Evidence map›Paper›PMID 41350881›Full record

ArticleAlzheimer's research & therapy2025

The incremental predictive value of biological aging indicators for cognitive impairment in older adults: a longitudinal analysis on the Mr. OS & Ms. OS cohort.

Yafei Wu, Ting Zhang, Tung Wai Auyeung, Jenny Lee, Jason Leung, Timothy Kwok

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Article in Alzheimer's research & therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Yafei WuDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
Ting ZhangDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
Tung Wai AuyeungJockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
Jenny LeeJockey Club Institute of Ageing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
Jason LeungJockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
Timothy KwokDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China. tkwok@cuhk.edu.hk.

Funding

Osteoporotic fractures in Chinese men: MrOs Hong KongR01AR049439 · NIAMS · CHINESE UNIVERSITY OF HONG KONG · PI LEUNG, PING CHUNG · 2003 to 2007
$2.0M
National Institutes of Health R01 grant AR049439-01A1National Natural Science Foundation of China 82300622NIAMS NIH HHS R01 AR049439Research Grants Council Earmarked Grant CUHK4101/02 MShanghai Sailing Program 23YF1423100
6 · The paper itself

Abstract

backgroundBiological aging (BA) markers such as frailty and telomere length are closely linked to cognitive impairment (CI). However, the incremental value of biochemical marker-enriched frailty index (FI) and telomere length for predicting CI remains underexplored. We aimed to assess the incremental value of BA markers beyond conventional cognitive tests for CI risk stratification.

methodsA total of 1674 community-dwelling older adults without baseline CI were obtained from the Mr. OS & Ms. OS (Hong Kong) cohort. Baseline BA measures included frailty phenotype, three FI versions (without/with 2 or 4 serum biochemical markers: creatinine, homocysteine, high-sensitivity C-reactive protein, and 25-hydroxyvitamin D), and leukocyte telomere length. CI was assessed by concurrently using the MMSE and CSI-D tests at the 7-year follow-up. Penalized logistic regression was used to evaluate the incremental value of BA indicators beyond cognitive tests for CI prediction, with the area under the precision-recall curve (AUPRC) as the primary performance metric.

resultsThe mean age of the study sample was 70.7 years (SD: 4.2), and 44.1% were females. The 7-year incidence of CI was 17.0% (285/1674). Compared to baseline CSI-D score, the FI incorporating four biochemical markers demonstrated significant incremental value for CI prediction (AUPRC improvement: 0.037, P < 0.001), while other frailty indicators (frailty phenotype and other two FI versions) showed no significant added value. Telomere length provided additional predictive value across all frailty-related models (AUPRC improvements: 0.009–0.078, all P < 0.001) except the FI without biochemical markers. The optimal prediction model, which considered the FI with four biochemical markers and telomere length, achieved an AUPRC (SD) of 0.568 ± 0.092 and an AUROC (SD) of 0.826 ± 0.037.

conclusionsFrailty index with four biochemical markers and telomere length showed moderate incremental value over cognitive tests for CI prediction in older adults. The findings highlight the importance of multisystem biological aging assessment in CI risk stratification. Further validation is warranted in large cohorts.

Indexed as

AgingCognitive DysfunctionAgedBiomarkersCohort StudiesC-Reactive ProteinCreatinineFemaleFrailtyHomocysteineHong KongHumansLongitudinal StudiesMaleNeuropsychological TestsPredictive Value of Tests25-hydroxyvitamin DBiomarkersC-Reactive ProteinCreatinineHomocysteineVitamin DBiochemical markerBiological agingCognitive impairmentFrailty indexTelomere length

Identifiers

PMID41350881
PMCPMC12797906

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.