Advertisement

Individual and cumulative association of commonly used biomarkers on frailty: a cross-sectional analysis of the Mexican Health and Aging Study

  • Mario Ulises Pérez-Zepeda
  • Carmen García-Peña
  • María Fernanda Carrillo-VegaEmail author
Original Article

Abstract

Frailty has been recognized as a common condition in older adults, however, there is scarce information on the association between frailty and commonly used biomarkers. The aim of this study was to assess the individual and cumulative association of biomarkers with frailty status. This is a cross-sectional analysis of the 2012 wave of the Mexican Health and Aging Study. A sub-sample of 60-year or older adults with anthropometric measurements was analyzed. Frailty was defined with a 31-item frailty index and those considered frail had a score ≥ 0.21. Biomarkers were further categorized as normal/abnormal and tested both one by one and grouped (according to their usual cutoff values). Adjusted logistic models were performed. A total of 1128 older adults were analyzed and their mean age was 69.45 years and 51.24% of them were women. 26.7% (n = 301) were categorized as frail. Individual biomarkers associated with frailty after adjusting for confounding were: hemoglobin [odds ratio (OR) 1.67, 95% confidence interval (CI) 1.13–2.46, p = 0.009], glycated hemoglobin (OR 2.04, 95% CI 1.54–2.7, p < 0.001) and vitamin D (OR 1.53, 95% CI 1.13–2.07, p = 0.005). Those with ≥ 4 abnormal biomarkers had an independent association with frailty when compared to those without any abnormal biomarker (OR 2.64, 95% CI 1.3–5.25, p = 0.005). Aside from the individual associations of specific biomarkers, our findings show that an incremental association of abnormal biomarkers increases the probability of frailty, accounting for the multidimensional nature of frailty and the possible interplay between components of the system that potentiate to give rise to a negative condition such as frailty.

Keywords

Frail older adult Geriatric epidemiology Biomarkers Aging 

Notes

Funding

The Mexican Health and Aging Study was supported in its 2012 version by National Institutes of Health/National Institute on Aging (R01AG018016, R Wong, PI).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the present study were in accordance with the ethical standards of the National Geriatrics Institute research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

40520_2019_1127_MOESM1_ESM.docx (305 kb)
Supplementary material 1 (DOCX 304 KB)

References

  1. 1.
    Morley JE, Vellas B, Van Kan GA et al (2013) Frailty consensus: a call to action. J Am Med Dir Assoc 14:392–397CrossRefGoogle Scholar
  2. 2.
    Mitnitski A, Song X, Rockwood K (2013) Assessing biological aging: the origin of deficit accumulation. Biogerontology 14:709–717CrossRefGoogle Scholar
  3. 3.
    Rockwood K, Theou O, Mitnitski A (2015) What are frailty instruments for? Age Ageing 44:545–547CrossRefGoogle Scholar
  4. 4.
    Walston J, Hadley EC, Ferrucci L et al (2006) Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc 54:991–1001CrossRefGoogle Scholar
  5. 5.
    Carpenter CR, Shelton E, Fowler S et al (2015) Risk factors and screening instruments to predict adverse outcomes for undifferentiated older emergency department patients: a systematic review and meta-analysis. Acad Emerg Med 22:1–21CrossRefGoogle Scholar
  6. 6.
    Gutierrez-Robledo LM (2002) Looking at the future of geriatric care in developing countries. J Gerontol A Biol Sci Med Sci 57:M162–M167CrossRefGoogle Scholar
  7. 7.
    Blodgett JM, Theou O, Howlett SE et al (2017) A frailty index from common clinical and laboratory tests predicts increased risk of death across the life course. GeroScience 39:447–455CrossRefGoogle Scholar
  8. 8.
    Rockwood K, Mcmillan M, Mitnitski A et al (2015) A frailty index based on common laboratory tests in comparison with a clinical frailty index for older adults in long-term care facilities. J Am Med Dir Assoc 16:842–847CrossRefGoogle Scholar
  9. 9.
    Gutierrez-Robledo LM, Avila-Funes JA, Amieva H et al (2016) Association of low serum 25-hydroxyvitamin D levels with the frailty syndrome in Mexican community-dwelling elderly. Aging Male 19:58–63CrossRefGoogle Scholar
  10. 10.
    Buta B, Choudhury PP, Xue QL et al (2017) The association of vitamin D deficiency and incident frailty in older women: the role of cardiometabolic diseases. J Am Geriatr Soc 65:619–624CrossRefGoogle Scholar
  11. 11.
    Ensrud KE, Blackwell TL, Cauley JA et al (2011) Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study. J Am Geriatr Soc 59:101–106CrossRefGoogle Scholar
  12. 12.
    Ensrud KE, Ewing SK, Fredman L et al (2010) Circulating 25-hydroxyvitamin D levels and frailty status in older women. J Clin Endocrinol Metab 95:5266–5273CrossRefGoogle Scholar
  13. 13.
    Orces CH (2017) Prevalence of clinically relevant muscle weakness and its association with vitamin D status among older adults in Ecuador. Aging Clin Exp Res 29:943–949CrossRefGoogle Scholar
  14. 14.
    Puts MT, Visser M, Twisk JW et al (2005) Endocrine and inflammatory markers as predictors of frailty. Clin Endocrinol (Oxf) 63:403–411CrossRefGoogle Scholar
  15. 15.
    Cesari M, Penninx BW, Pahor M et al (2004) Inflammatory markers and physical performance in older persons: the InCHIANTI study. J Gerontol A Biol Sci Med Sci 59:242–248CrossRefGoogle Scholar
  16. 16.
    Virgini VS, Wijsman LW, Rodondi N et al (2014) Subclinical thyroid dysfunction and functional capacity among elderly. Thyroid 24:208–214CrossRefGoogle Scholar
  17. 17.
    Fried LP, Xue QL, Cappola AR et al (2009) Nonlinear multisystem physiological dysregulation associated with frailty in older women: implications for etiology and treatment. J Gerontol A Biol Sci Med Sci 64:1049–1057CrossRefGoogle Scholar
  18. 18.
    Cappola AR, Xue QL, Fried LP (2009) Multiple hormonal deficiencies in anabolic hormones are found in frail older women: the women’s health and aging studies. J Gerontol A Biol Sci Med Sci 64:243–248CrossRefGoogle Scholar
  19. 19.
    Ferrucci L, Cavazzini C, Corsi A et al (2002) Biomarkers of frailty in older persons. J Endocrinol Investig 25:10–15CrossRefGoogle Scholar
  20. 20.
    Wong R, Michaels-Obregon A, Palloni A (2017) Cohort profile: the Mexican Health and Aging Study (MHAS). Int J Epidemiol 46:e2CrossRefGoogle Scholar
  21. 21.
    Wong R, Michaels-Obregon A, Palloni A et al (2015) Progression of aging in Mexico: the Mexican Health and Aging Study (MHAS) 2012. Salud Publica Mex 57:S79–S89CrossRefGoogle Scholar
  22. 22.
    Searle SD, Mitnitski A, Gahbauer EA et al (2008) A standard procedure for creating a frailty index. BMC Geriatr 8:24CrossRefGoogle Scholar
  23. 23.
    Garcia-Gonzalez JJ, Garcia-Pena C, Franco-Marina F et al (2009) A frailty index to predict the mortality risk in a population of senior Mexican adults. BMC Geriatr 9:47CrossRefGoogle Scholar
  24. 24.
    Schalk BW, Visser M, Deeg DJ et al (2004) Lower levels of serum albumin and total cholesterol and future decline in functional performance in older persons: the longitudinal aging study Amsterdam. Age Ageing 33:266–272CrossRefGoogle Scholar
  25. 25.
    Schoufour JD, Echteld MA, Boonstra A et al (2016) Biochemical measures and frailty in people with intellectual disabilities. Age Ageing 45:142–148CrossRefGoogle Scholar
  26. 26.
    Castrejon-Perez RC, Aguilar-Salinas CA, Gutierrez-Robledo LM et al (2017) Frailty, diabetes, and the convergence of chronic disease in an age-related condition: a population-based nationwide cross-sectional analysis of the Mexican nutrition and health survey. Aging Clin Exp Res 30:935–941CrossRefGoogle Scholar
  27. 27.
    Castrejon-Perez RC, Gutierrez-Robledo LM, Cesari M et al (2017) Diabetes mellitus, hypertension and frailty: A population-based, cross-sectional study of Mexican older adults. Geriatr Gerontol Int 17:925–930CrossRefGoogle Scholar
  28. 28.
    Zuliani G, Volpato S, Romagnoni F et al (2004) Combined measurement of serum albumin and high-density lipoprotein cholesterol strongly predicts mortality in frail older nursing-home residents. Aging Clin Exp Res 16:472–475CrossRefGoogle Scholar
  29. 29.
    Shardell M, Hicks GE, Miller RR et al (2009) Association of low vitamin D levels with the frailty syndrome in men and women. J Gerontol A Biol Sci Med Sci 64:69–75CrossRefGoogle Scholar
  30. 30.
    Van Hemelrijck M, Harari D, Garmo H et al (2012) Biomarker-based score to predict mortality in persons aged 50 years and older: a new approach in the Swedish AMORIS study. Int J Mol Epidemiol Genet 3:66–76Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Instituto Nacional de GeriatríaMexicoMéxico
  2. 2.Instituto de Envejecimiento, Facultad de MedicinaPontificia Universidad JaverianaBogotáColombia
  3. 3.Instituto Nacional de GeriatríaMexicoMexico

Personalised recommendations