The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access originally published online on February 4, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009 64A(4):455-461; doi:10.1093/gerona/gln038
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Chronic Inflammation Is Associated With Low Physical Function in Older Adults Across Multiple Comorbidities
1 Section on Gerontology and Geriatric Medicine, Department of Internal Medicine
2 Department of Biostatistical Sciences, Division of Public Health Sciences
3 Section on Cardiology, Department of Internal Medicine
4 Department of Health and Exercise Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
5 Department of Aging and Geriatric Research, College of Medicine, Institute on Aging, University of Florida, Gainesville
Address correspondence to Tina E. Brinkley, PhD, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157. Email: tbrinkle{at}wfubmc.edu
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Abstract |
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Background: Chronic subclinical inflammation may contribute to impaired physical function in older adults; however, more data are needed to determine whether inflammation is a common mechanism for functional decline, independent of disease or health status.
Methods: We examined associations between physical function and inflammatory biomarkers in 542 older men and women enrolled in four clinical studies at Wake Forest University between 2001 and 2006. All participants were at least 55 years and had chronic obstructive pulmonary disease, congestive heart failure, high cardiovascular risk, or self-reported physical disability. Uniform clinical assessments were used across studies, including grip strength; a Short Physical Performance Battery (SPPB; includes balance, 4-m walk, and repeated chair stands); inflammatory biomarker assays for interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-
), and C-reactive protein (CRP); and anthropometric measures.
Results: Higher levels of CRP and IL-6, but not TNF-, were associated with lower grip strength and SPPB scores and longer times to complete the 4-m walk and repeated chair stands tests, independent of age, gender, and race. More importantly, these relationships were generally independent of disease status. Further adjustment for fat mass, lean mass, or percent body fat altered some of these relationships but did not significantly change the overall results.
Conclusions: Elevated CRP and IL-6 levels are associated with poorer physical function in older adults with various comorbidities, as assessed by a common battery of clinical assessments. Chronic subclinical inflammation may be a marker of functional limitations in older persons across several diseases/health conditions.
Keywords Inflammation; Physical function; Aging; Comorbidities
Received: January 14, 2008; Accepted: August 17, 2008