Discordance Between Biological and Chronological Age as a Predictor of In-Hospital Functional Decline
DOI:
https://doi.org/10.53350/pjmhs02026207.6Keywords:
biological age; chronological age; PhenoAge; functional decline; older adults; hospitalizationAbstract
Background: Biological age may reflect physiological reserve more accurately than chronological age. This study evaluated whether discordance between biological and chronological age predicted in-hospital functional decline among older medical inpatients.
Methods: This prospective observational cohort study included 120 patients aged 60 years or older admitted to a medical ward of General Hospital Lahore between February 2024 and February 2025. Biological age was estimated using the PhenoAge model based on chronological age and nine routine biomarkers. Age discordance was calculated by subtracting chronological age from biological age. Functional status was assessed using the Barthel Index before admission and at discharge. Functional decline was defined as a reduction of at least 10 points. Multivariable logistic regression identified independent predictors.
Results: The mean chronological age was 69.1 ± 6.8 years, while the mean biological age was 74.0 ± 9.4 years. Functional decline occurred in 39 patients (32.5%). Patients with decline had greater age discordance than those without decline (9.4 ± 7.0 versus 2.7 ± 5.4 years; p<0.001). Functional decline occurred in 11.8% of patients without acceleration, 26.3% with moderate acceleration, and 52.1% with marked acceleration. Each five-year increase in age discordance independently increased the odds of functional decline by 56% (adjusted odds ratio 1.56; 95% confidence interval 1.22–2.00; p<0.001).
Conclusion: Positive biological-age discordance independently predicted in-hospital functional decline. Biological-age estimation may improve early identification of vulnerable older patients and support geriatric, nutritional, mobility, and discharge interventions.
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Copyright (c) 2026 Farah Shafi, Iqra Kanwal, Zohaib Akram, Amina Tassadaq, Arooj Tassadaq, Muhammad Kashif
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