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The joint effects of frailty and telomere length for predicting mortality in older adults: the National Health and Nutrition Examination Survey 1999–2002

  • Dan Liu
  • Zhuoting Zhu
  • Long Zhou
  • Ming YangEmail author
Original Article
  • 55 Downloads

Abstract

Background

Frailty and short telomere length, which address different aspects of biological aging, are separately associated with mortality in older adults.

Aims

To evaluate whether the combination of these two biomarkers would be a better predictor of mortality than either alone.

Methods

This present study included participants 60 years of age or older from the National Health and Nutrition Examination Survey in the 1999–2002 phase. The frailty phenotype was identified based on the Fried definition. Telomere length relative to standard reference DNA (T/S ratio) was assessed using quantitative polymerase chain reaction (PCR). Cox proportional hazards regression models were used to estimate the individual and combined effects of frailty phenotype and telomere length on all-cause and cardiovascular mortality.

Results

Compared with participants with neither impairment, the mortality risks increased slightly among participants with short telomere length only (hazard ratio [HR] 1.19, 95% confidence interval [CI]: 1.00–1.42) or pre-frailty only (HR 2.16, 95% CI 1.80–2.60) and gradually elevated approximately 3 folds with both short telomere length and pre-frailty (HR 2.23, 95% CI 1.81–2.74) or frailty (HR 3.57, 95% CI 2.56–4.98). Moreover, participants with both short telomere length and frailty had the highest increased all-cause mortality (HR 5.16, 95% CI 3.38–7.85) and cardiovascular mortality (HR 4.67, 95% CI 2.02–10.82).

Discussion and conclusions

The combined predictor had more capability of predicting mortality, which suggested that integrating both molecular biomarkers and physiological functional parameters would be a more informative measure of biological aging.

Keywords

Frailty phenotype Telomere length Mortality 

Notes

Acknowledgments

We appreciated all the NHANES participants and staff for their efforts and contributions.

Compliance with ethical standards

Conflict of interest

We declare that we have no competing interests.

Ethical approval

The National Center for Health Statistics (NCHS) Research Ethics Review Board approved the NHANES protocol.

Statement of human and animal rights

All procedures performed in the study were in accodance with recommendations of the International Council for Harmonisation (ICH) Good Clinical Practice (GCP) standards (ICH-GCP) and the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

40520_2019_1376_MOESM1_ESM.docx (90 kb)
Supplementary material 1 (DOCX 99 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE)BonnGermany
  2. 2.State Key Laboratory of OphthalmologyZhongshan Ophthalmic Center, Sun Yat-sen UniversityGuangzhouChina
  3. 3.School of Public HealthXi’an Jiaotong University Health Science CenterXi’anChina
  4. 4.The Center of Gerontology and Geriatrics, West China HospitalSichuan UniversityChengduChina
  5. 5.Precision Medicine Research CenterWest China Hospital, Sichuan UniversityChengduChina

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