This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The evaluation, treatment, and rehabilitation of frail older adults is a cornerstone of geriatric medicine. Most studies and our preliminary data support the concept that frail individuals are the most vulnerable subset of older adults, with significantly higher rates of morbidity, mortality, and functional decline as compared to age-matched individuals who are not frail. As increasing numbers of Americans live into their 80's and 90's, it will be of critical importance for investigators and clinicians to understand the physiologic basis of frailty and the evolution of disability in order to identify individuals at risk and to facilitate improved prevention and treatment. In the past several years, a number of papers have identified immunologic and endocrine factors that suggest a role in frailty and disability. The purpose and significance of this study is to identify the biologic correlates that may predict frailty in the WHAS II longitudinal study. Through longitudinal data collection and analyses, we may be able to identify causal pathways in these processes as well. In order to accomplish this, we will measure pro and anti- inflammatory cytokines, including IL-6, IFN-gamma, IL-10, and TNF-alpha in addition to any other cytokine deemed important in the evolution of these processes. In addition, hormones such as DHEA-S, IGF-1, salivary cortisol, estradiole, and testosterone will be measured and correlated with the adverse health outcomes of frailty, disability, and mortality.
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