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Association between telomere length, frailty and death in older adults

Abstract

Frailty is considered a clinical marker of functional ageing. Telomere length (TL) has been proposed as a biomarker of biological age but its role in human ageing is controversial. The main aim of the study was to evaluate the longitudinal association of TL with incident frailty and mortality in two cohorts of Spanish community–dwelling older adults. TL was determined at baseline in blood samples from older adults included in Toledo Study for Healthy Aging and ENRICA cohorts while frailty was determined by frailty phenotype (FP) at baseline and at follow-up (3.5 years). Deaths occurring during follow-up were also recorded. Associations of TL with frailty and mortality were analysed by logistic regression with progressive adjustment. Data were separately analysed in the two cohorts and in all subjects by performing a meta-analysis. TL was not different between frail and non-frail subjects. Longer telomeres were not associated with lower risk of prevalent frailty. Similarly, TL at baseline failed to predict incident frailty (OR: 1.04 [0.88–1.23]) or even the development of a new FP criterion (OR: 0.97 [0.90–1.05]) at follow-up. Lack of association was also observed when analysing the development of specific FP criteria. Finally, while frailty at baseline was significantly associated with higher risk of death at follow-up (OR: 4.08 [1.97–8.43], p < 0.001), TL did not significantly change the mortality risk (OR: 1.05 [0.94–1.16]). Results show that TL does not predict incident frailty or mortality in older adults. This suggests that TL is not a reliable biomarker of functional age.

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Acknowledgments

We appreciate the altruistic contribution of the participants from the Toledo Study for Healthy Aging cohort and ENRICA cohort.

Funding

This work has received funding from the European Union’s Seventh Framework Programme (FP7/2007-2013) under grant agreement number 305483 and was supported by grants from the Ministry of Economy and Competitiveness and co-financed by FEDER funds (Instituto de Salud Carlos III, PI15/00674, PI15/01160) and CIBERFES (CB16/10/00464), Spanish Government.

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Authors and Affiliations

Authors

Contributions

MEA, JA, JAC, SW, FRA and LRM participated in conceptualization and design of the study; MEA, JA, JAC, SW, JGM, IGP, FLGG, FRA and LRM performed data acquisition analysis and interpretation; MEA, JA, JAC, SW, FRA and LRM wrote the original draft of the manuscript; all authors reviewed, edited and approved the final version of the manuscript.

Corresponding author

Correspondence to Leocadio Rodríguez-Mañas.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The study protocols were approved by the Clinical Research Ethics Committee of the Complejo Hospitalario de Toledo (Toledo Study for Healthy Aging cohort), and by the Clinical Research Ethics Committee of the ‘La Paz’ University Hospital in Madrid (ENRICA cohort).

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All participants gave written informed consent to participate.

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El Assar, M., Angulo, J., Carnicero, J.A. et al. Association between telomere length, frailty and death in older adults. GeroScience 43, 1015–1027 (2021). https://doi.org/10.1007/s11357-020-00291-0

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  • DOI: https://doi.org/10.1007/s11357-020-00291-0

Keywords

  • Ageing
  • Telomere
  • Functional decline
  • Frailty
  • Mortality
  • Biomarker