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Cited by 901Nutrition and Health in AgingFrailty in Older AdultsAdipokines, Inflammation, and Metabolic Diseases

Inflammatory Markers and Physical Performance in Older Persons: The InCHIANTI Study

Cesari, M., Penninx, B. W. J. H., Pahor, M., Lauretani, F., Corsi, A. M., Williams, G. R., Guralnik, J. M., Ferrucci, L.·2004·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
DOI 10.1093/gerona/59.3.m242
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Abstract

BACKGROUND: Some studies have proposed chronic inflammation as an underlying biological mechanism responsible for physical function decline in elderly people. The aim of this study is to evaluate the relationship between several inflammatory markers and physical performance in an older population. METHODS: This study is part of the "Invecchiare in Chianti" (InCHIANTI) study, a prospective population-based study of older people, aimed at identifying risk factors for late-life disability. The study sample consisted of 1020 participants aged 65 years and older living in the Chianti area of Italy. Physical performance was assessed using walking speed, the chair-stand test, and the standing balance test. Hand-grip strength was assessed using a hand-held dynamometer. Serum levels of C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor-alpha (TNF-alpha), IL-10, IL-1beta, IL-6sR, and IL-1RA were determined. Linear regression analyses were used to assess the multivariate relationship of inflammatory marker levels with physical performance, scored as a continuous variable from 0 to 3, and hand-grip strength after adjustment for demographics, chronic conditions, medication use, and other biological variables. RESULTS: CRP, IL-6, and IL1RA were significantly correlated with physical performance (r=-0.162, r=-0.251, and r=-0.127, respectively). Significant correlations with hand-grip strength were found for CRP and IL-6 (r=-0.081 and r=-0.089, respectively). After adjustment for covariates, high levels of IL-6 and IL-1RA continued to be strongly associated with worse physical performance (p<.001 and p=0.004, respectively). High levels of CRP (p<.001) and IL-6 (p<.001) were associated with low hand-grip strength. Mean adjusted physical performance scores ranged from 2.21 in the CRP<0.59 mg/dl group to 2.07 in the CRP>0.60 mg/dl group (p for trend=.004), and from 2.25 in the lowest IL-6 quartile to 2.08 in the highest IL-6 quartile (p for trend<.001). This trend was also reflected in mean adjusted hand-grip strength, with a range from 28.8 kg for the CRP<0.59 mg/dl group to 26.0 kg for the CRP>0.60 mg/dl group (p for trend=.001), and from 27.4 kg for the lowest IL-6 quartile to 25.1 kg for the highest IL-6 quartile (p for trend=.001). CONCLUSIONS: Inflammation, measured as high levels of IL-6, CRP, and IL-1RA, is significantly associated with poor physical performance and muscle strength in older persons. These data also support the biological face validity of physical performance measures. The assessment of inflammatory markers may represent a useful screening test and perhaps a potential target of intervention.

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Crossref · 10.1093/gerona/59.3.m242

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  • Higher levels of inflammatory markers in blood are associated with greater loss of muscle mass and strength, accelerated loss of mobility, lower-extremity performance and physical activity, and depression in older individuals.

    “higher levels of inflammatory markers in blood are associated with a greater loss of muscle mass and strength, accelerated loss of mobility, lower-extremity performance and physical activity, and depression in older individuals”

    From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [227]

  • In overweight and obese subjects, a hypoenergetic diet with whole-grain foods decreased CRP by 38% independent of weight loss, but did not change IL-6, TNF-a or PAI-1 activity over 12 weeks.

    “CRP concentration decreased by 38 % (CRP at baseline 5•9-6•0 mg/l) in the whole-grain group independent of the observed weight loss (319) .”

    From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [319]

  • Low-grade chronic inflammation, characterized by elevations in plasma CRP, TNF-α, and particularly IL-6, is an independent risk factor for disability, impaired mobility, and slow walking speed.

    “low-grade chronic inflammation, characterized by elevations in plasma C-reactive protein (CRP), tumor necrosis factor Alpha (TNF-α), and particularly interleukin-6 (IL-6),(Brinkley, Leng, Miller, Kitzman, Pahor, Berry, Marsh, Kritchevsky, and Nicklas 2009;Cesari, Penninx, Pahor, Lauretani, Corsi, Guralnik, and Ferrucci 2004;Ferrucci, Harris, Guralnik, Wacholder, Tracy, Corti, Penninx, Pahor, Wall”

    From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Cesari et al. 2004

  • Cross-sectional studies demonstrate an association between physical inactivity and low-grade systemic inflammation in healthy subjects, elderly people, and patients with intermittent claudication.

    “Cross-sectional studies demonstrate an association between physical inactivity and low-grade systemic inflammation in healthy subjects [71–75], in elderly people [76, 77], and in patients with intermittent claudication [78].”

    From Exercise as a Mean to Control Low‐Grade Systemic Inflammation (2008) · cites this paper as [77]

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Authors
Cesari, M., Penninx, B. W. J. H., Pahor, M., Lauretani, F., Corsi, A. M., Williams, G. R., Guralnik, J. M., & Ferrucci, L.
Affiliations
  • Wake Forest University Health Sciences (US)
  • National Research Council (IT)
  • Bristol-Myers Squibb (United States) (US)
  • National Institutes of Health (US)
Corresponding author
Cesari, M.
ORCID
Venue
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher
Oxford University Press (OUP)
Published
2004-03-01
Volume
59
Issue
3
Pages
M242-M248
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/59.3.m242
OpenAlex
W2131692209
Cited by
901
References
46
Citations by year
2026: 36 · 2025: 31 · 2024: 54 · 2023: 52 · 2022: 53 · 2021: 39 · 2020: 60 · 2019: 43 · 2018: 47 · 2017: 53 · 2016: 47 · 2015: 49 · 2014: 53 · 2013: 48 · 2012: 27
FWCI
15.25
Type
journal article
Language
en
Open access
closed
Locations
  • The Journals of Gerontology Series A (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute on Aging (P30AG021332)
  • National Institute on Minority Health and Health Disparities (263-MD-916413, 263MD 821336)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
chronic inflammation, inflammatory markers, physical performance, older adults, C-reactive protein, interleukin-6, interleukin-1 receptor antagonist, grip strength, walking speed, chair stand test, standing balance, late-life disability, InCHIANTI study, functional decline in aging, cytokines, TNF-α, IL-10, IL-1β
MeSH terms
Aged, Aged, 80 and over, Aging, Female, Humans, Italy, Male, Physical Fitness, Prospective Studies, Risk Factors, Biomarkers, Inflammation Mediators

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