Frailty through the Lens of Chronic Low-grade Inflammation in Older Adults: A Cross-sectional Study

Background: Frailty is recognized as a geriatric giant that is associated with vulnerability and poor health outcomes in older adults. The interrelationship between frailty and systemic inflammation (inflammaging) is poorly studied, especially in the population residing in developing countries. The objective of the study was to study the prevalence of frailty and prefrailty and its associations with inflammatory markers and geriatric syndromes. Methodology: A cross-sectional observational study was conducted in 387 older adults aged ≥60 years attending outpatient departments (OPDs) in a tertiary care hospital. Frailty assessment was done by Fried’s criteria. Inflammatory markers included interleukin-6 (IL-6) and highly sensitive C-reactive protein (hsCRP). Inflammatory markers were measured using enzyme-linked immunosorbent assay-based assays. Statistical analysis employed the Chi-square test, Kruskal–Wallis test, and logistic regression analysis. Results: Frailty was present in 19.9% of subjects, with prefrailty in 37%, while 43.1% of subjects were nonfrail. There were significant associations between frailty and decreased calf circumference ( P < 0.001), smoking ( P < 0.001), hypertension ( P = 0.010), diabetes mellitus ( P = 0.042), chronic obstructive pulmonary disease (COPD) ( P = 0.047), falls ( P < 0.001), urinary incontinence ( P = 0.019), and depression ( P < 0.001). hsCRP and IL-6 levels showed significant elevation with increasing frailty severity ( P < 0.001 and P = 0.005, respectively). Logistic regression identified calf circumference, smoking, hypertension, diabetes, COPD, falls, incontinence, and depression as independent predictors of frailty. Conclusion: Frailty and prefrailty were prevalent among older adults attending OPD in a tertiary care hospital. Indian older adults have a significant association of frailty with inflammatory markers. Early identification and targeted intervention addressing reversible risk factors may help in improving the outcomes in older adults.