ArticleEClinicalMedicine2020
Education, biological ageing, all-cause and cause-specific mortality and morbidity: UK biobank cohort study.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed.
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- Deep learning aging marker from retinal images unveils sex-specific clinical and genetic signatures.Nature communications · 2026Article
- Clinical and Modifiable Factors Associated With Disability and Relapse in MOGAD: A Multicentre Cohort Study.Annals of clinical and translational neurology · 2026Article
- Assessing all-cause mortality and years of life lost associated with impaired biological health over time: the Tromsø study.European journal of public health · 2026Article
- Unhealthy sleep patterns and irregular night shift work are associated with increased risk of allergic rhinitis: a large prospective cohort study.BMC public health · 2026Article
- A streamlined CMR-derived machine-learning model for estimating cardiovascular biological age: development and validation in the UK-biobank and multi-ethnic study of atherosclerosis.European heart journal. Cardiovascular Imaging · 2026Article
- Stress, Well-Being, and Reproduction in Wildlife.Advances in experimental medicine and biology · 2026Review
- Allostatic load and kidney cancer incidence and mortality: a genetic susceptibility and proteomic mediation analysis.BMC cancer · 2025Article
- Impact of education level on complications and mortalities in type 2 diabetes: A UK biobank prospective cohort study.BMC public health · 2025Article
- Association of Income Inequality and Sleep Duration With Cardiovascular Outcomes in China and the UK.JACC. Asia · 2025Article
- Factors influencing the prevalence and death rate of COPD: a pan-database ecological study covering 201 countries and regions from 1990 to 2021.EClinicalMedicine · 2025Article
- DunedinPACNI estimates the longitudinal Pace of Aging from a single brain image to track health and disease.Nature aging · 2025Article
- An estimate of the longitudinal pace of aging from a single brain scan predicts dementia conversion, morbidity, and mortality.bioRxiv : the preprint server for biology · 2025Article
- Impact ofProceedings of the National Academy of Sciences of the United States of America · 2025Article
- Mediating and moderating effects of plasma proteomic biomarkers on the association between poor oral health problems and brain white matter microstructural integrity: the UK Biobank study.Molecular psychiatry · 2025Article
- Hypothalamic volume is associated with age, sex and cognitive function across lifespan: a comparative analysis of two large population-based cohort studies.EBioMedicine · 2025Article
- Impact of diabetes on the association between serum urate levels and incident dementia: a cohort study in the UK biobank.The journal of nutrition, health & aging · 2024Article
- Mediating and moderating effects of plasma proteomic biomarkers on the association between poor oral health problems and incident dementia: The UK Biobank study.GeroScience · 2024Article
- Age, sex, and APOE gene-specific associations between dynapenic obesity and dementia in a large cohort.The journal of nutrition, health & aging · 2024Article
- Gut microbiota in centenarians: A potential metabolic and aging regulator in the study of extreme longevity.Aging medicine (Milton (N.S.W)) · 2024Review
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Authors and funding
17 authors.
Funding
Abstract
backgroundSocioeconomic position as measured by education may be embodied and affect the functioning of key physiological systems. Links between social disadvantage, its biological imprint, and cause-specific mortality and morbidity have not been investigated in large populations, and yet may point towards areas for public health interventions beyond targeting individual behaviours.
methodsUsing data from 366,748 UK Biobank participants with 13 biomarker measurements, we calculated a Biological Health Score (BHS, ranging from 0 to 1) capturing the level of functioning of five physiological systems. Associations between BHS and incidence of cardiovascular disease (CVD) and cancer, and mortality from all, CVD, cancer, and external causes were examined. We explored the role of education in these associations. Mendelian randomisation using genetic evidence was used to triangulate these findings.
findingsAn increase in BHS of 0.1 was associated with all-cause (HR = 1.14 [1.12-1.16] and 1.09 [1.07-1.12] in men and women respectively), cancer (HR = 1.11 [1.09-1.14] and 1.07 [1.04-1.10]) and CVD (HR = 1.25 [1.20-1.31] and 1.21 [1.11-1.31]) mortality, CVD incidence (HR = 1.15 [1.13-1.16] and 1.17 [1.15-1.19]). These associations survived adjustment for education, lifestyle-behaviours, body mass index (BMI), co-morbidities and medical treatments. Mendelian randomisation further supported the link between the BHS and CVD incidence (HR = 1.31 [1.21-1.42]). The BHS contributed to CVD incidence prediction (age-adjusted C-statistic = 0.58), other than through education and health behaviours.
interpretationThe BHS captures features of the embodiment of education, health behaviours, and more proximal unknown factors which all complementarily contribute to all-cause, cancer and CVD morbidity and premature death.
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