iScienceAug 20, 2026

Faster biological aging is linked to worse outcomes in frail ICU patients

Longevity & Aging Weekly Brief ↗PubMed ↗DOI ↗

Updated Aug 21, 2026

Abstract

Among 327 frail patients in ICUs, 63.6% exhibited accelerated biological aging.

Accelerated biological aging was measured using the Levine PhenoAge model.
Biological age was better at predicting 30-day mortality than chronological age (AUROC 0.66 vs. 0.54).
Patients with accelerated aging had longer ICU stays compared to those without.
The 30-day mortality rate was higher in patients with accelerated aging (30% vs. 11%).
Accelerated biological aging was associated with a greater risk of death or ICU readmission.

Simplified

Chronological age often fails to reflect biological vulnerability in critical illness. In this prospective multinational prevalence study, we assessed whether accelerated biological aging, measured by the Levine PhenoAge model, improves prognostication among frail adults (clinical frailty scale ≥4) admitted to eight ICUs across six countries. Accelerated aging (PhenoAgeAccel) was defined as PhenoAge exceeding chronological age after regression adjustment. Among 784 ICU bed-days, 327 bed-days (41.7%) were occupied by frail patients, of whom 208 (63.6%) showed PhenoAgeAccel. Biological age outperformed chronological age for predicting 30-day mortality (AUROC 0.66 vs. 0.54). PhenoAgeAccel was associated with longer ICU stay, higher 30-day mortality (30% vs. 11%; relative risk [RR] 2.70), and greater risk of death or ICU readmission (RR 2.48), remaining significant after adjustment for frailty. Accelerated biological aging is common in frail ICU patients and may improve short-term risk stratification beyond chronological age alone.

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Faster biological aging is linked to worse outcomes in frail ICU patients

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