Kuiper · The journals of gerontology. Series A, Biological sciences and medical sciences 2023 · prospective cohort study · n=3222

Epigenetic and Metabolomic Biomarkers for Biological Age: A Comparative Analysis of Mortality and Frailty Risk.

Cited 85 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective cohort study

PubMed 37303208 · doi:10.1093/gerona/glad137 · record verified 2026-08-30

What was done

The authors compared multiple biological age markers in two prospective cohorts totaling 3,222 participants. They evaluated epigenetic clocks (DNAm Horvath, DNAm Hannum, DNAm Lin, DNAm epiTOC, DNAm PhenoAge, DNAm DunedinPoAm, DNAm GrimAge, and DNAm Zhang) alongside metabolomic markers (MetaboAge and MetaboHealth) to assess how well they reflect five frailty measures and predict all-cause mortality.

What was found

The abstract reports no specific numerical effect sizes, hazard ratios, or confidence intervals. Qualitatively, biomarkers trained on mortality and biophysiological data outperformed markers trained solely on chronological age. DNAm GrimAge and MetaboHealth demonstrated the strongest associations with frailty and mortality; these associations were mutually independent and remained independent of clinical geriatric frailty scores.

Why it matters

These findings indicate that epigenetic and metabolomic clocks capture complementary, non-overlapping dimensions of biological aging. Combining mortality-trained molecular biomarkers with traditional clinical assessments could improve risk stratification for frailty and death.

Limits

The abstract does not report numerical effect sizes, follow-up durations, or demographic details of the two cohorts. Because this is an observational study, residual confounding cannot be ruled out, and clinical utility in routine practice remains to be established.

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