Iron Dysregulation and Frailty Syndrome

Abstract

Patients with diagnosed frailty syndrome (FS) represent a special group of patients with chronic disease. In the classic definition, frailty syndrome includes such parameters as reduced muscle strength, subjective feeling of fatigue, unintentional weight loss, slow gait, and low physical activity. Frailty syndrome leads to an increased incidence of adverse events, such as falls, hospitalizations, and the need to place patients in care and health institutions associated with the loss of independence; frailty syndrome is also associated with an increased incidence of death. In European countries, the frequency of frailty syndrome in the geriatric population is estimated to be 17% with a range from 5.8% to 27%, and its incidence increases with age. A much higher percentage of frailty syndrome patients is also observed among hospitalized patients. The incidence of frailty syndrome is influenced by many socio-economic factors, but also medical factors. Materials and Methods: A total of 120 patients, >65 years of age, participated in the study. During the study, anthropometric measurements, surveys, laboratory determinations of basic biochemical parameters, and iron status were investigated; 5 mL of peripheral blood in EDTA was also collected for further laboratory tests of hepcidin and soluable transferrin receptor (sTfR) using ELISA. Then, the statistical analysis was performed based on survey and clinical data. Results: Among the patients >65 years of age, the incidence of frailty syndrome was 27.5%. It was found that its occurrence was associated with socio-economic factors, malnutrition, multiple morbidities, reduced muscle strength and gait speed, and polypharmacotherapy. The relationship between reduced iron concentration and the occurrence of frailty syndrome was confirmed. Conclusions: According to the analysis, it was found that a decrease in iron concentration was associated with frailty syndrome.

Association of soluble transferrin receptor/log ferritin index with all-cause and cause-specific mortality: National Health and Nutrition Examination Survey

“…Patients with diagnosed frailty syndrome represent a unique group of individuals with chronic illnesses. In the classic definition, frailty syndrome includes parameters such as reduced muscle strength, subjective fatigue, unintentional weight loss, slow gait, and low physical activity, which increase the incidence of adverse events, such as falls, hospitalizations and even death ( 36 ). Moreover, iron deficiency commonly co-occurs with depressive symptoms in older individuals ( 21 ).…”

“…Second, iron deficiency frequently co-occurs with chronic inflammatory diseases ( 34 ). The sTfR has been found to significantly and positively correlate with CRP concentration ( 36 ) and antioxidant status, independently of covariates such as serum ferritin and hepcidin ( 38 ). Mild elevation of sTfR levels in multiple sclerosis patients may indicate active inflammation with ongoing oxidative damage that is not detectable through history or examination ( 39 ).…”

“…Iron deficiency is also common in patients with idiopathic pulmonary arterial hypertension and is associated with disease severity and poor clinical outcome (35). Third, a confirmed relationship exists between reduced iron concentration and the occurrence of frailty syndrome (36). Patients with diagnosed frailty syndrome represent a unique group of individuals with chronic illnesses.…”

Composite Biomarkers for Assessing Frailty Status in Stable Older Adults With Cardiovascular Disease

“…19 A recent study confirmed the relationship between reduced iron concentration and the occurrence of frailty syndrome. 20 Iron deficiency affects up to 50% of CVD patients, and its association with poor quality of life, impaired exercise tolerance, and increased mortality rates has been widely established. 21 Current European Society of Cardiology Guidelines for CVD recommend a diagnostic workup for iron deficiency in all CVD patients.…”