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Related Experiment Video

Updated: May 6, 2026

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
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Kidney function and prevalent and incident frailty.

Lorien S Dalrymple1, Ronit Katz, Dena E Rifkin

  • 1Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.

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Summary

Lower kidney function, measured by cystatin C, is linked to frailty in older adults. This association was not seen with creatinine-based estimates, suggesting cystatin C better reflects kidney function

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Area of Science:

  • Gerontology
  • Nephrology
  • Public Health

Background:

  • Kidney disease is linked to physiological changes that can increase frailty risk in older adults.
  • Frailty is a significant concern in aging populations, impacting health outcomes and quality of life.

Purpose of the Study:

  • To investigate the association between reduced kidney function and prevalent or incident frailty in elderly individuals.
  • To compare the utility of cystatin C-based estimated glomerular filtration rate (eGFR(cys)) versus creatinine-based eGFR (eGFR(SCr)) in predicting frailty.

Main Methods:

  • The Cardiovascular Health Study (CHS) enrolled community-dwelling adults aged 65+.
  • Prevalent frailty analysis included 4150 participants, while incident frailty analysis involved 3459 participants without baseline frailty.
  • Frailty was assessed using criteria including weight loss, exhaustion, weakness, slowness, and low physical activity. eGFR was calculated using both cystatin C and serum creatinine.

Main Results:

  • Lower eGFR(cys) was significantly associated with higher odds of prevalent frailty (e.g., eGFR(cys) 15-44 OR 2.87) and higher incidence of frailty (e.g., eGFR(cys) 15-44 IRR 2.28).
  • Specifically, eGFR(cys) categories below 60 ml/min/1.73 m(2) showed increased risk for prevalent and incident frailty.
  • In contrast, lower eGFR(SCr) levels were not associated with increased risk of prevalent or incident frailty.

Conclusions:

  • Reduced kidney function, as indicated by lower eGFR(cys), is associated with a greater risk of frailty in community-dwelling older adults.
  • These findings suggest that cystatin C may be a more sensitive marker than creatinine for assessing kidney function's impact on frailty.
  • The results underscore the importance of considering non-GFR determinants of kidney function in geriatric health assessments.