Relationship between coronary risk factors, c-reactive protein, bone mineral density and carotid circulation among frail elderly

ABSTRACT

Frailty may now be regarded as a geriatric syndrome of decreased reserve and resistance tostressors, resulting from cumulative declines across multiple physiologic systems, causing vulnerability toadverse health outcomes including falls, hospitalisation, institutionalisation and mortality. Theinflammatory mediators as C-reactive protein have been associated with the development of the geriatricfrailty. Several studies have pointed out increased level of homocystiene in frail elderly Increasing frailtywas associated with lower bone mineral density, as both bone mass and muscle strength decrease duringageing and this has also been associated with higher risk of osteoporotic fractures in frail elderly. To compare frail and non-frail elderly regarding Bone mineral density, carotid circulation andserum levels of Homocysteine, coronary risk factors and CRP. 104 elderly patients, who were assigned to 2 groups. Group A [52 frail participants]diagnosed byFried's criteria as applied byAvila-Funes et al., 2008. Group B [52 non-frailparticipants].All participants were subjected to the following through history, physical examination,ADL, IADL assessment, MMSE ,GDS, laboratory investigations including; CRP, homocystiene and totallipid profile, measurement of bone mineral density by DEXA and carotid intima-media thickness bycarotid duplex. There was no statistically significant difference in age, sex, among both groups.Frail participantshad higher ADL and IADL dependence, higher incidence of depression, cognitive impairment andosteoprosis.They also had higher levels of homocystiene, CRP, CIMT and lower levels of HDLcholesterol. Osteoporosis is more prevalent among frail elderly also frailty is associated with more ADL and IADL dependence, higher GDS scores and lower MMSE score in addition to higher mean level ofhomocystiene, CRP and triglycerides in addition to low serum HDL and higher CIMT