Clinical PracticeThe influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well‐being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline.No Patient or Public ContributionAs this is a scoping review, no patient or public contributions are required.

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“…However, many biomarkers that are routinely used in sepsis may show a different performance in elderly patients due to several factors including the presence of chronic inflammation in this population. For example, patients with frailty are characterized by having lower lymphocyte counts, and higher levels of inflammatory markers including interleukin 6, C-reactive protein (CRP), and tumor necrosis factor-α [ 69 ]. In addition, there are also differences in pathogens in the elderly population with an increased rate of multi-resistant organisms due to the greater use of healthcare facilities and cumulative antibiotic exposure [ 70 ].…”

Section: The Biomarker Approach In the Elderly Patientmentioning

confidence: 99%

Biomarkers for risk stratification and antibiotic stewardship in elderly patients

Falcone¹,

Bauer

Ferrer

et al. 2023

Aging Clin Exp Res

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Purpose Optimal treatment of infections in the elderly patients population is challenging because clinical symptoms and signs may be less specific potentially resulting in both, over- and undertreatment. Elderly patients also have a less pronounced immune response to infection, which may influence kinetics of biomarkers of infection. Methods Within a group of experts, we critically reviewed the current literature regarding biomarkers for risk stratification and antibiotic stewardship in elderly patients with emphasis on procalcitonin (PCT). Results The expert group agreed that there is strong evidence that the elderly patient population is particularly vulnerable for infections and due to ambiguity of clinical signs and parameters in the elderly, there is considerable risk for undertreatment. At the same time, however, this group of patients is particularly vulnerable for off-target effects from antibiotic treatment and limiting the use of antibiotics is therefore important. The use of infection markers including PCT to guide individual treatment decisions has thus particular appeal in geriatric patients. For the elderly, there is evidence that PCT is a valuable biomarker for assessing the risk of septic complications and adverse outcomes, and helpful for guiding individual decisions for or against antibiotic treatment. There is need for additional educational efforts regarding the concept of “biomarker-guided antibiotic stewardship” for health care providers caring for elderly patients. Conclusion Use of biomarkers, most notably PCT, has high potential to improve the antibiotic management of elderly patients with possible infection for improving both, undertreatment and overtreatment. Within this narrative review, we aim to provide evidence-based concepts for the safe and efficient use of PCT in elderly patients.

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Inflammatory biomarkers in older adults with frailty: a systematic review and meta-analysis of cross-sectional studies

Cited by 57 publications

References 77 publications

A nutritional assessment tool, GNRI, predicts sarcopenia and its components in type 2 diabetes mellitus: A Japanese cross-sectional study

A nutritional assessment tool, GNRI, predicts sarcopenia and its components in type 2 diabetes mellitus: A Japanese cross-sectional study

Factors associated with the intrinsic capacity in older adults: A scoping review

Biomarkers for risk stratification and antibiotic stewardship in elderly patients

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