Insulin Resistance and Inflammation as Precursors of Frailty

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Abstract
The geriatric syndrome of frailty is characterized by decreased reserve in multiple physiologic systems.1 It predicts adverse health outcomes independent of advancing age, chronic disease, and functional limitations, thereby suggesting that it is a distinct condition.2-4 Using data from the Cardiovascular Health Study (CHS)5 and the Women's Heath and Aging Studies,6 our research group tested and validated the hypothesis that frailty could be defined as a syndrome consisting of involuntary weight loss, exhaustion, low physical activity, slowness, and weakness. Subsequently, a physiologic basis for this phenotype was explored.7 On cross-sectional analysis, frailty was associated with adiposity, altered markers of carbohydrate metabolism, hypertension, and elevated markers of inflammation and coagulation. All of these findings are characteristics of the metabolic syndrome (MetS).8