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Sluiskes MH, Goeman JJ, Beekman M, Slagboom PE, Putter H, Rodríguez-Girondo M. Clarifying the biological and statistical assumptions of cross-sectional biological age predictors: an elaborate illustration using synthetic and real data. BMC Med Res Methodol 2024; 24:58. [PMID: 38459475 PMCID: PMC10921716 DOI: 10.1186/s12874-024-02181-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/15/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND There is divergence in the rate at which people age. The concept of biological age is postulated to capture this variability, and hence to better represent an individual's true global physiological state than chronological age. Biological age predictors are often generated based on cross-sectional data, using biochemical or molecular markers as predictor variables. It is assumed that the difference between chronological and predicted biological age is informative of one's chronological age-independent aging divergence ∆. METHODS We investigated the statistical assumptions underlying the most popular cross-sectional biological age predictors, based on multiple linear regression, the Klemera-Doubal method or principal component analysis. We used synthetic and real data to illustrate the consequences if this assumption does not hold. RESULTS The most popular cross-sectional biological age predictors all use the same strong underlying assumption, namely that a candidate marker of aging's association with chronological age is directly informative of its association with the aging rate ∆. We called this the identical-association assumption and proved that it is untestable in a cross-sectional setting. If this assumption does not hold, weights assigned to candidate markers of aging are uninformative, and no more signal may be captured than if markers would have been assigned weights at random. CONCLUSIONS Cross-sectional methods for predicting biological age commonly use the untestable identical-association assumption, which previous literature in the field had never explicitly acknowledged. These methods have inherent limitations and may provide uninformative results, highlighting the importance of researchers exercising caution in the development and interpretation of cross-sectional biological age predictors.
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Affiliation(s)
- Marije H Sluiskes
- Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
| | - Jelle J Goeman
- Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Marian Beekman
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - P Eline Slagboom
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
- Max Planck Institute for the Biology of Ageing, Cologne, Germany
| | - Hein Putter
- Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Mar Rodríguez-Girondo
- Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
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Dalecka A, Bartoskova Polcrova A, Pikhart H, Bobak M, Ksinan AJ. Living in poverty and accelerated biological aging: evidence from population-representative sample of U.S. adults. BMC Public Health 2024; 24:458. [PMID: 38350911 PMCID: PMC10865704 DOI: 10.1186/s12889-024-17960-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Biological aging reflects a decline in the functions and integrity of the human body that is closely related to chronological aging. A variety of biomarkers have been found to predict biological age. Biological age higher than chronological age (biological age acceleration) indicates an accelerated state of biological aging and a higher risk of premature morbidity and mortality. This study investigated how socioeconomic disadvantages influence biological aging. METHODS The data from the National Health and Nutrition Examination Survey (NHANES) IV, including 10 nationally representative cross-sectional surveys between 1999-2018, were utilized. The analytic sample consisted of N = 48,348 individuals (20-84 years). We used a total of 11 biomarkers for estimating the biological age. Our main outcome was biological age acceleration, indexed by PhenoAge acceleration (PAA) and Klemera-Doubal biological age acceleration (KDM-A). Poverty was measured as a ratio of family income to the poverty thresholds defined by the U.S. Census Bureau, adjusted annually for inflation and family size (5 categories). The PAA and KDM-A were regressed on poverty levels, age, their interaction, education, sex, race, and a data collection wave. Sample weights were used to make the estimates representative of the U.S. adult population. RESULTS The results showed that higher poverty was associated with accelerated biological aging (PAA: unstandardized coefficient B = 1.38 p <.001, KDM: B = 0.96, p = .026 when comparing the highest and the lowest poverty level categories), above and beyond other covariates. The association between PAA and KDM-A and age was U-shaped. Importantly, there was an interaction between poverty levels and age (p <.001), as the effect of poverty was most pronounced in middle-aged categories while it was modest in younger and elderly groups. CONCLUSION In a nationally representative US adult population, we found that higher poverty was positively associated with the acceleration of biological age, particularly among middle-aged persons.
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Affiliation(s)
- Andrea Dalecka
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | | | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Martin Bobak
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Albert J Ksinan
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic.
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3
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Bafei SEC, Shen C. Biomarkers selection and mathematical modeling in biological age estimation. NPJ AGING 2023; 9:13. [PMID: 37393295 DOI: 10.1038/s41514-023-00110-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/08/2023] [Indexed: 07/03/2023]
Abstract
Biological age (BA) is important for clinical monitoring and preventing aging-related disorders and disabilities. Clinical and/or cellular biomarkers are measured and integrated in years using mathematical models to display an individual's BA. To date, there is not yet a single or set of biomarker(s) and technique(s) that is validated as providing the BA that reflects the best real aging status of individuals. Herein, a comprehensive overview of aging biomarkers is provided and the potential of genetic variations as proxy indicators of the aging state is highlighted. A comprehensive overview of BA estimation methods is also provided as well as a discussion of their performances, advantages, limitations, and potential approaches to overcome these limitations.
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Affiliation(s)
- Solim Essomandan Clémence Bafei
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Chong Shen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
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4
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Chen L, Zhang Y, Yu C, Guo Y, Sun D, Pang Y, Pei P, Yang L, Millwood IY, Walters RG, Chen Y, Du H, Liu Y, Burgess S, Stevens R, Chen J, Chen Z, Li L, Lv J. Modeling biological age using blood biomarkers and physical measurements in Chinese adults. EBioMedicine 2023; 89:104458. [PMID: 36758480 PMCID: PMC9941058 DOI: 10.1016/j.ebiom.2023.104458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND This study aimed to: 1) assess the associations of biological age acceleration based on Klemera and Doubal's method (KDM-AA) with long-term risk of all-cause mortality; and 2) compare the association of KDM-AA with all-cause mortality among participants potentially at different stages of the cardiovascular disease (CVD) continuum. METHODS The present study was based on a subpopulation of the China Kadoorie Biobank, with baseline survey during 2004-08. A total of 12,377 participants free of ischemic heart disease, stroke, or cancer at baseline were included, in which 8180 participants were identified to develop major coronary event (MCE), ischemic stroke (IS), intracerebral hemorrhage (ICH) or subarachnoid hemorrhage (SAH), and 4197 remained free of these cardiovascular diseases before 1 January 2014. These participants were followed up until 1 Jan 2018. KDM-AA was calculated by regressing biological age measurement, which was constructed based on baseline 16 physical and 9 biochemical markers using Klemera and Doubal's method, on chronological age. We estimated the associations of KDM-AA with the mortality risk using the hazard ratio (HR) and 95% confidence interval (CI) from Cox proportional hazard models. We assessed discrimination performance by Harrell's C-index and net reclassification index (NRI). FINDINGS The participants who developed MCE (mean KDM-AA = 0.1 year, standard deviation [SD] = 1.6 years) or ICH/SAH (0.3 ± 1.5 years) during subsequent follow-up showed accelerated aging at baseline compared to those of IS (0.0 ± 1.2 years) and control (-0.3 ± 1.3 years) groups. The KDM-AA was positively associated with long-term risk of all-cause mortality (HR = 1.20; 95% CI: 1.17, 1.23), and the association was robust for participants potentially at different stages of the CVD continuum. Adding KDM-AA improved mortality prediction compared to the model only with sociodemographic and lifestyle factors in whole participants, with the Harrell's C-index increasing from 0.813 (0.807, 0.819) to 0.821 (0.815, 0.826) (NRI = 0.011; 95% CI: 0.003, 0.019). INTERPRETATION In this middle-aged and elderly Chinese population, the KDM-AA is a promising measurement for biological age, and can capture the difference in cardiovascular health and predict the risk of all-cause mortality over a decade. FUNDING This work was supported by National Natural Science Foundation of China (82192904, 82192901, 82192900, 81941018). The CKB baseline survey and the first re-survey were supported by a grant from the Kadoorie Charitable Foundation Hong Kong. The long-term follow-up is supported by grants from the UK Wellcome Trust (212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z), grants (2016YFC0900500) from the National Key R&D Program of China, National Natural Science Foundation of China (81390540, 91846303), and Chinese Ministry of Science and Technology (2011BAI09B01).
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Affiliation(s)
- Lu Chen
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Yiqian Zhang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
| | - Yu Guo
- Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Dianjianyi Sun
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
| | - Yuanjie Pang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Iona Y Millwood
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Robin G Walters
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Yongmei Liu
- Qingdao Centers for Disease Control and Prevention (CDC), Qingdao, China
| | - Sushila Burgess
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Rebecca Stevens
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Liming Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China
| | - Jun Lv
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, 100191, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, 100191, China.
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Li Z, Zhang W, Duan Y, Niu Y, Chen Y, Liu X, Dong Z, Zheng Y, Chen X, Feng Z, Wang Y, Zhao D, Sun X, Cai G, Jiang H, Chen X. Progress in biological age research. Front Public Health 2023; 11:1074274. [PMID: 37124811 PMCID: PMC10130645 DOI: 10.3389/fpubh.2023.1074274] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/16/2023] [Indexed: 05/02/2023] Open
Abstract
Biological age (BA) is a common model to evaluate the function of aging individuals as it may provide a more accurate measure of the extent of human aging than chronological age (CA). Biological age is influenced by the used biomarkers and standards in selected aging biomarkers and the statistical method to construct BA. Traditional used BA estimation approaches include multiple linear regression (MLR), principal component analysis (PCA), Klemera and Doubal's method (KDM), and, in recent years, deep learning methods. This review summarizes the markers for each organ/system used to construct biological age and published literature using methods in BA research. Future research needs to explore the new aging markers and the standard in select markers and new methods in building BA models.
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Affiliation(s)
- Zhe Li
- The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Weiguang Zhang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Yuting Duan
- The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Yue Niu
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Yizhi Chen
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
- Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Hainan Academician Team Innovation Center, Sanya, China
| | - Xiaomin Liu
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Zheyi Dong
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Ying Zheng
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Xizhao Chen
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Zhe Feng
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Yong Wang
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Delong Zhao
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Xuefeng Sun
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Guangyan Cai
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
| | - Hongwei Jiang
- The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
- *Correspondence: Hongwei Jiang,
| | - Xiangmei Chen
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China
- Xiangmei Chen,
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Familial aggregation of the aging process: biological age measured in young adult offspring as a predictor of parental mortality. GeroScience 2022; 45:901-913. [PMID: 36401109 PMCID: PMC9886744 DOI: 10.1007/s11357-022-00687-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/06/2022] [Indexed: 11/20/2022] Open
Abstract
Measures of biological age (BA) integrate information across organ systems to quantify "biological aging," i.e., inter-individual differences in aging-related health decline. While longevity and lifespan aggregate in families, reflecting transmission of genes and environments across generations, little is known about intergenerational continuity of biological aging or the extent to which this continuity may be modified by environmental factors. Using data from the Jerusalem Perinatal Study (JPS), we tested if differences in offspring BA were related to mortality in their parents. We measured BA using biomarker data collected from 1473 offspring during clinical exams in 2007-2009, at age 32 ± 1.1. Parental mortality was obtained from population registry data for the years 2004-2016. We fitted parametric survival models to investigate the associations between offspring BA and parental all-cause and cause-specific mortality. We explored potential differences in these relationships by socioeconomic position (SEP) and offspring sex. Participants' BAs widely varied (SD = 6.95). Among those measured to be biologically older, parents had increased all-cause mortality (HR = 1.10, 95% CI: 1.08, 1.13), diabetes mortality (HR = 1.19, 95% CI: 1.08, 1.30), and cancer mortality (HR = 1.07, 95% CI: 1.02, 1.13). The association with all-cause mortality was stronger for families with low compared with high SEP (Pinteraction = 0.04) and for daughters as compared to sons (Pinteraction < 0.001). Using a clinical-biomarker-based BA estimate, observable by young adulthood prior to the onset of aging-related diseases, we demonstrate intergenerational continuity of the aging process. Furthermore, variation in this familial aggregation according to household socioeconomic position (SEP) at offspring birth and between families of sons and daughters proposes that the environment alters individuals' aging trajectory set by their parents.
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Abu Bakar SA, Syed Mohamed Shahruddin SNS, Ismail N, Wan Md Adnan WAH. Biological age for chronic kidney disease patients using index model. PeerJ 2022; 10:e13694. [PMID: 35935256 PMCID: PMC9351620 DOI: 10.7717/peerj.13694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/16/2022] [Indexed: 01/17/2023] Open
Abstract
The estimation of biological age (BA) is an important asymptomatic measure that can be used to understand the physical changes and the aging process of a living being. Factors that contribute towards profiling the human biological age can be diverse. Therefore, this study focuses on developing a BA model for patients with Chronic Kidney Disease (CKD). The procedure commences with the selection of significant biomarkers using a correlation test. Appropriate weighting is then assigned to each selected biomarker using the indexing method to produce a BA index. The BA index is matched to the age variation within the sample to acquire additional terms for the chronological age leading ultimately to the estimated BA. From a sample of 190 patients (133 trained data and 57 testing data) obtained from the University of Malaya Medical Centre (UMMC), Malaysia, the intensity of the BA is found to be between three to nine years from the chronological age. Visual observations further validate the high similarities between the training and testing data sets.
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Affiliation(s)
- Shaiful Anuar Abu Bakar
- Institute of Mathematical Sciences, Faculty of Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Noriszura Ismail
- Department of Mathematical Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
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Husted KLS, Brink-Kjær A, Fogelstrøm M, Hulst P, Bleibach A, Henneberg KÅ, Sørensen HBD, Dela F, Jacobsen JCB, Helge JW. A Model for Estimating Biological Age From Physiological Biomarkers of Healthy Aging: Cross-sectional Study. JMIR Aging 2022; 5:e35696. [PMID: 35536617 PMCID: PMC9131142 DOI: 10.2196/35696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/21/2022] [Accepted: 04/06/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Individual differences in the rate of aging and susceptibility to disease are not accounted for by chronological age alone. These individual differences are better explained by biological age, which may be estimated by biomarker prediction models. In the light of the aging demographics of the global population and the increase in lifestyle-related morbidities, it is interesting to invent a new biological age model to be used for health promotion. OBJECTIVE This study aims to develop a model that estimates biological age based on physiological biomarkers of healthy aging. METHODS Carefully selected physiological variables from a healthy study population of 100 women and men were used as biomarkers to establish an estimate of biological age. Principal component analysis was applied to the biomarkers and the first principal component was used to define the algorithm estimating biological age. RESULTS The first principal component accounted for 31% in women and 25% in men of the total variance in the biological age model combining mean arterial pressure, glycated hemoglobin, waist circumference, forced expiratory volume in 1 second, maximal oxygen consumption, adiponectin, high-density lipoprotein, total cholesterol, and soluble urokinase-type plasminogen activator receptor. The correlation between the corrected biological age and chronological age was r=0.86 (P<.001) and r=0.81 (P<.001) for women and men, respectively, and the agreement was high and unbiased. No difference was found between mean chronological age and mean biological age, and the slope of the regression line was near 1 for both sexes. CONCLUSIONS Estimating biological age from these 9 biomarkers of aging can be used to assess general health compared with the healthy aging trajectory. This may be useful to evaluate health interventions and as an aid to enhance awareness of individual health risks and behavior when deviating from this trajectory. TRIAL REGISTRATION ClinicalTrials.gov NCT03680768; https://clinicaltrials.gov/ct2/show/NCT03680768. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/19209.
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Affiliation(s)
- Karina Louise Skov Husted
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Physiotherapy and Occupational Therapy, University College Copenhagen, Copenhagen, Denmark
| | - Andreas Brink-Kjær
- Digital Health, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Mathilde Fogelstrøm
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hulst
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Akita Bleibach
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kaj-Åge Henneberg
- Biomedical Engineering, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | | | - Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Geriatrics, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Jens Christian Brings Jacobsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jørn Wulff Helge
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Wei K, Peng S, Liu N, Li G, Wang J, Chen X, He L, Chen Q, Lv Y, Guo H, Lin Y. All-Subset Analysis Improves the Predictive Accuracy of Biological Age for All-Cause Mortality in Chinese and U.S. Populations. J Gerontol A Biol Sci Med Sci 2022; 77:2288-2297. [PMID: 35417546 PMCID: PMC9923798 DOI: 10.1093/gerona/glac081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Klemera-Doubal's method (KDM) is an advanced and widely applied algorithm for estimating biological age (BA), but it has no uniform paradigm for biomarker processing. This article proposed all subsets of biomarkers for estimating BAs and assessed their association with mortality to determine the most predictive subset and BA. METHODS Clinical biomarkers, including those from physical examinations and blood assays, were assessed in the China Health and Nutrition Survey (CHNS) 2009 wave. Those correlated with chronological age (CA) were combined to produce complete subsets, and BA was estimated by KDM from each subset of biomarkers. A Cox proportional hazards regression model was used to examine and compare each BA's effect size and predictive capacity for all-cause mortality. Validation analysis was performed in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and National Health and Nutrition Examination Survey (NHANES). KD-BA and Levine's BA were compared in all cohorts. RESULTS A total of 130 918 panels of BAs were estimated from complete subsets comprising 3-17 biomarkers, whose Pearson coefficients with CA varied from 0.39 to 1. The most predictive subset consisted of 5 biomarkers, whose estimated KD-BA had the most predictive accuracy for all-cause mortality. Compared with Levine's BA, the accuracy of the best-fitting KD-BA in predicting death varied among specific populations. CONCLUSION All-subset analysis could effectively reduce the number of redundant biomarkers and significantly improve the accuracy of KD-BA in predicting all-cause mortality.
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Affiliation(s)
- Kai Wei
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shanshan Peng
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Na Liu
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Guyanan Li
- Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China
| | - Jiangjing Wang
- Shanghai Advanced Institute of Finance, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaotong Chen
- Department of Clinical Laboratory, Central Laboratory, Jing’an District Central Hospital of Shanghai, Fudan University, Shanghai, China
| | - Leqi He
- Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China
| | - Qiudan Chen
- Department of Clinical Laboratory, Central Laboratory, Jing’an District Central Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yuan Lv
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Huan Guo
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Lin
- Address correspondence to: Yong Lin, PhD, Department of Laboratory Medicine, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Jing’an District, Shanghai 200040, People’s Republic of China. E-mail:
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10
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Risk score-embedded deep learning for biological age estimation: Development and validation. Inf Sci (N Y) 2022. [DOI: 10.1016/j.ins.2021.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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11
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Bahour N, Cortez B, Pan H, Shah H, Doria A, Aguayo-Mazzucato C. Diabetes mellitus correlates with increased biological age as indicated by clinical biomarkers. GeroScience 2021; 44:415-427. [PMID: 34773197 PMCID: PMC8589453 DOI: 10.1007/s11357-021-00469-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 09/23/2021] [Indexed: 12/16/2022] Open
Abstract
Chronological age (CA) is determined by time of birth, whereas biological age (BA) is based on changes on a cellular level and strongly correlates with morbidity, mortality, and longevity. Type 2 diabetes (T2D) associates with increased morbidity and mortality; thus, we hypothesized that BA would be increased and calculated it from biomarkers collected at routine clinical visits. Deidentified data was obtained from three cohorts of patients (20–80 years old)—T2D, type 1 diabetes (T1D), and prediabetes—and compared to gender- and age-matched non-diabetics. Eight clinical biomarkers that correlated with CA in people without diabetes were used to calculate BA using the Klemera and Doubal method 1 (KDM1) and multiple linear regression (MLR). The phenotypic age (PhAge) formula was used with its predetermined biomarkers. BA of people with T2D was, on average, 12.02 years higher than people without diabetes (p < 0.0001), while BA in T1D was 16.32 years higher (p < 0.0001). Results were corroborated using MLR and PhAge. The biomarkers with the strongest correlation to increased BA in T2D using KDM were A1c (R2 = 0.23, p < 0.0001) and systolic blood pressure (R2 = 0.21, p < 0.0001). BMI had a positive correlation to BA in non-diabetes subjects but disappeared in those with diabetes. Mortality data using the ACCORD trial was used to validate our results and showed a significant correlation between higher BA and decreased survival. In conclusion, BA is increased in people with diabetes, irrespective of pathophysiology, and to a lesser extent in prediabetes.
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Affiliation(s)
- Nadine Bahour
- Joslin Diabetes Center, Harvard Medical School, 1 Joslin Place, Boston, MA, 02215, USA
| | - Briana Cortez
- University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, 78539, USA
| | - Hui Pan
- Joslin Diabetes Center, Harvard Medical School, 1 Joslin Place, Boston, MA, 02215, USA
| | - Hetal Shah
- Joslin Diabetes Center, Harvard Medical School, 1 Joslin Place, Boston, MA, 02215, USA
| | - Alessandro Doria
- Joslin Diabetes Center, Harvard Medical School, 1 Joslin Place, Boston, MA, 02215, USA
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12
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Husted KLS, Fogelstrøm M, Hulst P, Brink-Kjær A, Henneberg KÅ, Sorensen HBD, Dela F, Helge JW. A Biological Age Model Designed for Health Promotion Interventions: Protocol for an Interdisciplinary Study for Model Development. JMIR Res Protoc 2020; 9:e19209. [PMID: 33104001 PMCID: PMC7652682 DOI: 10.2196/19209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/16/2020] [Accepted: 09/30/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Actions to improve healthy aging and delay morbidity are crucial, given the global aging population. We believe that biological age estimation can help promote the health of the general population. Biological age reflects the heterogeneity in functional status and vulnerability to disease that chronological age cannot. Thus, biological age assessment is a tool that provides an intuitively meaningful outcome for the general population, and as such, facilitates our understanding of the extent to which lifestyle can increase health span. OBJECTIVE This interdisciplinary study intends to develop a biological age model and explore its usefulness. METHODS The model development comprised three consecutive phases: (1) conducting a cross-sectional study to gather candidate biomarkers from 100 individuals representing normal healthy aging people (the derivation cohort); (2) estimating the biological age using principal component analysis; and (3) testing the clinical use of the model in a validation cohort of overweight adults attending a lifestyle intervention course. RESULTS We completed the data collection and analysis of the cross-sectional study, and the initial results of the principal component analysis are ready. Interpretation and refinement of the model is ongoing. Recruitment to the validation cohort is forthcoming. We expect the results to be published by December 2021. CONCLUSIONS We expect the biological age model to be a useful indicator of disease risk and metabolic risk, and further research should focus on validating the model on a larger scale. TRIAL REGISTRATION ClinicalTrials.gov NCT03680768, https://clinicaltrials.gov/ct2/show/NCT03680768 (Phase 1 study); NCT04279366 https://clinicaltrials.gov/ct2/show/NCT04279366 (Phase 3 study). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19209.
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Affiliation(s)
- Karina Louise Skov Husted
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Physiotherapy and Occupational therapy, University College Copenhagen, Copenhagen, Denmark
| | - Mathilde Fogelstrøm
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Hulst
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Brink-Kjær
- Digital Health, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Kaj-Åge Henneberg
- Biomedical Engineering, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Geriatrics, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Jørn Wulff Helge
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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13
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Liu Z. Development and Validation of 2 Composite Aging Measures Using Routine Clinical Biomarkers in the Chinese Population: Analyses From 2 Prospective Cohort Studies. J Gerontol A Biol Sci Med Sci 2020; 76:1627-1632. [PMID: 32946548 PMCID: PMC8521780 DOI: 10.1093/gerona/glaa238] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND This study aimed to: (i) develop 2 composite aging measures in the Chinese population using 2 recent advanced algorithms (the Klemera and Doubal method and Mahalanobis distance); and (ii) validate the 2 measures by examining their associations with mortality and disease counts. METHODS Based on data from the China Nutrition and Health Survey (CHNS) 2009 wave (N = 8119, aged 20-79 years, 53.5% women), a nationwide prospective cohort study of the Chinese population, we developed Klemera and Doubal method-biological age (KDM-BA) and physiological dysregulation (PD, derived from Mahalanobis distance) using 12 biomarkers. For the validation analysis, we used Cox proportional hazard regression models (for mortality) and linear, Poisson, and logistic regression models (for disease counts) to examine the associations. We replicated the validation analysis in the China Health and Retirement Longitudinal Study (CHARLS, N = 9304, aged 45-99 years, 53.4% women). RESULTS Both aging measures were predictive of mortality after accounting for age and gender (KDM-BA, per 1-year, hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.08, 1.19; PD, per 1-SD, HR = 1.50, 95% CI = 1.33, 1.69). With few exceptions, these mortality predictions were robust across stratifications by age, gender, education, and health behaviors. The 2 aging measures were associated with disease counts both cross-sectionally and longitudinally. These results were generally replicable in CHARLS although 4 biomarkers were not available. CONCLUSIONS We successfully developed and validated 2 composite aging measures-KDM-BA and PD, which have great potentials for applications in early identifications and preventions of aging and aging-related diseases in China.
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Affiliation(s)
- Zuyun Liu
- Center for Clinical Big Data and Analytics, Second Affiliated Hospital and Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China,Department of Pathology, Yale School of Medicine, New Haven, Connecticut,Address correspondence to: Zuyun Liu, PhD, Department of Big Data in Health Science, School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou 310058, Zhejiang, China. E-mail:
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14
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Jee H. Selection of a set of biomarkers and comparisons of biological age estimation models for Korean men. J Exerc Rehabil 2019; 15:31-36. [PMID: 30899733 PMCID: PMC6416494 DOI: 10.12965/jer.1836644.322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/08/2019] [Indexed: 12/13/2022] Open
Abstract
Biological age (BA) represents the rate of the senescence with a set of biomarkers. The BA prediction models have not been compared to obtain an optimal BA prediction model with BA biomarkers for Korean men. The study aims to obtain a set of BA biomarkers and compare three of the reported statistical approaches for an optimal BA prediction model. The Korea National Health and Nutrition Examination Surveys data of 2009 to 2011 were used to select six BA biomarkers from 940 healthy subjects aged between 30 to 80 years. The multiple linear regression (MLR), principal component analysis (PCA), and Klemera and Doubal methods (KDM) were used to obtain three BA prediction models. Correlation coefficients (r) with 95% confidence intervals (CI) and regression slopes were assessed. One of the Euro Quality of Life-5 Dimensions, mobility, was compared for feasibility test of each BA models. KDM showed greatest correlation (r=0.88 [P<0.05]) with smallest 95% CI and regression slope (1.00). PCA also showed strong correlation (r=0.79 [P<0.05]) with small 95% CI and regression slope (0.94). MLR (r=0.68 [P<0.05]) showed over and underestimated BA results at the end of the age spectrum. Estimations of BA were most reliable with KDM. The PCA and MLR approaches were comparatively simple to devise for Korean men.
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Affiliation(s)
- Haemi Jee
- Department of Sports and Health Care, Namseoul University, Cheonan, Korea
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15
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The many ages of man: diverse approaches to assessing ageing-related biological and psychological measures and their relationship to chronological age. Curr Opin Psychiatry 2019; 32:130-137. [PMID: 30461440 DOI: 10.1097/yco.0000000000000473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Chronological age is a crude measure and may not be the best indicator of the ageing process. Establishing valid and reliable biomarkers to understand the true effect of ageing is of great interest. We provide an overview of biological and psychological characteristics that change with age and can potentially serve as markers of the ageing process, and discuss if an integration of these characteristics may more accurately measure the true age of a person. We also describe the clinicopathological continuum of these ageing-related changes. RECENT FINDINGS Ageing-related changes in the biological and psychological systems of the body have been studied to varying degrees and with differing emphases. Despite the development of ageing indices, there is no single indicator that can holistically estimate the ageing process. Differential ageing of bodily systems remains poorly understood, and valid methods have not been developed for composite markers of biological and psychological processes. SUMMARY The ageing process is complex and heterogeneous. Incorporating biological and psychological measures may improve accuracy in reflecting an individual's 'true age,' and elucidate why some people age successfully, whereas others show ageing-related decline and disease.
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17
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Abstract
At present, no single indicator could be used as a golden index to estimate aging process. The biological age (BA), which combines several important biomarkers with mathematical modeling, has been proposed for >50 years as an aging estimation method to replace chronological age (CA). The common methods used for BA estimation include the multiple linear regression (MLR), the principal component analysis (PCA), the Hochschild's method, and the Klemera and Doubal's method (KDM). The fundamental differences in these four methods are the roles of CA and the selection criteria of aging biomarkers. In MLR and PCA, CA is treated as the selection criterion and an independent index. The Hochschild's method and KDM share a similar concept, making CA an independent variable. Previous studies have either simply constructed the BA model by one or compared the four methods together. However, reviews have yet to illustrate and compare the four methods systematically. Since the BA model is a potential estimation of aging for clinical use, such as predicting onset and prognosis of diseases, improving the elderly's living qualities, and realizing successful aging, here we summarize previous BA studies, illustrate the basic statistical steps, and thoroughly discuss the comparisons among the four common BA estimation methods.
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Affiliation(s)
- Linpei Jia
- Department of Nephrology, Second Hospital of Jilin University, Changchun, Jilin Province
- Department of Nephrology, Chinese People’s Liberation Army General Hospital, Beijing
- State Key Laboratory of Kidney Disease, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China
| | - Weiguang Zhang
- Department of Nephrology, Chinese People’s Liberation Army General Hospital, Beijing
- State Key Laboratory of Kidney Disease, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China
| | - Xiangmei Chen
- Department of Nephrology, Second Hospital of Jilin University, Changchun, Jilin Province
- Department of Nephrology, Chinese People’s Liberation Army General Hospital, Beijing
- State Key Laboratory of Kidney Disease, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China
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