Correlations of the red blood cell distribution width-to-albumin ratio, homocysteine, and C-reactive protein with secondary frailty in older patients with multimorbidity

OBJECTIVE: To investigate the correlations of red blood cell distribution width (RDW)/albumin (ALB), homocysteine (Hcy), and C-reactive protein (CRP) with secondary frailty after comprehensive intervention for sarcopenia in older patients with multimorbidity, and the predictive value of their combined use for secondary frailty after comprehensive intervention. METHODS: A total of 120 older inpatients with multimorbidity and sarcopenia admitted to Kunming Second People's Hospital from January 2024 to May 2025 were prospectively selected and assigned to the frailty group (n=34) or the non-frailty group (n=86) according to the occurrence of secondary frailty after comprehensive intervention. After comparing baseline characteristics between the 2 groups and using propensity score matching to reduce between-group bias, RDW/ALB, H cy, and CRP were compared between the 2 groups, the effects of each indicator on secondary frailty after comprehensive intervention for sarcopenia in older patients with multimorbidity were investigated, and the predictive value of RDW/ALB, Hcy, and CRP, individually and in combination, for secondary frailty after comprehensive intervention for sarcopenia in older patients with multimorbidity was analyzed. RESULTS: RDW/ALB, Hcy, and CRP levels were higher in the frailty group than in the non-frailty group (P＜0.05). Elevated RDW/ALB, Hcy, and CRP were all independent factors associated with secondary frailty after comprehensive intervention for sarcopenia in older patients with multimorbidity (P＜0.05). When RDW/ALB, Hcy, and CRP were used individually for prediction, RDW/ALB had the largest area under the curve (AUC), CRP had the highest sensitivity, and Hcy had the highest specificity (P＜0.05), and the AUC for combined prediction using CRP+RDW/ALB+Hcy was higher than that for prediction using each indicator alone (P＜0.05). CONCLUSIONS: RDW/ALB, Hcy, and CRP are associated with secondary frailty after comprehensive intervention for sarcopenia in older patients with multimorbidity, and their combined measurement can provide a reference for clinical prediction of secondary frailty.