Circulating Interleukin-6 (but Not Other Immune Mediators) Associates with Criteria for Fried’s Frailty among Very Old Adults

Background and Aim. Frailty is a geriatric condition resulting from physiological changes covering the musculoskeletal, immune, and neuroendocrine systems, leading to a greater inflammatory state. The present research aimed to investigate the association of components of Fried’s frailty (as well as of the phenotype as a whole) with total serum levels of a panel of inflammatory mediators. Methods. One hundred and sixty-one very old patients (aged ≥80 years) devoid of cognitive decline were eligible for analyses. Clinical and biochemical data along with physical and cognitive assessments encompassing dual-energy X-ray scans and hand dynamometry were adopted to investigate frailty criteria, while circulating immune mediators (IFNγ, IL-2, IL-4, IL-6, IL-10, and TNFα) were assessed using high-throughput flow cytometry. Results. Preliminarily, IL-6 correlated positively with waist-to-hip ratio and C-reactive protein and negatively with glycemia. In analyses controlled for these factors, serum levels of IL-6 were comparatively augmented among the very old participants with reduced grip strength (OR = 3.299; 95% CI 1.08–6.09; p = 0.032 ) and among those with slow walk speed (OR = 2.460; 95% CI 1.16–7.05; p = 0.022 ). Conclusions. Our study shows a strong negative correlation of IL-6 levels with Fried’s frailty components of grip strength and walk speed in very old adults, regardless of confounding factors.

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Grip strength and inflammatory biomarker profiles in very old adults

Age and Ageing ◽

10.1093/ageing/afx088 ◽

2017 ◽

Vol 46 (6) ◽

pp. 976-982 ◽

Cited By ~ 13

Author(s):

Antoneta Granic ◽

Karen Davies ◽

Carmen Martin-Ruiz ◽

Carol Jagger ◽

Thomas B L Kirkwood ◽

...

Keyword(s):

Grip Strength ◽

Very Old ◽

Old Adults ◽

Inflammatory Biomarker

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P-409: Mortality in very old patients using statins with high cholesterol and albumin serum levels

European Geriatric Medicine ◽

10.1016/s1878-7649(15)30506-4 ◽

2015 ◽

Vol 6 ◽

pp. S141-S142

Author(s):

D. Justo ◽

M. Tchernichovsky ◽

H. Mayan

Keyword(s):

Serum Levels ◽

High Cholesterol ◽

Old Patients ◽

Very Old ◽

Very Old Patients

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Initial level and rate of change in grip strength predict all-cause mortality in very old adults

Age and Ageing ◽

10.1093/ageing/afx087 ◽

2017 ◽

Vol 46 (6) ◽

pp. 970-976 ◽

Cited By ~ 14

Author(s):

Antoneta Granic ◽

Karen Davies ◽

Carol Jagger ◽

Richard M. Dodds ◽

Thomas B L Kirkwood ◽

...

Keyword(s):

Grip Strength ◽

Initial Level ◽

Rate Of Change ◽

Very Old ◽

Old Adults ◽

All Cause Mortality

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Upregulated Intrathecal Expression of VEGF-A and Long Lasting Global Upregulation of Proinflammatory Immune Mediators in Vaccine Breakthrough Tick-Borne Encephalitis

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.696337 ◽

2021 ◽

Vol 11 ◽

Author(s):

Miša Pavletič ◽

Misa Korva ◽

Nataša Knap ◽

Petra Bogovič ◽

Lara Lusa ◽

...

Keyword(s):

Immune Cell ◽

Serum Levels ◽

Effective Vaccine ◽

Convalescent Phase ◽

Cell Counts ◽

Immune Mediators ◽

Tick Borne Encephalitis ◽

Healthy Donors ◽

Proinflammatory Responses ◽

Inflammatory State

Although anti-TBE vaccines are highly effective, vaccine breakthrough (VBT) cases have been reported. With increasing evidence for immune system involvement in TBE pathogenesis, we characterized the immune mediators reflecting innate and adaptive T and B cell responses in neurological and convalescent phase in VBT TBE patients. At the beginning of the neurological phase, VBT patients have significantly higher serum levels of several innate and adaptive inflammatory cytokines compared to healthy donors, reflecting a global inflammatory state. The majority of cytokines, particularly those associated with innate and Th1 responses, are highly concentrated in CSF and positively correlate with intrathecal immune cell counts, demonstrating the localization of Th1 and proinflammatory responses in CNS, the site of disease in TBE. Interestingly, compared to unvaccinated TBE patients, VBT TBE patients have significantly higher CSF levels of VEGF-A and IFN-β and higher systemic levels of neutrophil chemoattractants IL-8/CXCL8 and GROα/CXCL1 on admission. Moreover, serum levels of IL-8/CXCL8 and GROα/CXCL1 remain elevated for two months after the onset of neurological symptoms, indicating a prolonged systemic immune activation in VBT patients. These findings provide the first insights into the type of immune responses and their dynamics during TBE in VBT patients. An observed systemic upregulation of neutrophil derived inflammation in acute and convalescent phase of TBE together with highly expressed VEGF-A could contribute to BBB disruption that facilitates the entry of immune cells and supports the intrathecal localization of Th1 responses observed in VBT patients.

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Relationship Between Perceived Physical and Mental Fatigability and Physical Performance in Very Old Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.576 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 178-178

Author(s):

Yixin Hu ◽

Zhuangzhuang Zhang ◽

Woei-Nan Bair ◽

Anying Bai ◽

Li Fan

Keyword(s):

Grip Strength ◽

Physical Performance ◽

Performance Measures ◽

Gait Speed ◽

Clinical Importance ◽

Community Dwelling ◽

Very Old ◽

Chair Stand ◽

Old Adults ◽

Usual Gait Speed

Abstract To investigate the relationship between perceived physical and mental fatigability and physical performance in community-dwelling very old adults (≥80 years). We examined the association in one retired community in Beijing including 404 very old adults. Pittsburgh Fatigability Scale (PFS), Chinese version, was used to assess perceived fatigability in physical domain (PFS-P) and mental domain (PFS-M). High fatigability is defined as PFS-P ≥ 15, and PFS-M ≥ 13. Physical performance measures include grip strength, usual gait speed, chair stand and Short Physical Performance Battery (SPPB) test. Women have higher PFS scores (both PFS-P & PFS-M) and higher prevalence of high fatigability than men. After adjusting for sex, usual gait speed and SPPB scores were significantly associated with PFS-P & PFS-M, while grip strength and chair stand performance were significantly associated with PFS-P only. After multivariable adjustment, usual gait speed (B=-3.745, P=0.021) and chair stand performance (B=0.335, P=0.005) were significantly associated with PFS-P, while usual gait speed (B=-2.656, P=0.006) and SPPB scores (B=-0.214, P=0.029) were significantly associated with PFS-M. Perceived physical and mental fatigability is highly prevalent in very older adults and they differ by sex. The significant associations between PFS scores and performance measures suggest that PFS is of potential clinical importance, especially when testing performance measures are not feasible. Utilization of PFS score can assist in identifying target populations who are at risk of reduced physical functions, such as older with depression, older women. Interventions to improve usual gait speed are likely to reduce both perceived physical and mental fatigability.

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Central Nervous System Depressants and Risk of Hospitalization due to Community-Acquired Pneumonia in very Old Patients

Current Drug Safety ◽

10.2174/1574886315666200319110114 ◽

2020 ◽

Vol 15 (2) ◽

pp. 131-136

Author(s):

Jeronimo Espinosa ◽

Paulino A. Alvarez ◽

Veronica Castro ◽

Maria F. Caceres ◽

Maria C. Soler-Riera ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Drug Interactions ◽

Community Acquired Pneumonia ◽

Old Patients ◽

Very Old ◽

Old Adults ◽

Increased Risk ◽

Wide Range ◽

Very Old Patients

Background: Central Nervous System (CNS) depressants like antipsychotics, opioids, benzodiazepines and zolpidem are frequently used by patients of a wide range of ages. Uncertainty remains about their effect in very old adults (>80 years old) and their potential for pharmacodynamic and pharmacokinetic drug-drug interactions in this population. Objective: To assess if the use of CNS depressants is associated with a higher risk of hospitalization due to community-acquired pneumonia (CAP) in very old patients. Methods: In this prospective study, 362 patients over 80 years of age who had been consequently admitted to the general ward of a teaching hospital were examined. Each patient was assessed, by our pharmacovigilance team within 24 hours of admission, to identify outpatient medication use and potential drug-drug interactions. Results: The overall use of CNS depressants as a group was not associated with a higher risk of admission due to CAP in very old patients (55% vs. 49%; OR=1.28 [0.76-2.16], p=0.34). However, the use of antipsychotics was associated with a higher rate of admissions due to CAP in this population (OR=1.98 [1.10-3.57], p=0.02). No association was seen between opioids (p=0.27), zolpidem (p=0.83), or benzodiazepines (p=0.15) and the rate of admissions due to CAP in these patients. Moreover, pharmacodynamic or pharmacokinetic interactions leading to CNS depression were equally found in patients admitted for CAP and those admitted for other reasons. Conclusion: The use of antipsychotics in very old adults was associated with an increased risk of hospital admission due to CAP. This suggests that the use of these medications in this population should be done with caution. No association was observed with opioids, benzodiazepines and zolpidem with the latter outcome.

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