Abstract

BackgroundThe biological mechanisms underlying frailty in older people are poorly understood. There is some evidence to suggest that DNA methylation patterns may be altered in frail individuals.MethodsParticipants were 791 people aged 70 years from the Lothian Birth Cohort 1936. DNA methylation was measured in whole blood. Biological age was estimated using two measures of DNA methylation-based age acceleration-extrinsic and intrinsic epigenetic age acceleration. We carried out an epigenome-wide association study of physical frailty, as defined by the Fried phenotype. Multinomial logistic regression was used to calculate relative risk ratios for being physically frail or pre-frail according to epigenetic age acceleration.ResultsThere was a single significant (P = 1.16 × 10–7) association in the epigenome-wide association study comparing frail versus not frail. The same CpG was not significant when comparing pre-frail versus not frail. Greater extrinsic epigenetic age acceleration was associated with an increased risk of being physically frail, but not of being pre-frail. For a year increase in extrinsic epigenetic age acceleration, age- and sex-adjusted relative risk ratios (95% CI) for being physically frail or pre-frail were 1.06 (1.02, 1.10) and 1.02 (1.00, 1.04), respectively. After further adjustment for smoking and chronic disease, the association with physical frailty remained significant. Intrinsic epigenetic age acceleration was not associated with physical frailty status.ConclusionsPeople who are biologically older, as indexed by greater extrinsic epigenetic age acceleration, are more likely to be physically frail. Future research will need to investigate whether epigenetic age acceleration plays a causal role in the onset of physical frailty.

Highlights

  • Frailty is a clinical syndrome that becomes increasingly common at older ages [1]

  • deoxyribonucleic acid (DNA) methylation is involved in the regulation of gene expression and occurs at cytosine-phosphate-guanine (CpG)

  • Participants The Lothian Birth Cohort 1936 (LBC1936) was established to study cognitive aging in surviving members of the 1947 Scottish Mental Survey [20, 21]. 1091 community-dwelling people were recruited aged around 70 years, mostly from the Edinburgh area of Scotland

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Summary

Introduction

Frailty is a clinical syndrome that becomes increasingly common at older ages [1]. Its core features are increased vulnerability to stressors due to impairments in multiple systems, decreased physiological reserves, and a decline in the ability to maintain homeostasis [2]. It increases the risk of adverse outcomes, including falls, disability, hospitalization, institutionalization, and death [2,3,4]. Epigenetic changes affect all cells and tissues over the lifespan [6] One such change involves alterations to deoxyribonucleic acid (DNA) methylation patterns. The biological mechanisms underlying frailty in older people are poorly understood. There is some evidence to suggest that DNA methylation patterns may be altered in frail individuals

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