Inflammatory mediators, muscle and functional performance of community-dwelling elderly women
Introduction
Aging populations are a worldwide phenomenon, and the World Health Organization has stated that Brazil will have the sixth oldest population in the world by 2025. Like other countries, there is a predominance of women among the elderly population (55%) in Brazil, and there is growing interest in gerontological research on the “feminization of old age” phenomenon (IBGE, 2010).
The presence of an aging population leads to a greater prevalence of functional disability (Raiche, Hebert, Dubois, Gueye, & Dubuc, 2012). Several clinical measurements can be applied as predictors of function and disability in the elderly; gait speed, for example, has been noted to be a feasible, reliable, and valid measure (Fritz & Lusardi, 2009) as well as a predictor of adverse effects such as disability, risk for falls, and mortality (Studenski et al., 2009). According to Fried, Ferruci, Darer, Williamson, & Anderson (2004) sarcopenia is one of the factors that influence performance on gait speed tests.
Based on a European consensus achieved in 2010, Cruz-Jentoft et al. proposed that sarcopenia is a geriatric syndrome characterized by loss of muscle mass and function without the need for the occurrence of disease for its appearance, although this process could be enhanced due to some chronic conditions. There is a high prevalence of sarcopenia among the elderly (Arango-Lopera, Arroyo, Gutierrez-Robledo, & Perez-Zepeda, 2012), and instruments such as isokinetic dynamometers and handgrip dynamometers can be used to assess muscle function (Aquino et al., 2002, Mathiovetz et al., 1984).
Hormonal, metabolic, and neural factors, as well as level of physical activity and immunosenescence contribute to the development and progression of sarcopenia. For example, plasma levels of acute inflammation-phase proteins and cytokines such as IL-6, tumor necrosis factor alpha (TNF-α) are increased 2–4 times because of immunosenescence in aging (Krabbe, Pedersen, & Bruunsgaard, 2004).
Most studies on cytokines focus on IL-6, which has been called “the cytokine of the gerontologists” (Ershler, 1993). Its physiological role has been studied within the context of the acute inflammatory-phase response. Other authors report that IL-6 is a multifunctional cytokine, acting as both a pro-inflammatory and anti-inflammatory cytokine depending on the conditions (Pedersen, Steenberg, & Schjering, 2001). It is also suggested that an isoform of IL-6 produced during proper muscle contraction (myokine) would be capable of inhibiting pro-inflammatory cytokines. Another cytokine related to the pro-inflammatory condition in the elderly is TNF-α, which, like IL-6, participates in the inflammatory cascade event during the acute phase of a tissue injury (Pedersen et al., 2001).
Natural induction of cytokines during inflammation seems to have a positive effect; however, overproduction of cytokines and maintenance of an inflammatory state for an extended period would probably be harmful. High levels of pro-inflammatory cytokines have been shown to be negatively related to muscle strength and mass as well as to functional performance in the elderly (Haddad, Zaldivar, Cooper, & Adanis, 2005). However, there is no consensus in the literature on a cutoff point to predict adverse physical and functional outcomes; the data in the literature are conflicting and studies are scarce in Brazil.
Therefore, the purpose of this study was to investigate the correlation between the inflammatory mediators IL-6 and sTNFR1 and muscle and physical performance in community-dwelling elderly women and association between the variables.
Section snippets
Study design and ethical aspects
This was a cross-sectional study. The Universidade Federal de Minas Gerais Ethics Committee approved the research protocol (ETIC 038/2010). We informed the participants of the characteristics of the study and they signed an informed consent form.
Sample
Sample selection was performed by convenience, and 221 community-dwelling elderly women aged 65 years or older were included in the study. Exclusion criteria were cognitive dysfunction as detected by Mini-Mental State Examination (MMSE) score, was
Results
The inclusion criteria for this study were met by 221 elderly women aged 71.07 ± 4.93 years. Participants were overweight (as determined by BMI), moderately active (as determined by the HAP), had a small number of comorbidities, and small percentage of the sample had depressive symptoms (as determined by the short version GDS-15 score) or cognitive dysfunction (as determined by the MMSE score). Descriptive sample characteristics are listed in Table 1. The variables habitual gait speed, peak
Discussion
The purpose of this study was to assess the correlation of plasma levels of IL-6 and sTNFR1 with the isokinetic muscle performance of knee flexors and extensors, and gait speed in community-dwelling elderly women. This research focus was selected because of multiple inter-related factors that contribute to the development and progression of sarcopenia in the elderly. Sarcopenia is enhanced by immunosenescence, in which the induction and expression of inflammatory mediators such as IL-6 and
Conclusion
There was no negative correlation between the inflammatory mediators IL-6 and sTNFR1 and muscle or physical performance in community-dwelling older women. These results may be explained by the fact that the cytokine levels did not reach the threshold needed to influence the muscle tissue and functionality of the participants.
Conflict of interest
None.
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