A three-biomarker panel for frailty prediction and risk stratification in institutionalized older adults: a...

Frailty affects between 20 and 75% of residents in long-term care facilities; however, there is a notable absence of objective biological assessment tools for proactive risk stratification.

To address this gap, we examined inflammatory and metabolic biomarkers using a validated 52-item Frailty Index in a cohort of 292 older adults residing in institutions. Each participant completed an assessment of the Frailty Index and underwent quantification of 12 inflammatory and metabolic-nutritional biomarkers that encompass the pathways of inflammation, proteostasis, and metabolic dysregulation.

In a study of 292 institutionalized older adults (mean age 82.6 ± 6.7 years, 68.8% female, 58.6% frail), a simplified three-biomarker panel-interleukin-6 (IL-6), prealbumin, and high-sensitivity C-reactive protein (hs-CRP)-demonstrated excellent predictive accuracy. A simplified three-biomarker panel-interleukin-6 (IL-6), prealbumin, and high-sensitivity C-reactive protein (hs-CRP)achieved excellent diagnostic accuracy (area under curve (AUC) = 0.861, 95% confidence interval (CI) 0.801-0.915), with 81.2% sensitivity and 85.4% specificity for This parsimonious panel retained 96.5% of the predictive performance of the full 12-biomarker model while using only routinely available laboratory tests.

Taken together, these results underscore the potential of inflammatory and metabolic biomarkers for the early identification of high-risk residents, thereby supporting personalized nursing care. Integrating biomarker-guided stratification may facilitate the targeted allocation of nutritional support, physical therapy, and inflammatory management, potentially preventing 30-40% of frailty progression.