Oxidative stress and frailty: A systematic review and synthesis of the best evidence

Maturitas. 2017 May:99:66-72. doi: 10.1016/j.maturitas.2017.01.006. Epub 2017 Jan 16.

Abstract

Objective: Oxidative stress (OS) is associated with accelerated aging. Previous studies have suggested a possible relationship between OS and frailty but this association remains unclear. We conducted a systematic review to investigate potential interactions between OS and frailty.

Methods: A systematic literature search of original reports providing data on 'OS and antioxidant' parameters and frailty was carried out across major electronic databases from inception until May 2016. Cross-sectional/case control and longitudinal studies reporting data on the association between frailty and anti-oxidants-OS biomarkers were considered for inclusion. Results were summarized with a synthesis based on the best evidence.

Results: From 1856 hits, 8 studies (cross-sectional/case control) were included (N=6349; mean age of 75±12years; 56.4% females). Overall, there were 588 (=9.3%) frail, 3036 pre-frail (=47.8%), 40 (=0.6%) pre-frail/robust, and 2685 (=42.3%) robust subjects. Six cross-sectional/case control studies demonstrated that frailty was associated with an increase in peripheral OS biomarkers, including lipoprotein phospholipase A2 (1 study), isoprostanes (2 studies), malonaldehyde (2 studies), 8-hydroxy-20-deoxyguanosine (2 studies), derivate of reactive oxygen metabolites (2 studies), oxidized glutathione/glutathione (1 study), 4-hydroxy-2,3-nonenal (1 study), and protein carbonylation levels (1 study). In addition, preliminary evidence points to lower anti-oxidant parameters (vitamin C, E, α-tocopherol, biological anti-oxidant potential, total thiol levels) in frailty.

Conclusion: Frailty and pre-frailty appear to be associated with higher OS and possibly lower anti-oxidant parameters. However, due to the cross-sectional design, it is not possible to disentangle the directionality of the relationships observed. Thus, future high-quality and in particular longitudinal research is required to confirm or refute these relationships and to further elucidate pathophysiological mechanisms.

Keywords: Anti-oxidant; Frail; Frailty; Oxidative stress.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • 1-Alkyl-2-acetylglycerophosphocholine Esterase / metabolism
  • 8-Hydroxy-2'-Deoxyguanosine
  • Aged
  • Aged, 80 and over
  • Aging / metabolism*
  • Aldehydes / metabolism
  • Biomarkers / metabolism*
  • Cross-Sectional Studies
  • Deoxyguanosine / analogs & derivatives
  • Deoxyguanosine / metabolism
  • Frail Elderly
  • Glutathione / metabolism
  • Glutathione Disulfide / metabolism
  • Humans
  • Isoprostanes / metabolism
  • Longitudinal Studies
  • Oxidative Stress*
  • Reactive Oxygen Species / metabolism
  • Sulfhydryl Compounds / metabolism
  • alpha-Tocopherol / metabolism

Substances

  • Aldehydes
  • Biomarkers
  • Isoprostanes
  • Reactive Oxygen Species
  • Sulfhydryl Compounds
  • 8-Hydroxy-2'-Deoxyguanosine
  • 1-Alkyl-2-acetylglycerophosphocholine Esterase
  • Deoxyguanosine
  • Glutathione
  • alpha-Tocopherol
  • 4-hydroxy-2-nonenal
  • Glutathione Disulfide