{"title":"Microvascular health and frailty: nailfold capillaroscopy as a window into aging.","authors":"Arzu Nevin Dagdemir, Pinar Akyuz Dagli, Gulsah Soyturk, Rana Tuna Dogrul, Zeynep Sahiner, Cemile Peker, Hande Selvi Oztorun, Yuksel Maras, Sukran Erten, Gunes Eken, Kamile Silay","doi":"10.1007/s41999-026-01494-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Frailty is a prevalent geriatric syndrome characterized by diminished physiological reserves and increased vulnerability to stressors. Microvascular dysfunction and inflammaging have been proposed as key biological mechanisms underlying frailty; however, objective and practical vascular biomarkers remain limited. Nailfold capillaroscopy (NFC), a non-invasive imaging method that visualizes microcirculatory architecture, may offer novel insight into the vascular component of frailty. This study aimed to investigate the association between frailty and NFC findings in older adults.</p><p><strong>Methods: </strong>This cross-sectional study evaluated 102 individuals aged 65 years or older (mean age 78.7 ± 8.1 years; 67% female) who underwent a comprehensive geriatric assessment. Frailty was assessed using the Clinical Frailty Scale (CFS) and the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale. NFC was performed on eight fingers following standardized protocols. A total NFC score was derived from capillary density, giant capillaries, microhemorrhages, neoangiogenesis, tortuosity, and additional morphological features. Receiver operating characteristic (ROC) curve analysis was used to determine discriminatory performance, while multivariable logistic regression identified independent predictors of frailty.</p><p><strong>Results: </strong>Frail participants exhibited significantly reduced capillary density and higher frequencies of giant capillaries, microhemorrhages, morphological abnormalities, neoangiogenesis, and tortuosity (all p < 0.001). An NFC score ≥ 5 was associated with frailty, with an area under the ROC curve of 0.68.</p><p><strong>Conclusion: </strong>Microvascular abnormalities detected through NFC are strongly associated with frailty in older adults. An NFC threshold of ≥ 5 may serve as a practical, non-invasive indicator of elevated frailty risk. These findings support the potential value of incorporating NFC into geriatric assessment, and prospective studies are needed to clarify its prognostic and clinical utility.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Geriatric Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s41999-026-01494-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Frailty is a prevalent geriatric syndrome characterized by diminished physiological reserves and increased vulnerability to stressors. Microvascular dysfunction and inflammaging have been proposed as key biological mechanisms underlying frailty; however, objective and practical vascular biomarkers remain limited. Nailfold capillaroscopy (NFC), a non-invasive imaging method that visualizes microcirculatory architecture, may offer novel insight into the vascular component of frailty. This study aimed to investigate the association between frailty and NFC findings in older adults.
Methods: This cross-sectional study evaluated 102 individuals aged 65 years or older (mean age 78.7 ± 8.1 years; 67% female) who underwent a comprehensive geriatric assessment. Frailty was assessed using the Clinical Frailty Scale (CFS) and the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale. NFC was performed on eight fingers following standardized protocols. A total NFC score was derived from capillary density, giant capillaries, microhemorrhages, neoangiogenesis, tortuosity, and additional morphological features. Receiver operating characteristic (ROC) curve analysis was used to determine discriminatory performance, while multivariable logistic regression identified independent predictors of frailty.
Results: Frail participants exhibited significantly reduced capillary density and higher frequencies of giant capillaries, microhemorrhages, morphological abnormalities, neoangiogenesis, and tortuosity (all p < 0.001). An NFC score ≥ 5 was associated with frailty, with an area under the ROC curve of 0.68.
Conclusion: Microvascular abnormalities detected through NFC are strongly associated with frailty in older adults. An NFC threshold of ≥ 5 may serve as a practical, non-invasive indicator of elevated frailty risk. These findings support the potential value of incorporating NFC into geriatric assessment, and prospective studies are needed to clarify its prognostic and clinical utility.
期刊介绍：
European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine.
The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
