Abstract
Epigenetic age provides a reliable biomarker for biological aging, reflecting the cumulative impact on health over time. Frailty is common among elderly individuals and is further compounded by hypertension, which increases the risk associated with aging. Therefore, we examined the relationship between epigenetic aging and frailty in a non-Western population and explored synergistic effects of frailty and hypertension on epigenetic age. Thai women (60-80 years) were assessed for physical, blood, and biochemical parameters. Age acceleration (AA) residuals were derived to explore deviations between chronological and epigenetic age. We classified 126 participants into robust, pre-frail, and frail groups based on the Fried phenotype and Kihon Checklist. GrimAge1 and GrimAge2 outperformed other epigenetic age estimators in terms of correlation with frailty status. Furthermore, these age models were significantly correlated with physical performance tests. AA varied significantly among groups, with robust individuals having lower Grim1AA and Grim2AA levels than pre-frail individuals. Furthermore, hypertensive participants with pre-frail had significantly different levels of Grim1AA and Grim2AA compared to robust without hypertension. Our findings reveal a complex relationship among frailty, epigenetic age, physical performances, and hypertension. Grim2Age exhibits a strong correlation with chronological age and shows accelerated AA in frail individuals, particularly those with hypertension.