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Quantification of biological age as a determinant of age-related diseases in the Rotterdam Study: a structural equation modeling approach

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Abstract

Chronological age alone is not a sufficient measure of the true physiological state of the body. The aims of the present study were to: (1) quantify biological age based on a physiological biomarker composite model; (2) and evaluate its association with death and age-related disease onset in the setting of an elderly population. Using structural equation modeling we computed biological age for 1699 individuals recruited from the first and second waves of the Rotterdam study. The algorithm included nine physiological parameters (c-reactive protein, creatinine, albumin, total cholesterol, cytomegalovirus optical density, urea nitrogen, alkaline phosphatase, forced expiratory volume and systolic blood pressure). We assessed the association between biological age, all-cause mortality, all-cause morbidity and specific age-related diseases over a median follow-up of 11 years. Biological age, compared to chronological age or the traditional biomarkers of age-related diseases, showed a stronger association with all-cause mortality (HR 1.15 vs. 1.13 and 1.10), all-cause morbidity (HR 1.06 vs. 1.05 and 1.03), stroke (HR 1.17 vs. 1.08 and 1.04), cancer (HR 1.07 vs. 1.04 and 1.02) and diabetes mellitus (HR 1.12 vs. 1.01 and 0.98). Individuals who were biologically younger exhibited a healthier life-style as reflected in their lower BMI (P < 0.001) and lower incidence of stroke (P < 0.001), cancer (P < 0.01) and diabetes mellitus (P = 0.02). Collectively, our findings suggest that biological age based on the biomarker composite model of nine physiological parameters is a useful construct to assess individuals 65 years and older at increased risk for specific age-related diseases.

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Acknowledgements

The dedication and commitment by which study participants, general practitioners, and pharmacists of the Ommoord district contribute to the Rotterdam Study are gratefully acknowledged. We thank all staff at the Rotterdam Study research center, facilitating assessment of participants throughout the years, and Frank J.A. van Rooij as data manager.

Funding

The Rotterdam Study is sponsored by the Erasmus Medical Centre and Erasmus University Rotterdam, The Netherlands Organization for Scientific Research (NWO), The Netherlands Organization for Health Research and Development (ZonMW), the Research Institute for Diseases in the Elderly (RIDE), The Netherlands Genomics Initiative, the Ministry of Education, Culture and Science, the Ministry of Health, Welfare and Sports, the European Commission (DG XII), and the Municipality of Rotterdam. Further support was obtained from the Netherlands Consortium for Healthy Ageing. This study is supported by Janssen Prevention Centre.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Reem Waziry, Henning Tiemeier, Albert Hofman & Jaap Goudsmit

  2. Department of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands

    Reem Waziry, Sanaz Sedaghat, Henning Tiemeier, Mohsen Ghanbari, Albert Hofman & M. Arfan Ikram

  3. Janssen Prevention Center, Janssen Pharmaceutical Companies of Johnson & Johnson, Leiden, The Netherlands

    Luuk Gras, Gerrit J. Weverling, Jaco Klap & Frank de Wolf

  4. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Sanaz Sedaghat

  5. Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Henning Tiemeier

  6. Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands

    M. Arfan Ikram

  7. Amsterdam Neuroscience, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands

    Jaap Goudsmit

  8. Department of Infectious Disease Epidemiology, School of Public Health, Imperial College, London, UK

    Frank de Wolf

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  1. Reem Waziry
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Correspondence to Reem Waziry.

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Waziry, R., Gras, L., Sedaghat, S. et al. Quantification of biological age as a determinant of age-related diseases in the Rotterdam Study: a structural equation modeling approach. Eur J Epidemiol 34, 793–799 (2019). https://doi.org/10.1007/s10654-019-00497-3

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  • DOI: https://doi.org/10.1007/s10654-019-00497-3

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