title: Heterogeneity of Human Aging and Its Assessment.
abstract: Understanding the heterogeneity in health of older adults is a compelling question in the biology of aging. We analyzed the performance of five measures of health heterogeneity, judging them by their ability to predict mortality. Using clinical and biomarker data on 1,013 participants of the Canadian Study of Health and Aging who were followed for up to 6 years, we calculated two indices of biological age using the Klemera and Doubal method, which controversially includes using chronological age as a "biomarker," and three frailty indices (FIs) that do not include chronological age: a standard clinical FI, an FI from standard laboratory blood tests and blood pressure, and their combination (FI-combined). Predictive validity was tested using Cox proportional hazards analysis and discriminative ability by the area under the receiver-operating characteristic curves. All five measures showed moderate performance that was improved by combining measures to evaluate larger numbers of items. The greatest addition in explanatory power came from the FI-combined that showed the best mortality prediction in an age-adjusted model. More extensive comparisons across different databases are required, but these results do not support including chronological age as a biomarker.
authors.affiliation: Department of Medicine and.
authors.forename: Arnold
authors.initials: A
authors.lastname: Mitnitski
authors.affiliation: Department of Medicine and.|Department of Pharmacology (Division of Geriatric Medicine), Dalhousie University, Halifax, Nova Scotia, Canada.|Department of Physiology, Institute of Cardiovascular Sciences and.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Howlett
authors.affiliation: Department of Medicine and.|Department of Geriatric Medicine and Institute of Brain, Behaviour and Neurosciences, University of Manchester, UK.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015415:Biomarkers / Q000097:blood*; D001795:Blood Pressure Determination / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009026:Mortality; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers
keywords: Biological age; Biological aging; Biomarkers; Frailty indices; Health heterogeneity