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Associations of Weakness and Inflammation with Disability, Poor Cognition, and Multimorbidity in Older Adults

Kimberly S. Casten, MD, M.Phil. (University of Michigan PM&R Program, Ann Arbor, MI, United States)

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Saturday, November 16, 2019

Session Title: General Rehabilitation Case & Research Report

Session Time: 11:15am-12:45pm

Location: Research Hub - Kiosk 1

Disclosures: Kimberly S. Casten, MD, M.Phil.: Nothing to disclose

Objective: The expanding aging population has led to a growth of chronic disease morbidity, including aging-related mobility impairments and loss of nondisabled years in the United States. Muscle weakness and inflammation have both been implicated in sarcopenia. Weak grip strength is associated with increased inflammatory biomarkers. Higher levels of inflammatory markers increase muscle catabolism, loss of strength, mobility, activity levels, and worsened depression. Inflammation accumulation with aging is a risk factor for CVD, cancer, CKD, dementia, depression, multiple comorbidities, impaired mobility and ADLs.

Design: Prospective cohort study examining incidence of physical disability, multiple comorbidities, and cognitive impairment with grip strength normalized to body mass, and hs-CRP. Analyses were performed with linear and logistic regression. All models adjusted for sociodemographic variables: age, race, wealth, education, smoking status.

Setting: Physical disability was determined by self-reported difficulty with ADLs and physical capacity. Multimorbidity was defined as at least 2 serious medical diagnoses. The Telephone Interview for Cognitive Status determined cognitive impairment and dementia.

Participants: Adults aged 51 or older from the 2006/2008 Health and Retirement Study (HRS) with at least 6 years follow-up. n=10,751; Males: n=4421; Females: n=6330

Interventions: None

Main Outcome Measures: Independent effects of normalized grip strength and hs-CRP on the incidence of physical disability, multimorbidity, and cognitive impairment.

Results: Higher NGS was significantly associated with lower incidence of disability (OR: 0.82, 0.80) and multimorbidity (OR: 0.92, 0.90) risk (all P <.0001) for men and women, respectively. Higher hs-CRP was associated with multimorbidity, only in women (OR 1.8, P <.005). There was no significant association with dementia. All subjects with high hs-CRP (>3.0 mg/L) had lower NGS (0.27, 0.20) than individuals with normal hs-CRP (0.32, 0.24) (P <.001).

Conclusions: NGS predicts disability and multimorbidity in older adults. Chronic inflammation is associated with multimorbidity among women. Future research is needed to understand the biological links between low strength capacity and poor health in older adults.

Level of Evidence: Level I

To cite this abstract in AMA style:

Casten KS. Associations of Weakness and Inflammation with Disability, Poor Cognition, and Multimorbidity in Older Adults [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/associations-of-weakness-and-inflammation-with-disability-poor-cognition-and-multimorbidity-in-older-adults/. Accessed May 22, 2025.
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