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Erema, V.V.;  Yakovchik, A.Y.;  Kashtanova, D.A.;  Bochkaeva, Z.V.;  Ivanov, M.V.;  Sosin, D.V.;  Matkava, L.R.;  Yudin, V.S.;  Makarov, V.V.;  Keskinov, A.A.; et al. Biological Age Predictors. Encyclopedia. Available online: https://encyclopedia.pub/entry/38575 (accessed on 02 May 2024).
Erema VV,  Yakovchik AY,  Kashtanova DA,  Bochkaeva ZV,  Ivanov MV,  Sosin DV, et al. Biological Age Predictors. Encyclopedia. Available at: https://encyclopedia.pub/entry/38575. Accessed May 02, 2024.
Erema, Veronika V., Anna Y. Yakovchik, Daria A. Kashtanova, Zanda V. Bochkaeva, Mikhail V. Ivanov, Dmitry V. Sosin, Lorena R. Matkava, Vladimir S. Yudin, Valentin V. Makarov, Anton A. Keskinov, et al. "Biological Age Predictors" Encyclopedia, https://encyclopedia.pub/entry/38575 (accessed May 02, 2024).
Erema, V.V.,  Yakovchik, A.Y.,  Kashtanova, D.A.,  Bochkaeva, Z.V.,  Ivanov, M.V.,  Sosin, D.V.,  Matkava, L.R.,  Yudin, V.S.,  Makarov, V.V.,  Keskinov, A.A.,  Kraevoy, S.A., & Yudin, S.M. (2022, December 12). Biological Age Predictors. In Encyclopedia. https://encyclopedia.pub/entry/38575
Erema, Veronika V., et al. "Biological Age Predictors." Encyclopedia. Web. 12 December, 2022.
Biological Age Predictors
Edit

Age is a major risk factor for chronic noncommunicable diseases. It is a recognized contributor to severe COVID-19 and associated complications. However, many studies have suggested that it is biological rather than chronological age that underlies the development of numerous diseases. People age at a different pace, which is determined not only by genetic predisposition but also by external factors, such as socioeconomic factors and lifestyle. The likelihood of aging-associated diseases and mortality varies even among people of the same age. Certain combinations of biomarkers are more reliable predictors of biological age or mortality

biological age molecular clock age-related diseases

1. Introduction

Age is a major risk factor for chronic noncommunicable diseases, such as heart disease [1], cancer [2], chronic obstructive pulmonary disease [3], Alzheimer’s disease [4], etc. It is a recognized contributor to severe COVID-19 and associated complications [5]. However, many studies have suggested that it is biological rather than chronological age that underlies the development of numerous diseases. People age at a different pace, which is determined not only by genetic predisposition but also by external factors, such as socioeconomic factors and lifestyle. The likelihood of aging-associated diseases and mortality varies even among people of the same age; hence, it could be reflective of their biological age.
The last 15 years saw the emergence of various biological age markers. Ideally, they should correlate with chronological age and be predictive of age-related diseases and mortality. Clinicians use several tests as markers of biological age: maximal oxygen consumption, forced expiratory volume in 1 s, vertical jump, grip strength, whole-body reaction time, unilateral distance, sit-and-reach test, systolic blood pressure, waist circumference, and soft lean mass [6]. Certain inflammatory markers have also been associated with age: IL-6, IL-8, IL-15, IL-1β, TNFα [7][8][9], lipid profile (HDL cholesterol, LDL cholesterol, triglycerides [7][8][10][11]), glucose metabolism profile (glycohemoglobin (Hba1c) and glucose (fasted or oral glucose tolerance test (OGTT) [12]), insulin and C-peptide [13]. Kidney function indicators, such as creatinine, cystatin C, urea, and albumin, have also been associated with age [14]. Microbiome analysis is another way of assessing biological age, since the microbiome has been significantly associated with age [15].
Aging leads to increased genome instability, which can be evaluated using micronucleus assay [16]. Age has also been associated with telomere length [17] and an increase in reactive oxygen species [18]. However, the most common marker of biological age is DNA methylation. It is widely used in forensic medicine as the most reliable age estimator. Other age-associated epigenetic markers could be changes in miRNA concentrations [19], histone modifications [20], and chromatin remodeling [18].
Individually, these markers are not informative due to their non-specificity. Moreover, changes in their levels can be a manifestation of age-associated conditions, rather than an indication of age. These markers are effective estimators in large study cohorts; however, they may vary significantly at the individual level in clinical practice [21]. To overcome these limitations, artificial intelligence has been used to create models that consider a variety of factors. These models are widely used in clinical practice. They can predict mortality from all causes and the incidence of major aging-associated diseases, including hypertension, diabetes, cardio-vascular diseases, stroke, cancer, and dementia [22][23].

2. Biological Age Predictors

2.1. Clinical Parameters and Blood Biochemistry as Markers of Aging

Blood Biochemistry-Based Calculators

Individually, most clinical biomarkers are insufficiently sensitive to measure the pace of aging and biological age. Studies, however, have shown that certain combinations of biomarkers are more reliable predictors of biological age or mortality.
Putin E. et al. developed the first blood marker-based model of aging using a group of 21 deep neural networks (DNNs) that were trained on more than 60,000 samples from common blood biochemistry and cell count tests [10]. For each patient, they used only 41 biomarkers; nonetheless, the DNN group achieved a rather small interval of mean absolute error (MAE) = 5.55 years (r = 0.91, R2 = 0.82). The top 10 biomarkers included albumin, erythrocytes, glucose, alkaline phosphatase, hematocrit, urea, RDW, cholesterol, alpha-2-globulin, and lymphocytes. Mamoshina P. et al. [24] presented a new aging clock trained on the data from several populations. The most effective predictor achieved an MAE of 5.94 years despite being trained on fewer features (21 vs. 41). It is likely that ethnically diverse aging clocks are more accurate than conventional ones in predicting chronological age and measuring biological age. The most important blood biochemistry parameters for all three populations were albumin, glucose, urea, and hemoglobin.
The models laid the foundation for the following calculators: Aging.AI 1.0 (r = 0.91, Rsq = 0.82, MAE = 5.5 years), Aging.AI 2.0 (r = 0.79, Rsq = 0.63, MAE = 6.2 years), and Aging.AI 3.0 (r = 0.8, Rsq = 0.65, MAE = 5.9 years) [25]. The predictors use various combinations of input parameters: albumin, glucose, alkaline phosphatase, urea, erythrocytes, cholesterol, RDW, alpha-2-globulins, hematocrit, alpha-amylase, lymphocytes, ESR, total and direct bilirubin, gamma GT, creatinine, LDH, total protein, alpha-1 globulins, beta globulins, gamma globulins, triglycerides, chlorides, HDL-C, LDL-C, calcium, potassium, sodium, iron, hemoglobin, MCH, MCHC, MCV, platelets, leukocytes, ALT, AST, basophils, eosinophils, monocytes, and neutrophils. The parameters are measured in whole blood, plasma or blood serum.
Several authors have used the above predictors in their studies. Cohen [26] used 10 biomarkers from Aging.AI (albumin, glucose, alkaline phosphatase, urea, erythrocytes, cholesterol, RDW, alpha-2 globulins, hematocrit, and lymphocytes) to predict chronological age in cohorts from the Women’s Health and Aging Study I &II (WHAS), the Baltimore Longitudinal Study on Aging (BLSA), Invecchiare in Chianti (InCHIANTI) and publicly available cross-sectional data from a representative sample of the American population from the National Health and Nutrition Examination Survey (NHANES). The performance in all four data sets was not as robust, with MAE ranging from 12.7 (NHANES) to 17.4 (BLSA). The authors excluded the possibility that the results were due to the use of 10 biomarkers rather than 41 and suggested that it could be caused by the absence of children in the cohorts and the differences in ethnic, socioeconomic, and environmental backgrounds. Overall, the results were consistent with those reported by Putin E. et al. [10] and showed the model’s tendency to underestimate the age of individuals over 70 years of age, i.e., it lacked discriminatory power in older age ranges.
Psychological status-based calculation of biological age using medical history and self-estimation of physiological and emotional states.
Currently, there are extremely few papers on psychological markers of aging. However, they deserve further investigation, particularly due to the non-invasive nature of the associated procedures. Repeatedly, biological aging has been shown to lead to cognitive decline. Diagnosed cognitive dysfunction is a predictor of unsuccessful aging and mortality; however, it has a low predictive power in younger people. Zhavoronkov et al. used deep neural networks (DNNs) to classify human behavior for biological age prediction [27]. They presented two new models, PsychoAge and SubjAge, which were similar to the aging clock. To predict chronological and subjective age, they trained the DNNs on a set of 50 modifiable behavioral features based on anonymous surveys of U.S. residents from the Midlife in the United States (MIDUS). After filtering and exclusion, the final dataset comprised 6071 samples. DNNs were able to accurately predict age, with MAE = 6.7 years for chronological age and MAE = 7.3 years for subjective age. Both PsychoAge and SubjAge have also been shown to be predictive of the risk of all-cause mortality. For both models, the top five important variables were related to sex life in the past 10 years, marital status, health limitations on vigorous activity, and intake of prescription blood pressure drugs. Headache frequency in the past 30 days ranked 5th in PsychoAge and 9th in SubjAge. Neuroticism, one of the five most commonly used personality traits, was the only one present among the top 25 features in PsychoAge. Openness and extraversion, another “big fiver”, were the only personality traits in SubjAge.

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