The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study

Background. Olfactory dysfunction might unveil the association between ageing and frailty, as it is associated with declining cognitive function, depression, reduced physical performance, reduced dietary intake, and mortality; all these conditions are characterized by increased levels of inflammator...

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Main Authors: Alice Laudisio, Luca Navarini, Domenico Paolo Emanuele Margiotta, Davide Onofrio Fontana, Irene Chiarella, Daniele Spitaleri, Stefania Bandinelli, Antonella Gemma, Luigi Ferrucci, Raffaele Antonelli Incalzi
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Immunology Research
Online Access:http://dx.doi.org/10.1155/2019/3128231
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author Alice Laudisio
Luca Navarini
Domenico Paolo Emanuele Margiotta
Davide Onofrio Fontana
Irene Chiarella
Daniele Spitaleri
Stefania Bandinelli
Antonella Gemma
Luigi Ferrucci
Raffaele Antonelli Incalzi
author_facet Alice Laudisio
Luca Navarini
Domenico Paolo Emanuele Margiotta
Davide Onofrio Fontana
Irene Chiarella
Daniele Spitaleri
Stefania Bandinelli
Antonella Gemma
Luigi Ferrucci
Raffaele Antonelli Incalzi
author_sort Alice Laudisio
collection DOAJ
description Background. Olfactory dysfunction might unveil the association between ageing and frailty, as it is associated with declining cognitive function, depression, reduced physical performance, reduced dietary intake, and mortality; all these conditions are characterized by increased levels of inflammatory parameters. The present study is aimed at evaluating the association between olfactory dysfunction, frailty, and mortality and whether such association might be mediated by inflammation. Methods. We analysed data of 1035 participants aged 65+ enrolled in the “InCHIANTI” study. Olfactory function was tested by the recognition of the smells of coffee, mint, and air. Olfactory dysfunction was defined as lack of recognition of at least two smells. Considering the items “shrinking,” “exhaustion,” “sedentariness,” “slowness,” and “weakness” included in the Fried definition, frailty was defined as the presence of at least three criteria, prefrailty of one or two, and robustness of none. Serum interleukin-6 (IL-6) was measured in duplicate by high-sensitivity enzyme-linked immunosorbent assays. Logistic regression was adopted to assess the association of frailty with olfactory function, as well as with the increasing number of olfactory deficits. Cox regression was used to test the association between olfactory dysfunction and 9-year survival. Results. Olfactory dysfunction was associated with frailty, after adjusting (OR 1.94, 95% CI=1.07-3.51; P=.028); analysis of the interaction term indicated that the association varied according to interleukin-6 levels (P for interaction=.005). Increasing levels of olfactory dysfunction were associated with increasing probability of being frail. Also, olfactory dysfunction was associated with reduced survival (HR 1.52, 95% CI=1.16-1.98; P=.002); this association varied according to the presence of frailty (P for interaction=.017) and prefrailty status (P for interaction=.046), as well as increased interleukin-6 levels (P for interaction = .011). Conclusions. Impairment of olfactory function might represent a marker of frailty, prefrailty, and consequently reduced survival in an advanced age. Inflammation might represent the possible link between these conditions.
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spelling doaj-art-ec46cc4b6ec2407a854b1d0f3f7630d42025-08-20T03:21:24ZengWileyJournal of Immunology Research2314-88612314-71562019-01-01201910.1155/2019/31282313128231The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI StudyAlice Laudisio0Luca Navarini1Domenico Paolo Emanuele Margiotta2Davide Onofrio Fontana3Irene Chiarella4Daniele Spitaleri5Stefania Bandinelli6Antonella Gemma7Luigi Ferrucci8Raffaele Antonelli Incalzi9Unit of Geriatrics, Department of Medicine, Università Campus Bio-Medico, Rome, ItalyUnit of Allergology, Immunology, Rheumatology, Department of Medicine, Università Campus Bio-Medico, Rome, ItalyUnit of Allergology, Immunology, Rheumatology, Department of Medicine, Università Campus Bio-Medico, Rome, ItalyUnit of Geriatrics, Department of Medicine, Università Campus Bio-Medico, Rome, ItalyUnit of Geriatrics, Department of Medicine, Università Campus Bio-Medico, Rome, ItalyUnit of Geriatrics, Department of Medicine, Università Campus Bio-Medico, Rome, ItalyGeriatric Rehabilitation Unit, Azienda Sanitaria di Firenze, Florence, ItalyDepartment of Homecare Service, Azienda Sanitaria Locale Roma E, Rome, ItalyLongitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, USAUnit of Geriatrics, Department of Medicine, Università Campus Bio-Medico, Rome, ItalyBackground. Olfactory dysfunction might unveil the association between ageing and frailty, as it is associated with declining cognitive function, depression, reduced physical performance, reduced dietary intake, and mortality; all these conditions are characterized by increased levels of inflammatory parameters. The present study is aimed at evaluating the association between olfactory dysfunction, frailty, and mortality and whether such association might be mediated by inflammation. Methods. We analysed data of 1035 participants aged 65+ enrolled in the “InCHIANTI” study. Olfactory function was tested by the recognition of the smells of coffee, mint, and air. Olfactory dysfunction was defined as lack of recognition of at least two smells. Considering the items “shrinking,” “exhaustion,” “sedentariness,” “slowness,” and “weakness” included in the Fried definition, frailty was defined as the presence of at least three criteria, prefrailty of one or two, and robustness of none. Serum interleukin-6 (IL-6) was measured in duplicate by high-sensitivity enzyme-linked immunosorbent assays. Logistic regression was adopted to assess the association of frailty with olfactory function, as well as with the increasing number of olfactory deficits. Cox regression was used to test the association between olfactory dysfunction and 9-year survival. Results. Olfactory dysfunction was associated with frailty, after adjusting (OR 1.94, 95% CI=1.07-3.51; P=.028); analysis of the interaction term indicated that the association varied according to interleukin-6 levels (P for interaction=.005). Increasing levels of olfactory dysfunction were associated with increasing probability of being frail. Also, olfactory dysfunction was associated with reduced survival (HR 1.52, 95% CI=1.16-1.98; P=.002); this association varied according to the presence of frailty (P for interaction=.017) and prefrailty status (P for interaction=.046), as well as increased interleukin-6 levels (P for interaction = .011). Conclusions. Impairment of olfactory function might represent a marker of frailty, prefrailty, and consequently reduced survival in an advanced age. Inflammation might represent the possible link between these conditions.http://dx.doi.org/10.1155/2019/3128231
spellingShingle Alice Laudisio
Luca Navarini
Domenico Paolo Emanuele Margiotta
Davide Onofrio Fontana
Irene Chiarella
Daniele Spitaleri
Stefania Bandinelli
Antonella Gemma
Luigi Ferrucci
Raffaele Antonelli Incalzi
The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study
Journal of Immunology Research
title The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study
title_full The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study
title_fullStr The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study
title_full_unstemmed The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study
title_short The Association of Olfactory Dysfunction, Frailty, and Mortality Is Mediated by Inflammation: Results from the InCHIANTI Study
title_sort association of olfactory dysfunction frailty and mortality is mediated by inflammation results from the inchianti study
url http://dx.doi.org/10.1155/2019/3128231
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