The journals of gerontology. Series A, Biological sciences and medical sciences最新文献

{"title":"Biological age associates with longitudinal frailty-related functional decline: the Health and Retirement Study.","authors":"Savvina Prapiadou, Tamara N Kimball, Benjamin Y Q Tan, Reinier W P Tack, Devanshi Choksi, Marie-Gabrielle Duperron, Jasper R Senff, Evy M Reinders, Tan L Feng, Sanjula D Singh, Jonathan Rosand, Christopher D Anderson","doi":"10.1093/gerona/glag213","DOIUrl":"10.1093/gerona/glag213","url":null,"abstract":"<p><p>Epigenetic clocks have emerged as markers of biological aging. Understanding their association with age-related functional decline may provide insights into DNA-mediated mechanisms underlying frailty-related functional decline and reveal which clocks best associate with accelerated functional decline. We therefore examined associations between established epigenetic clock measures and longitudinal trajectories of cognitive function, grip strength, and walking speed. We analyzed data from 4018 participants in the Health and Retirement Study with available DNA methylation data and up to 12 years of follow-up data. Using linear mixed-effects models, we examined retrospective associations between 12 epigenetic clocks and longitudinal trajectories of frailty-related functional decline, modeling interactions between each epigenetic clock and time, adjusting for chronological age and sociodemographic covariates. In longitudinal analyses controlling for chronological age, older epigenetic age was associated with faster cognitive decline for Hannum (β = -0.0054, 95% CI, -0.0095 to -0.0014, p = .009) and DNAmGrimAge (β = -0.0141, 95% CI, -0.0174 to -0.0107, p < .001). Higher DNAmGrimAge was associated with accelerated decline in grip strength (β = -0.024, 95% CI, -0.033 to -0.015, p < .001) and decline in walking speed (β = -0.0008, 95% CI, -0.0013 to -0.0004, p < .001). Higher epigenetic clock biological age estimates, particularly DNAmGrimAge, are retrospectively associated with accelerated frailty-related functional decline across multiple functional domains. Systematic comparison of clock derivations may reveal specific epigenetic patterns underlying age-related functional deterioration.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unequal embodiment: racial and ethnic heterogeneity in the predictors and age-related health outcomes associated with accelerated biological aging.","authors":"Mariela Villalba Madrid, Francisco Ríos Casas, Mateo P Farina","doi":"10.1093/gerona/glag207","DOIUrl":"10.1093/gerona/glag207","url":null,"abstract":"<p><strong>Background: </strong>This study investigates whether life-course and socioeconomic exposures are similarly associated with accelerated biological aging across racial and ethnic groups and whether accelerated biological aging predicts health outcomes equivalently across groups.</p><p><strong>Methods: </strong>Data came from the Health and Retirement Study (2016-2022). Accelerated biological age was derived from 22 blood-based biomarkers from the 2016 Venous Blood Study. We used linear regression models with interactions between race/ethnicity and life-course exposures (childhood adversity and adult/midlife socioeconomic status (SES)) to assess group differences in accelerated aging. We used linear, ordered logistic, and logistic regression models with interactions between accelerated biological age and race/ethnicity to assess group differences in health outcomes. We examined differences by foreign-born status among Hispanic adults.</p><p><strong>Results: </strong>Associations between life-course exposures, accelerated biological aging, and health varied by race/ethnicity. Compared to non-Hispanic White adults, childhood health and adversity were not associated with accelerated biological aging for non-Hispanic Black and Hispanic adults, and among these groups, higher midlife SES did not decelerate biological aging. The association between accelerated biological age and health outcomes varied by race/ethnicity; accelerated biological age was less predictive among non-Hispanic Black and Hispanic adults. Among Hispanic adults, increased biological age was more strongly linked to multimorbidity among foreign-born individuals than U.S.-born individuals.</p><p><strong>Conclusions: </strong>The processes linking life-course conditions to biological aging and biological aging to later-life health do not translate uniformly across racial/ethnic groups. Future research should explore the sources of heterogeneity in life-course exposures and the mechanisms by which biological age translates into health outcomes.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global transitions of concomitant patterns and risk factors of cardio-renal-metabolic conditions among the elderly.","authors":"Shuzhen Zhao, Chengnan Guo, Xin Zhang, Yi Li, Jingkun Hu, Jiayi Huang, Luojia Dai, Zhenqiu Liu, Tiejun Zhang","doi":"10.1093/gerona/glag218","DOIUrl":"10.1093/gerona/glag218","url":null,"abstract":"<p><strong>Background: </strong>Cardio-renal-metabolic (CRM) diseases-including ischemic heart disease (IHD), stroke, type 2 diabetes (T2DM), and chronic kidney disease (CKD)-pose major threats to healthy aging. Yet the co-occurrence and evolution of these conditions across regions, and their modifiable risk factors, remain unclear.</p><p><strong>Methods: </strong>We analyzed CRM incidence among adults aged ≥55 years in 204 countries and territories from 1990 to 2021. Fifteen multimorbidity patterns were identified based on the population-level coexistence of high CRM incidence. Temporal dynamics were assessed using Bayesian age-period-cohort modeling, and interpretable machine learning was used to screen corresponding risk factors.</p><p><strong>Results: </strong>From 1990 to 2021, global incidence declined for IHD and stroke but rose for T2DM and CKD. High-income regions transitioned from IHD-dominated to T2DM- and CKD-predominant patterns, while North Africa and the Middle East became hotspots for the concurrence of high CRM incidence. Inequalities linked to sociodemographic development widened and are projected to persist through 2035. Declines in IHD and stroke were associated with improvements in blood pressure and lipid control, whereas rises in obesity and trans-fat intake were linked to increases in T2DM and CKD. Regional variation and clustering of these risk factors corresponded to global disparities in incidence trends. Addressing these risk factors was projected to improve healthy life expectancy at age 55, particularly in the Middle East and North Africa.</p><p><strong>Conclusions: </strong>Co-occurrence of CRM conditions is undergoing a transition, characterized by heterogeneous regional risk profiles and widening inequalities. Targeted prevention and policy strategies may be considered to promote healthy longevity worldwide.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic profiling of telomere length: associations with aging-related phenotypes and modifiable lifestyle factors in Chinese older adults.","authors":"Tianpei Ma, Xunying Zhao, Ke Jiang, Lei Lin, Lanjin Xu, Nan Yang, Xin Chen, Qingwen Zhao, Xingyu Zhang, Haiyu Yan, Xinyang Dui, Jinyu Xiao, Mengyu Fan, Lu Long, Jiaqiang Liao, Tao Zhang, Xia Jiang, Jiayuan Li","doi":"10.1093/gerona/glag209","DOIUrl":"10.1093/gerona/glag209","url":null,"abstract":"<p><strong>Background: </strong>Telomere length (TL) is a well-established biomarker of cellular senescence, yet the metabolic profile of TL and its associations with aging-related phenotypes and responses to modifiable lifestyle factors remain unclear.</p><p><strong>Methods: </strong>TL was measured using quantitative real-time polymerase chain reaction (qPCR) in 282 participants from the West China Health and Aging Cohort (WCHAC). Plasma metabolites were analyzed using liquid chromatography-tandem mass spectrometry. TL-associated metabolic signatures (Met-TL) were identified through elastic net regression models. Associations between Met-TL and aging-related phenotypes and modifiable lifestyle factors were evaluated using linear and logistic regression models in a larger, non-overlapping sample of 5957 WCHAC participants. Furthermore, we employed mediation analysis to explore the mediating effects of Met-TL between lifestyle factors and aging-related diseases.</p><p><strong>Results: </strong>We identified a plasma metabolite signature comprising 26 metabolites explaining 17.5% of TL variance. Met-TL significantly associated with aging-related phenotypes (44 Bonferroni-corrected associations) and modifiable lifestyle factors (4 associations). Notably, Met-TL showed robust associations with steatohepatitis and hepatic biomarkers. Mediation analysis revealed that Met-TL partially explained the protective association between healthy lifestyle and steatohepatitis, with a mediation proportion of 8.2%.</p><p><strong>Conclusion: </strong>These findings provide novel insights into the metabolic profile of TL in older adults. The Met-TL may serve as a promising biomarker of cellular aging, particularly in identifying liver dysfunction, facilitating the development of personalized aging monitoring and anti-aging intervention strategies.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A blood DNA methylation marker of cognitive ability is associated with six-year cognitive performance independent of blood Alzheimer's disease biomarkers.","authors":"Deirdre M O'Shea, Lily Wang, David Lukacsovich, Wei Zhang, James E Galvin","doi":"10.1093/gerona/glag222","DOIUrl":"10.1093/gerona/glag222","url":null,"abstract":"<p><p>MethylCog is a 29-CpG blood DNA methylation (DNAm) score developed to index general cognitive ability (g). Whether it captures cognition-related information associated with later cognitive performance that is not fully represented by blood-based biomarkers of Alzheimer's disease and related dementias (ADRD) remains unclear. Using the held-out Health and Retirement Study Harmonized Cognitive Assessment Protocol (HRS-HCAP) test set from the original MethylCog study (N = 605), we examined associations with baseline g after adjustment for age, sex, education, apolipoprotein E (APOE) ε4 carrier status, neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), phosphorylated tau 181 (p-tau181), and amyloid-β 42/40 ratio (Aβ42/40). Prospective associations with six-year follow-up g were examined after adjustment for baseline g, age, sex, education, and APOE ε4 carrier status, with additional adjustment for the ADRD biomarker panel. MethylCog remained associated with baseline g in the fully adjusted cross-sectional model (standardized β = .178, 95% CI: .111-.244, p < .001; ΔAdjR² = .025). MethylCog was also associated with six-year follow-up g after adjustment for baseline g and all covariates and biomarkers (standardized β = .101, 95% CI: .033-.170, p = .004; N = 331; ΔAdjR² = .007). Findings were similar among participants without baseline cognitive impairment. These findings provide preliminary evidence that a cognition-trained DNAm signature captures variation in later cognitive performance not fully represented by baseline cognition or available ADRD blood biomarkers.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Napping characteristics and incident dementia: results from the National Health and Aging Trends Study.","authors":"Kening Jiang, Alden L Gross, Catriona Tingsea Wu, Junxin Li, Halima Amjad, Emerson M Wickwire, Jennifer S Albrecht, Atul Malhotra, Chien-Yu Irene Tseng, Marc Kaizi-Lutu, Chunyu Liu, Christopher N Kaufmann, Adam P Spira","doi":"10.1093/gerona/glag208","DOIUrl":"10.1093/gerona/glag208","url":null,"abstract":"<p><strong>Background: </strong>Whether daytime napping may be a risk factor for dementia, in addition to nighttime sleep disturbances, remains unclear. This study investigated longitudinal associations of napping characteristics with incident dementia among U.S. older adults.</p><p><strong>Methods: </strong>Data came from the National Health and Aging Trends Study (NHATS). Napping characteristics were self-reported in a sleep module at round 3 (2013), including (1) frequency (non-napper, infrequent, frequent); (2) intention (non-napper, intentional, unintentional); (3) duration (non-napper, ≤30 minutes, >30 minutes). Dementia classification was established at each round using a validated algorithm, and possible/probable dementia served as our outcome. We included 995 participants free of possible/probable dementia at round 3 who were followed up to round 13 (2023). Discrete-time complementary log-log models were used for hazard ratio (HR) of incident possible/probable dementia associated with napping characteristics, adjusting for demographic, health, and sleep variables (duration, daytime sleepiness, and obstructive sleep apnea risk).</p><p><strong>Results: </strong>When compared to non-nappers, frequent nappers had 1.48 times the hazard of developing incident possible/probable dementia (95% confidence interval [CI]: 1.14, 1.94). Unintentional napping was associated with incident possible/probable dementia (HR = 1.39, 95% CI: 1.06, 1.81). No associations were found for infrequent or intentional napping. Napping ≤30 minutes was associated with possible/probable dementia (HR = 1.40, 95% CI: 1.06, 1.85), but the association of napping >30 minutes was attenuated with additional adjustment for sleep variables (HR = 1.28, 95% CI: 0.96, 1.69).</p><p><strong>Conclusions: </strong>Daytime napping may be a modifiable risk factor for dementia if supported by further evidence. Future studies with detailed napping characteristics and longer follow-up are needed.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anthropometric aging links neuromusculoskeletal diseases to cognitive and physical deficits.","authors":"Qu Tian, Suha Shin, Amber B Courville, Kong Y Chen, Luigi Ferrucci","doi":"10.1093/gerona/glag217","DOIUrl":"10.1093/gerona/glag217","url":null,"abstract":"<p><strong>Background: </strong>Aging changes whole-body anthropometry. Accelerated anthropometric aging can be operationalized as the age gap between the anthropometric-predicted age and the chronological age (AAG). What disease conditions affect AAG and subsequent functional deficits remains unclear.</p><p><strong>Methods: </strong>In 302 Baltimore Longitudinal Study of Aging participants (mean age = 71.7 years, 58% women, 30% Black), we examined the associations between AAG and disease conditions using multivariable linear regression, adjusted for age, sex, and race, and further tested whether AAG would mediate the association between diseases and functional outcomes.</p><p><strong>Results: </strong>Across disease conditions examined, AAG was specifically associated with osteoporosis, connective tissue disease, and neurodegenerative disease (including mild cognitive impairment, dementia, and Parkinson's disease) (p = .006, .047, and .034, respectively) and showed a trend to spinal stenosis (p = .098). AAG was not associated with pulmonary and vascular conditions, diabetes, hyperlipidemia, liver and kidney diseases, eye diseases, or cancer. AAG significantly mediated the associations between osteoporosis, connective tissue disease, and neurodegenerative disease and a range of cognitive and physical function measures (mediation effects all p < .05). Notably, AAG mediated the associations between neurodegenerative disease and measures important for motor planning and control, such as visuospatial ability, gesture imitation, and rapid gait speed. AAG also mediated the associations of osteoporosis and spinal stenosis with muscle strength.</p><p><strong>Conclusions: </strong>Anthropometric aging is specifically associated with neuromusculoskeletal diseases and may partly account for the associations between certain disease conditions and subsequent functional deficits. Future studies involving blood biomarkers are warranted to uncover the biological processes of anthropometric aging.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-national comparison of the association between adult child educational attainment and older parents' functional health.","authors":"Yulin Yang, Karla Renata Flores Romero, Sirena Gutierrez, Ah-Reum Lee, Emma Nichols, Jacqueline Torres","doi":"10.1093/gerona/glag210","DOIUrl":"10.1093/gerona/glag210","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence points to the protective role of adult child education in older parents' health, including their risk of ADL and IADL difficulties. Yet, little is known whether this association varies cross-nationally due to contextual differences in intergenerational transfers, family dynamics, and other factors. This study examines the relationship between adult child education and parents' functional health outcomes across countries, using comparable population-based datasets.</p><p><strong>Methods: </strong>We used harmonized data from seven population-based studies accessed through the Gateway to Global Aging Data. Our analytic sample included 88 683 adults 60 years and older from 24 countries. We estimated and meta-analyzed associations between adult child education and respondents' (parents') difficulty with basic and instrumental activities of daily living (ADL and IADLs), controlling for respondents' own education and other sociodemographic characteristics. We also considered heterogeneity across parent and child demographics (eg, parent gender, child gender).</p><p><strong>Results: </strong>Across all studies, each additional year of education averaged across adult children was associated with a 3% lower risk of difficulty with both ADLs (95% Confidence Interval [CI]: 0.95, 0.98) and IADLs (95% CI: 0.95, 0.98). Statistical heterogeneity appeared to be driven by one study (eg, I2 = 78.94% when the study was included vs I2 = 0.04% when excluded). Results suggest limited heterogeneity across demographic subgroups.</p><p><strong>Conclusion: </strong>\"Upward\" intergenerational benefits of higher adult child education for parents' late-life ADL and IADL difficulties appear to be relatively consistent across a range of global settings. Further research is needed to uncover the mechanisms driving these cross-national associations.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging markers predict disease progression in early-stage multiple system atrophy: a 2-year prospective cohort study.","authors":"Lingyu Zhang, Junyu Lin, Chunyu Li, Qianqian Wei, Ruwei Ou, Tianmi Yang, Yi Xiao, Qirui Jiang, Xueping Chen, Bi Zhao, Huifang Shang","doi":"10.1093/gerona/glag194","DOIUrl":"10.1093/gerona/glag194","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) markers are identified as important indicators for the diagnosis of multiple system atrophy (MSA). However, whether these MRI markers can predict the disease progression of MSA remains undefined. We aimed to investigate the relationship between MRI markers and disease progression in patients with early MSA.</p><p><strong>Methods: </strong>The patients were divided into MRI-positive and MRI-negative groups based on MSA-specific MRI markers. Disease progression was evaluated using the Unified MSA Rating Scale (UMSARS), Montreal Cognitive Assessment, and Frontal Assessment Battery. A repeated measures ANCOVA was used to compare the rate of disease progression between the two groups. A multiple linear regression model was used to assess the association between MRI subtype and disease progression.</p><p><strong>Results: </strong>A total of 144 patients with early MSA were enrolled, and 73 patients completed the 2-year follow-up. Patients with MSA and MSA of the parkinsonian subtype (MSA-P) in the MRI-positive group exhibited significantly faster disease progression on the total UMSARS score over a 2-year follow-up compared to those in the MRI-negative group (p = .002 and p = .020, respectively). Multiple linear regression analysis revealed that MRI-positive status was a significant predictor of more severe disease progression on the UMSARS total score in patients with MSA and MSA-P at the 1- and 2-year follow-up after adjusting for age, sex, and baseline disease duration (all p < .05).</p><p><strong>Conclusions: </strong>This study highlights that MRI markers are valuable imaging predictors of disease progression in early MSA, in addition to their diagnostic role.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal trajectories of social frailty and the risk of all-cause mortality among older adults in South Korea: exploration of the mediating role of cognitive functioning.","authors":"Seong-Uk Baek, Jin-Ha Yoon","doi":"10.1093/gerona/glag191","DOIUrl":"10.1093/gerona/glag191","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence indicates that social frailty leads to adverse health outcomes in older adults. However, longitudinal trajectories of social frailty and their relationship with all-cause mortality have not been fully investigated. We analyzed the association between social frailty trajectories and all-cause mortality, and the mediating role of cognitive functioning in this relationship.</p><p><strong>Methods: </strong>A nationally representative sample of older adults in South Korea was analyzed (n = 5941). Social frailty was measured multidimensionally through social activity, social networks, social support, loneliness, and living alone. Social frailty trajectories from 2006 to 2014 were identified using a growth mixture model. Subsequent change in cognitive functioning was assessed using the Mini-Mental State Examination. Participants were then followed for all-cause mortality through 2022. Cox regression was employed to assess the relationship between social frailty trajectory and all-cause mortality, using hazard ratios (HRs) and 95% confidence intervals (CIs). Mediation analysis was performed to assess the mediating role of poor cognitive functioning.</p><p><strong>Results: </strong>Two social frailty trajectories were identified: stable-low trajectory (n = 5065, 85.3%) and high-increasing trajectory (n = 876, 14.7%). Compared to the stable-low social frailty trajectory, the high-increasing social frailty trajectory was linked to an elevated risk for all-cause mortality (HR = 1.32; 95% CI = 1.11-1.57). Subsequent poor cognitive functioning partially accounted for the excess hazard of all-cause mortality among those experiencing a high-increasing social frailty trajectory (proportion mediated: 20.8%, 95% CI: 10.5%-59.5%).</p><p><strong>Conclusions: </strong>Experiencing an increasing social frailty trajectory was linked to elevated mortality risk in older adults, and subsequent poor cognitive functioning partially accounted for this association.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}