Biological age linked with risk for all-cause, CV death, especially in cancer survivors
High biological age was significantly associated with both all-cause and CVD mortality, especially among cancer survivors, according to new data published in JAMA Network Open.
“Cancer is an age-related disease. In the United States, the median age at cancer diagnosis is 66 years,” Dongyu Zhang, MD, PhD, research assistant professor in the department of epidemiology at the University of Florida College of Public Health and Health Professions in Gainesville, Florida, and colleagues wrote. “In older people diagnosed with cancer, aging and cancer treatment toxic effects are associated with unfavorable prognoses, such as death and adverse cardiovascular outcomes, which are the cause of death for more than 10% of individuals who had cancer.”
On the hypothesis that cancer survivors with high biological age would experience increased risk for all-cause and CVD-specific mortality, researchers used data from the National Health and Nutrition Examination Survey to identify adults with a history of cancer who survived for 1 year or more after diagnosis and compared mortality with an age-matched cohort of individuals without prior cancer.
Zhang and colleagues derived biological age (BA) by estimating Levine phenotypic age and linear regression.
“Prior research showed that Levine phenotypic age was associated with mortality even after adjusting for chronological age, and BA value represented acceleration of Levine phenotypic age,” the researchers wrote.
Among 2,002 cancer survivors (54% women; 76% white) and 2,002 matched controls (51% women; 56% white), the mean age was 64.7 years.
Median follow-up was more than 8 years in both groups.
Researchers reported that the percent increase in all-cause and CVD mortality in the highest quartile of biological age compared with the lowest was greater among patients with a history of cancer compared with the matched cohort (all-cause mortality, 189% vs. 119%; CVD mortality, 157% vs. 109%).
Among cancer survivors, high biological age was associated with increased risk for all-cause (adjusted HR = 2.65; 95% CI, 2.09-3.35; P < .001) and CVD mortality (aHR = 2.3; 95% CI, 1.37-3.85; P = .01).
Although overall risk was lower, researchers observed a similar association between biological age and all-cause and CVD mortality among matched controls. The association pattern was similar for the matched cohort, although HRs were lower (aHR for all-cause mortality = 2.37; 95% CI, 1.86-3.03; P < .001; aHR for CVD mortality = 2.11; 95% CI, 1.27-3.49; P = .007).
“Individuals with a prior cancer diagnosis had increased BA, which was associated with increased all-cause and CVD-specific mortality,” the researchers wrote. “Biomarkers incorporated in BA were measures that could be obtained in routine clinical practice, suggesting that clinicians and health researchers may be able to leverage these real-world resources (eg, blood testing results in electronic health records) to monitor BA for cancer survivors, estimate risk of adverse events, and inform cancer survivors of prognosis more precisely. Future prospective studies should explore the association of interventions ameliorating BA in cancer survivors with decreased adverse outcomes in survivorship.”
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