Wenxiang Guo, Leonardo Bencivenga, Bruno Micael Zanforlini, Chiara Curreri, Maria Cristina Ferrara, Benedetta Maisano, Luca Tinelli, Laura Andreea Ceparano, Raffaella Merenda, Chiara Cosma, Lucia Manfron, Nicolò Gentili, Silvia Sturani, Monica Cardi, Alice Campion, Benedetta Berardi, Martina Lombardi, Elisabetta D'Aversa, Francesca Salvatori, Veronica Tisato, Joanne Vanessa Vargas, Grazia Daniela Femminella, Donato Gemmati, Giuseppe Sergi, Giuseppe Bellelli, Paolo Mazzola, Caterina Trevisan, Stefano Volpato
{"title":"感染、DNA甲基化和端粒长度对住院老年患者衰弱轨迹的影响：INFRAGEN研究方案","authors":"Wenxiang Guo, Leonardo Bencivenga, Bruno Micael Zanforlini, Chiara Curreri, Maria Cristina Ferrara, Benedetta Maisano, Luca Tinelli, Laura Andreea Ceparano, Raffaella Merenda, Chiara Cosma, Lucia Manfron, Nicolò Gentili, Silvia Sturani, Monica Cardi, Alice Campion, Benedetta Berardi, Martina Lombardi, Elisabetta D'Aversa, Francesca Salvatori, Veronica Tisato, Joanne Vanessa Vargas, Grazia Daniela Femminella, Donato Gemmati, Giuseppe Sergi, Giuseppe Bellelli, Paolo Mazzola, Caterina Trevisan, Stefano Volpato","doi":"10.1186/s12877-025-06194-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Infectious diseases are among the most common causes of hospitalization in older adults and may lead to a high burden on the individual's health and healthcare system. However, it is unclear whether and to which extent these events might affect frailty, fastening its development or hampering its reversion. The aims of the INFRAGEN project are 1) to assess the impact of acute infections on frailty trajectories in older inpatients, and 2) to evaluate the modifying effect of sociodemographic, clinical, functional, and genetic/epigenetic factors on that association.</p><p><strong>Methods: </strong>INFRAGEN is a multicenter prospective observational study that will be conducted in the acute Geriatric Units of four Italian centers (Ferrara, Padova, Monza, and Napoli). The project will involve individuals aged ≥ 70 with no or mild-to-moderate pre-admission frailty (Clinical Frailty Scale [CFS] < 6) and diagnosis of acute infectious diseases at the time of hospital admission or during hospitalization. For each participant, we will record data concerning the multidimensional geriatric assessment and the type and severity of infectious diseases (diagnosed according to ICD-9 codes). Blood samples will be collected to assess Global DNA methylation, Leukocyte Telomere Length (LTL), and levels of circulating markers associated with biological processes related to frailty (inflammatory state, dysmetabolism, brain modifications, and oxidative stress). Frailty status will be evaluated through the CFS and Frailty Index at admission (referring to the 2 weeks before hospitalization), hospital discharge, and after 3 months. In a subsample, genetic/epigenetic analyses will also be performed at the 3-month follow-up.</p><p><strong>Discussion: </strong>INFRAGEN will contribute to exploring the complex pathophysiologic mechanisms of frailty in the context of infections in older adults through a translational approach.</p><p><strong>Trial registrations: </strong>NCT06430073 (ClinicalTrials.gov); Registration date: 2024-05-28.</p>","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":"25 1","pages":"545"},"PeriodicalIF":3.4000,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of infections, DNA methylation and telomere length on frailty trajectories in hospitalized older patients: the INFRAGEN study protocol.\",\"authors\":\"Wenxiang Guo, Leonardo Bencivenga, Bruno Micael Zanforlini, Chiara Curreri, Maria Cristina Ferrara, Benedetta Maisano, Luca Tinelli, Laura Andreea Ceparano, Raffaella Merenda, Chiara Cosma, Lucia Manfron, Nicolò Gentili, Silvia Sturani, Monica Cardi, Alice Campion, Benedetta Berardi, Martina Lombardi, Elisabetta D'Aversa, Francesca Salvatori, Veronica Tisato, Joanne Vanessa Vargas, Grazia Daniela Femminella, Donato Gemmati, Giuseppe Sergi, Giuseppe Bellelli, Paolo Mazzola, Caterina Trevisan, Stefano Volpato\",\"doi\":\"10.1186/s12877-025-06194-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Infectious diseases are among the most common causes of hospitalization in older adults and may lead to a high burden on the individual's health and healthcare system. However, it is unclear whether and to which extent these events might affect frailty, fastening its development or hampering its reversion. The aims of the INFRAGEN project are 1) to assess the impact of acute infections on frailty trajectories in older inpatients, and 2) to evaluate the modifying effect of sociodemographic, clinical, functional, and genetic/epigenetic factors on that association.</p><p><strong>Methods: </strong>INFRAGEN is a multicenter prospective observational study that will be conducted in the acute Geriatric Units of four Italian centers (Ferrara, Padova, Monza, and Napoli). The project will involve individuals aged ≥ 70 with no or mild-to-moderate pre-admission frailty (Clinical Frailty Scale [CFS] < 6) and diagnosis of acute infectious diseases at the time of hospital admission or during hospitalization. For each participant, we will record data concerning the multidimensional geriatric assessment and the type and severity of infectious diseases (diagnosed according to ICD-9 codes). Blood samples will be collected to assess Global DNA methylation, Leukocyte Telomere Length (LTL), and levels of circulating markers associated with biological processes related to frailty (inflammatory state, dysmetabolism, brain modifications, and oxidative stress). Frailty status will be evaluated through the CFS and Frailty Index at admission (referring to the 2 weeks before hospitalization), hospital discharge, and after 3 months. 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Effect of infections, DNA methylation and telomere length on frailty trajectories in hospitalized older patients: the INFRAGEN study protocol.
Background: Infectious diseases are among the most common causes of hospitalization in older adults and may lead to a high burden on the individual's health and healthcare system. However, it is unclear whether and to which extent these events might affect frailty, fastening its development or hampering its reversion. The aims of the INFRAGEN project are 1) to assess the impact of acute infections on frailty trajectories in older inpatients, and 2) to evaluate the modifying effect of sociodemographic, clinical, functional, and genetic/epigenetic factors on that association.
Methods: INFRAGEN is a multicenter prospective observational study that will be conducted in the acute Geriatric Units of four Italian centers (Ferrara, Padova, Monza, and Napoli). The project will involve individuals aged ≥ 70 with no or mild-to-moderate pre-admission frailty (Clinical Frailty Scale [CFS] < 6) and diagnosis of acute infectious diseases at the time of hospital admission or during hospitalization. For each participant, we will record data concerning the multidimensional geriatric assessment and the type and severity of infectious diseases (diagnosed according to ICD-9 codes). Blood samples will be collected to assess Global DNA methylation, Leukocyte Telomere Length (LTL), and levels of circulating markers associated with biological processes related to frailty (inflammatory state, dysmetabolism, brain modifications, and oxidative stress). Frailty status will be evaluated through the CFS and Frailty Index at admission (referring to the 2 weeks before hospitalization), hospital discharge, and after 3 months. In a subsample, genetic/epigenetic analyses will also be performed at the 3-month follow-up.
Discussion: INFRAGEN will contribute to exploring the complex pathophysiologic mechanisms of frailty in the context of infections in older adults through a translational approach.
期刊介绍：
BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
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