Homocysteine and C-Reactive Protein Levels Are Associated With Frailty in Older Spaniards: The Toledo Study for Healthy Aging

High-sensitivity C-reactive protein (hsCRP) and homocysteine (Hcy) are inflammation markers but are also related to cardiovascular diseases, disability, or higher risk of death. Although inflammation is considered to be associated with frailty, data regarding the association between hsCRP or Hcy and frailty are controversial or scarce, especially with respect to their association with prefrailty. Thus, our objective was to study the association of hsCRP and Hcy with prefrailty and frailty in 1,211 Spanish men and women aged 65â 98 years from the Toledo Study for Healthy Aging (TSHA) cohort, classified according to Friedâ s criteria. Hcy was independently associated with frailty (odds ratio [OR] = 1.06; 95% confidence interval [CI]: 1.01â 1.12), whereas hsCRP was independently associated with both prefrailty (OR = 1.03; 95% CI: 1.01â 1.06) and frailty (OR = 1.07; 95% CI: 1.02â 1.12). Furthermore, both markers were positively correlated with the number of Friedâ s criteria that were met and were independently associated with the criteria of exhaustion (Hcy: OR = 1.03, 95% CI: 1.00â 1.06), weakness (hsCRP: OR = 1.03, 95% CI: 1.01â 1.05), and low physical activity (hsCRP: OR = 1.04, 95% CI: 1.02â 1.06). Thus, our results highlight the importance of inflammation in age-related physical decline and, in particular, its association with fatigue, low strength, and decreased physical activity.This study was supported by the Instituto de Salud Carlos III (Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad; RD06/0013/0001, and RD12/0043/0012). Ministerio de Ciencia e Innovación; PI07/90175). NA-S was supported by fellowships from the Instituto de Salud Carlos III (Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad; RD06/0013/0001 and RD12/0043/0012) and by a fellowship from the Consejería de Salud, Junta de Andalucía (PC-0111-2016-0111). IC-C was supported by fellowships from the Ministerio de Educación, Cultura y Deporte (FPU13/01210) and Junta de Andalucía (CTS160)