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From Inflammation to Frailty: Investigating the Systemic Immunity-Inflammation Index in Older Patient

Year 2025, Volume: 4 Issue: 2, 47 - 52, 30.06.2025

Abstract

Introductıon: Chronic inflammation is increasingly recognized as a crucial contributor to frailty pathogenesis, but accurate diagnosis remains a challenge. Aim Our study aims to investigate the relationship between frailty and the Systemic Immunity-Inflammation Index (SII, SIRI), a comprehensive indicator of inflammation.

Methods: This cross-sectional study enrolled 200 patients. All participants underwent a comprehensive geriatric assessment. Frailty was assessed using the clinical frailty scale, (≥ 4; frail, <4 robust). 99 patients were included in the study as frail (Group 1) and 101 patients as robust (Group 2). To determine the SII, we used the formula: Platelet count×Neutrophil / Lymphocyte count. The calculation formula for SIRI is neutrophil count × monocyte count/Lymphocyte count.

Results: The average age of the participants was 75.15 ± 8,8, and 55% (n=110) were female. Patients were grouped frail and robust. The frail group had 99 patients, while the robust group comprised 101 patients. Frail patients showed higher median SII and SIRI scores than the robust group(p < 0.001). Bınary logistic regression analysis revealed that the SII and SIRI scores were significantly and independently associated with frailty even after adjusting for potential confounding factors respectively (r =1.52, 95% CI= 1.189–1.964, p < 0.001, r=1.004, 95% CI=0.585-1.724, p=0.987). The ROC analysis identified the optimal cut-off for SII in predicting sarcopenia as > 596. At this threshold, the negative predictive values were determined to be 83.8%, with a specificity of 86%, cut-off for SIRI in predicting sarcopenia as > 1.1 .

Conclusion: The results of this cross-sectional study indicate a positive correlation between systemic inflammatory biomarkers (SII, SIRI) and frailty.

References

  • 1. Jiang Z, Wang J, Cai X, Wang P, Liu S. L-shaped association of serum α-klotho and frailty among the middle-aged and older adults: results from NHANES 2007-2016. BMC Geriatr. (2023) 23:716. doi: 10.1186/s12877-023-04324-z
  • 2. Mahemuti N, Jing X, Zhang N, et al. Association between systemic immunity-inflammation index and hyperlipidemia: a population-based study from the NHANES (2015-2020). Nutrients. (2023) 15:1177. doi: 10.3390/nu15051177
  • 3. Tong YS, Tan J, Zhou XL, Song YQ, Song YJ. Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage III non-small cell lung cancer. J Transl Med. (2017) 15:221. doi: 10.1186/ s12967-017-1326-1
  • 4. Sun W, Fang Y, Zhou B, et al. The association of systemic inflammatory biomarkers with non-alcoholic fatty liver disease: a large population-based cross-sectional study. Prev Med Rep. (2024) 37:102536. doi: 10.1016/j.pmedr.2023.102536
  • 5. Jin N, Huang L, Hong J, et al. The association between systemic inflammation markers and the prevalence of hypertension. BMC Cardiovasc Disord. (2023) 23:615. doi: 10.1186/s12872-023-03661-6
  • 6. Soysal P, Stubbs B, Lucato P, et al. Inflammation and frailty in the elderly: a systematic review and meta-analysis. Ageing Res Rev. (2016) 31:1–8. doi: 10.1016/j.arr.2016.08.006
  • 7. Zhang H, Hao M, Hu Z, et al. Association of immunity markers with the risk of incident frailty: the Rugao longitudinal aging study. Immun Ageing. (2022) 19:1. doi: 10.1186/s12979-021-00257-6
  • 8. Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging. 2014;9:433-41.
  • 9. Arik G, Varan HD, Yavuz BB, et al. Validation of Katz index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015;61:344-50.
  • 10. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179-86.
  • 11. Sarikaya D, Halil M, Kuyumcu ME, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61:56-60.
  • 12. Midão L, Giardini A, Menditto E, Kardas P, Costa E. Polypharmacy prevalence among older adults based on the survey of health, ageing and retirement in Europe. Arch Gerontol Geriatr. 2018; 78:213-20.
  • 13. Rockwood K, Theou O. Using the Clinical Frailty Scale in Allocating Scarce Health Care Resources. Can Geriatr J. 2020;23:210-15.
  • 14. Özsürekci C, Balcı C, Kızılarslanoğlu MC, et al. An important problem in an aging country: identifying the frailty via 9 Point Clinical Frailty Scale. Acta Clin Belg. 2020;75:200-4.
  • 15. Qin Z, Li H, Wang L, et al. Systemic Immune-inflammation index is Associated with increased urinary albumin excretion: a Population-based study. Front Immunol. 2022;13:863640.
  • 16. Peng A, Zhang B, Wang S, et al. Comparison of the value of Various complex indexes of blood cell types and lipid levels in coronary heart disease.Front Cardiovas Med. (2023) 10:1284491. doi: 10.3389/fcvm.2023.1284491
  • 17. Pothier K, Gana W, Bailly N, Fougère B. Associations Between Frailty and Inflammation, Physical, and Psycho-Social Health in Older Adults: A Systematic Review. Front Psychol. 2022;13:805501. Published 2022 Mar 14. doi:10.3389/fpsyg.2022.805501
  • 18. Xue QL. The frailty syndrome: definition and natural history. Clin Geriatr Med. 2011;27(1):1-15. doi:10.1016/j.cger.2010.08.009
  • 19. Guo J, Huang X, Dou L, et al. Aging and aging-related diseases: from molecular mechanisms to interventions and treatments. Signal Transduct Target Ther. 2022;7(1):391. Published 2022 Dec 16. doi:10.1038/s41392-022-01251-0
  • 20. Varghese D, Ishida C, Patel P, et al. Polypharmacy. [Updated 2024 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532953/
  • 21. Liu Z, Zheng L. Associations between SII, SIRI, and cardiovascular disease in obese individuals: a nationwide cross-sectional analysis. Front Cardiovasc Med. 2024;11:1361088. Published 2024 Aug 22. doi:10.3389/fcvm.2024.1361088
  • 22. Dent E, Hanlon P, Sim M, et al. Recent developments in frailty identification, management, risk factors and prevention: A narrative review of leading journals in geriatrics and gerontology. Ageing Res Rev. 2023;91:102082. doi:10.1016/j.arr.2023.102082
  • 23. Alhalwani AY, Jambi S, Borai A, et al. Assessment of the systemic immune-inflammation index in type 2 diabetic patients with and without dry eye disease: A case-control study. Health Sci Rep. 2024;7(5):e1954. Published 2024 May 1. doi:10.1002/hsr2.1954
  • 24. Hernández B, Fuentes E, Palomo I, Alarcón M. Increased platelet function during frailty. Exp Hematol. 2019;77:12-25.e2. doi:10.1016/j.exphem.2019.08.006
  • 25. Qin Z, Li H, Wang L, et al. Systemic Immunity-Inflammation Index Is Associated With Increased Urinary Albumin Excretion: A Population-Based Study. Front Immunol. 2022;13:863640. Published 2022 Mar 21. doi:10.3389/fimmu.2022.863640
  • 26. Wang CP, Lorenzo C, Espinoza SE. Frailty Attenuates the Impact of Metformin on Reducing Mortality in Older Adults with Type 2 Diabetes. J Endocrinol Diabetes Obes. 2014;2(2):1031.
  • 27. Miller BF, Thyfault JP. Exercise-Pharmacology Interactions: Metformin, Statins, and Healthspan. Physiology(Bethesda).2020;35(5):338-347.doi:10.1152/physiol.00013.2020
There are 27 citations in total.

Details

Primary Language English
Subjects One Health, Health Services and Systems (Other)
Journal Section Research Articles
Authors

Zeynep Şahiner 0000-0003-1256-4412

Publication Date June 30, 2025
Submission Date May 13, 2025
Acceptance Date June 16, 2025
Published in Issue Year 2025 Volume: 4 Issue: 2

Cite

EndNote Şahiner Z (June 1, 2025) From Inflammation to Frailty: Investigating the Systemic Immunity-Inflammation Index in Older Patient. ACH Medical Journal 4 2 47–52.