| Abstract: | Background: Chronic inflammation, measured by interleukin-6, predicts incident disability among elderly people. However,little isknown about the relation of CRP to disability. Method: Participants(>60 years,N=1680)were from the National Health and Nutrition Examination Survey 1999-2002.Disability in activities of daily living(ADL), instrumental activities of daily living(IADL), leisure and social activities(LSA),lower extremity mobility(LEM),and general physical activities(GPA)was obtained by self-report. Peak muscle power was the product of is okinetic peak leg force and peak force velocity. Functional limitations were evaluated via habitual walking speed was obtained from a 20-foot timed walk. CRP levels were quantified by utilizing latex-enhanced nephelometry. Results: Elevated CRP levels were associated with disability in IADL,LSA, LEM,and GPA, independent of basic demographics, chronic medical diseases ,health behaviors,as well as nutritional markers. The corresponding odds ratios of disability for each standard-deviation increase in natural-logtrans formed CRP were 1.17(95%CI 1.02-1.35),1.19(95%CI1.00-1.40), 1.16(95%CI 1.02-1.33),and 1.18(95%CI 1.05-1.32), respectively. The relationship diminished after additional adjustment of leg power and/or walking speed,meaning that impairment in leg power and limitations in gait speed likely mediate the association between CRP and disability. CRP had an inverse relationship to leg power and walking speed. Likewise, additional adjustment for leg power substantially diminished the association between CRP and walking speed, suggesting a mediating effect of power between CRP and gait speed. Conclusions: Independent of chronic diseases, elevated CRP is associated with multiple domains of disability through mediation of muscle power, habitual gait speed, or both. Future research is needed to understand CRP as a risk factor for disability in older populations. |
