ASPO Abstracts
Accelerated biological aging is associated with a higher risk of all-cause, cancer-specific, and cardiovascular disease-specific death in older cancer survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2022
Abstract Body:
Purpose: To assess if risk of all-cause, cancer-specific, and cardiovascular disease (CVD)-specific death varies by levels of accelerated biological aging (ABA) in older cancer survivors.Methods: We identified 1,391 adults aged 60 years or older who survived for at least 1 year since cancer diagnosis from the cohort of 1999-2010 National Health and Nutrition Examination Survey. We conducted two steps to obtain the measure of ABA. First, based on validated algorithm in prior research, we estimated phenotypic age using 9 blood biomarkers (albumin, creatinine, glucose, c-reactive protein, lymphocyte percent, mean cell volume, red blood cell distribution width, alkaline phosphatase, and white blood cell count) and chronological age. Then, we estimated the residual from a linear model regressing phenotypic age on chronological age; the residual values reflected ABA, with a larger value indicating a higher level of ABA. Death was identified by linkage to the National Death Index through December 31, 2015, and ICD-10 was used to ascertain cause of death. Multivariable Cox proportional hazards models estimated adjusted hazard ratio (aHR) and 95% confidence intervals (CI) of mortality by categories of ABA. In analysis, ABA was categorized as quartiles based on residual values (<-5.3 (reference), -5.3 to <-1.3, -1.3 to <4.1, and ‚â•4.1). Restricted cubic splines were applied to depict dose-response curve for ABA.Results: The mean age of participants at baseline as 72.9 years (SD=7.2), 46.4% of them were female, 78.2% were white, and 11.7% were black. Overall, 588 participants died during the follow-up (median: 7.8 years); specifically, 167 and 118 participants died of cancer and CVD, respectively. Multivariable Cox proportional hazards models suggested that ABA (‚â•4.1 vs. <-5.3) was positively associated with all-cause (aHR=2.78, 95% CI 2.16-3.58), cancer-specific (aHR=3.09, 95% CI 1.91-4.99), and CVD-specific mortality (aHR=2.64, 95% CI 1.52-4.59). The dose-response curves suggested similar risk patterns for ABA compared to primary models.Conclusion: Our study suggests that older cancer survivors with higher ABA have a higher risk of death than their counterparts with lower levels of ABA.
Keywords: cancer survivorship, aging, epidemiology