Significant Association between Physical Performance and Inflammatory Biomarkers in Older Adults with Frailty in Rural Thailand

Background: The etiology of frailty is complex and incompletely understood, and is associated with alterations in the immune system, resulting in chronic low-grade inflammation. However, few studies have explored the inflammatory biomarkers related to physical performance in the elderly. Methods: We evaluated the prevalence of frailty with a cross-sectional study among older adults in rural communities in Thailand (n = 457, mean age of 71.4 ± 5.8 years) with Fried’s frailty phenotype including five criteria: weight loss, exhaustion, slowness, weakness, and inactivity. The association between inflammatory biomarkers (serum interleukin-6, IL-6 and C-reactive protein, CRP levels) and physical performance (grip strength, walk times and VO2Max) was examined in frail participants (n=64). Results: The prevalence of frailty and pre-frailty in this population was 37.4% (95% CI, 32.9-42.0) and 54% (95% CI, 49.4-58.7). Multiple linear regression analysis found that serum IL-6 level was significantly elevated in frail older adults with low grip strength (beta = -0.348, SE= 0.155, p = 0.029). Serum CRP level was also elevated significantly in frail older adults with low grip strength (beta = -0.049, SE= 0.023, p = 0.04) and low VO2Max (beta = -0.047, SE= 0.019, p = 0.016) after adjustment for sex, age, hypertension, diabetes, osteoporosis, heart disease, and BMI. Conclusion: Our findings support a low level of grip strength as predictor of inflammatory biomarkers in older adults with frailty. Primary care practitioners could use frailty indicators and performance combined with serum biomarkers for early health risk detection in older adults.