Serum Inflammatory Factors and Oxidative Stress Factors Are Associated With Increased Risk of Frailty and Cognitive Frailty in Patients With Cerebral Small Vessel Disease

Abstract

Objective: To study the correlation between serum inflammatory factors, oxidative stress factors and frailty, and cognitive frailty in patients with cerebral small vessel disease (CSVD).Methods: A total of 281 patients with CSVD were selected from Tianjin Huanhu Hospital and Inner Mongolia People's Hospital from March 2019 to March 2021. CSVD was diagnosed by MRI. The FRAIL scale was used to evaluate the frailty of patients. Patients with CSVD with frailty and MMSE score <27 were considered to have cognitive frailty. Patients with non-cognitive frailty were included in the control group. The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate the cognitive function of patients with CSVD. The serum interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase 3 (MMP-3), superoxide dismutase (SOD), and malondialdehyde (MDA) of patients with CSVD were detected. The correlation between blood inflammatory factors and oxidative stress factors with the frailty and cognitive frailty patients of CSVD were analyzed. Univariate and multivariate logistic regression were used to analyze the correlation between cognitive frailty and CSVD.Results: Among the patients with CSVD selected in this study, female patients and older patients had a higher proportion of frailty (p < 0.001). In the Frail group, MoCA score and MMSE score were significantly lower than in the Pre-Frail and Robust groups, Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores were significantly higher than the Pre-Frail and Robust groups, and the differences were statistically significant (p < 0.05). Serum CRP, IL-6, TNF-α, MMP-3, and MDA levels in the Frail group were higher, but SOD levels were lower. The levels of serum CRP, IL-6, TNF-α, MMP-3, and MDA in patients with CSVD in the Cognitive Frailty group were significantly higher than those of the Control group, while the levels of SOD were significantly lower than those of the Control group, and the differences were significant (p < 0.001). The results of univariate and multivariate logistic regression analysis showed that CRP, TNF-α, MMP-3, and MDA levels were associated with cognitive frailty in patients with CSVD (p < 0.05).Conclusion: The increase of serum CRP, TNF-α, MMP-3, and MDA levels are significantly related to the increased risk of frailty and cognitive frailty in patients with CSVD.

Understanding exogenous factors and biological mechanisms for cognitive frailty: a multidisciplinary scoping review

“…Zhang et al (2021) suggested sex was not a clear risk factor for CF. Sugimoto et al, (2022) indicated a number of studies reporting a higher prevalence of CF in women (Das, 2022; Ge et al, 2020; Ma et al, 2017; Mu et al, 2021). Though women experience higher rates of CI (Sharifi et al, 2021), or both PF and CI (Ge et al, 2020), men may be at higher risk of physical limitations only (Ge et al, 2020), and (Kritchevsky et al, 2019) noted higher functional limitations in women.…”

“…Ma and Chan, (2020) and Diniz et al, (2022) showed that both CF and PF alone are associated with elevated IL-6. Mu et al, (2021) found that CRP, TNF-α, MMP-3, and MDA levels were associated with CF in patients with cerebral small vessel disease, suggesting anti-inflammatory treatment may be helpful to delay cognitive decline. Recently, Visconte et al, (2023) showed that microglia-derived extracellular vesicles (MDVs), suggested to be involved in propagation of inflammatory signals, were increased in patients with MCI and frailty compared to non-frail controls.…”

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

“…They found a positive association between total antioxidant capacity and frailty, as well as for IL-6 and frailty before and after accounting for age and body mass index [91,92]. In other research, on patients with cerebral small vessel disease and cognitive frailty, an increased lipid peroxidation measured by MDA level and lower SOD activity were seen together with elevated inflammatory markers (CRP, IL-6, TNF-α) [93].…”

Effects of Baduanjin exercise on cognitive frailty, oxidative stress, and chronic inflammation in older adults with cognitive frailty: a randomized controlled trial

“…Although the causes of CF are complex and multidimensional, increasing studies indicate oxidative stress and inflammation play an important role in the development of CF in older adults (9,(51)(52)(53).…”