Neutrophil-to-lymphocyte ratio: a new marker for studying intradomain communication in geriatric practice

Background: aging is a multifactorial process. Geriatrics considers comorbidities and geriatric asthenia. A comprehensive evaluation of physical health, cognitive function, emotional state, social support, and environment is essential. The neutrophil-to-lymphocyte ratio (NLR) reflects the balance between inflammation and immune function; an increased NLR is a hallmark of systemic inflammation. NLR serves as a marker for cardiovascular disease, cancer, infections, and autoimmune disorders. In geriatric cohorts, NLR is employed to assess inflammatory status, predict clinical outcomes, and identify the risk of geriatric syndromes. Elevated NLR has been associated with physical decline, asthenia, sarcopenia, reduced muscle strength, cardiovascular diseases, and stroke. Chronic inflammation impacts cognitive functions, contributes to dementia, affects psychological status, and is linked to depression and anxiety. NLR may be utilized for screening, monitoring treatment efficacy, and evaluating interventions. Aim: to assess the correlation between NLR and indices of health domains in women over 65 years of age. Materials and Methods: the study evaluated somatic health characteristics (anthropometric data, blood pressure, pulse rate, complete blood count, NLR, platelet-to-lymphocyte ratio, blood biochemistry, glomerular filtration rate, echocardiography, electrocardiographic parameters recorded using the "Cardiovisor" software, mean weighted deviation in heart rate variability from 24-hour ECG monitoring, medication therapy), musculoskeletal system parameters (using the FRAIL and Katz indices, handgrip strength, SARC-F questionnaire, bioimpedance analysis), sensory system (ophthalmologic examination), cognitive domain (MMSE questionnaire), psychological status (Beck and asthenic state scales), and nutritional status (Mini Nutritional Assessment-Short Form). Results: in individuals with physical inactivity, the NLR value was higher (4.21±0.35) versus those with an active lifestyle (2.71±0.26), p<0.001. Thus, physical inactivity is a statistically significant predictor of NLR changes (Area Under the Curve, AUC=1.000). In patients with arterial hypertension (AH), NLR levels (4.21±0.35) were significantly higher than in those without AH (2.71±0.26), p<0.001. AH is a statistically significant predictor of elevated NLR (AUC=1.000). Among patients with presarcopenia, the median NLR (4.20) was significantly higher compared to those without it (3.13), p<0.001. Presarcopenia is a statistically significant predictor of NLR changes ( AUC=0.741). In patients with diabetes mellitus (DM), the median NLR was significantly higher (4.21) than in those without DM (2.73), p<0.001. DM is a statistically significant predictor of NLR changes (AUC=0.957). Conclusion: NLR should be regarded not only as a routine parameter in the complete blood count but also as a promising indicator reflecting the complex interplay between immunity and the aging body. Due to its accessibility, ease of calculation, and potential prognostic value, NLR constitutes a useful tool for the geriatric practitioner. Keywords: domains, neutrophil-to-lymphocyte ratio, NLR, women, preventive geriatrics. For citation: Kochetkova I.V. Neutrophil-to-lymphocyte ratio: a new marker for studying intradomain communication in geriatric practice. RMJ. 2025;6:23–29. DOI: 10.32364/2225-2282-2025-6-5