Diagnostic accuracy
Do blood ageing markers predict death better as a bundle than one-by-one?
Open access · cc by · source: Europe PMC
In 777 Newcastle 85+ participants, a 40-biomarker frailty index predicted 7-year mortality (HR 1.05 per 1% FI-B; AUC 0.66) better than any single marker (AUC ≤0.61); combining with the clinical FI raised AUC to 0.75.
Study at a glance
- Design
- Cohort — Newcastle 85+ cohort: baseline biomarker/clinical frailty indices vs up to 7-year mortality.
- N
- N=845 · 845 enrolled (mean age 85.5); FI-B calculable in 777 (60.9% women).
- Population
- Very old adults in the Newcastle 85+ Study (UK), mean age 85.5 years.
- Outcome
- All-cause mortality predicted by a 40-item biomarker frailty index (FI-B) vs clinical FI-CD, Fried phenotype, and single biomarkers.
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Key findings
Mean FI-B 0.35 vs FI-CD 0.22; nobody had FI-B <0.12. Each 1% FI-B rise raised HR by 5.4%. FI-B beat every individual biomarker and was robust to dropping items. Combined FI-CD/FI-B AUC was 0.75 vs 0.71 and 0.66 alone.
Methodology
Built FI-B from 40 cellular-ageing, inflammation, haematology, and immunosenescence markers, compared it with a clinical deficit FI and the Fried phenotype, and tested 7-year mortality with Cox models, Kaplan–Meier strata, random biomarker subsamples, and ROC AUCs.
Limitations
Moderate AUCs are not bedside tests; FI-B and FI-CD correlated only weakly (r=0.16), so blood markers do not simply duplicate clinical frailty.
How this study connects
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