Associations of epigenetic aging with self-rated health, access to care, and healthcare utilization in a representative sample of United States adults

Nwanaji-Enwerem, Jamaji C.; Khodasevich, Dennis; Gladish, Nicole; Shen, Hanyang; Bozack, Anne K.; Daredia, Saher; Needham, Belinda L.; Rehkopf, David H.; Cardenas, Andres

doi:10.1186/s13148-025-01887-z

Table 3 Adjusted Associations of Healthcare Access and Utilization with Epigenetic Aging Biomarkers^†

From: Associations of epigenetic aging with self-rated health, access to care, and healthcare utilization in a representative sample of United States adults

		Main model		Not adjusted for self-rated health model		Leukocyte-adjusted model
Utilization metric	Biomarker	Estimate (95% CI)	P-value	Estimate (95% CI)	P-value	Estimate (95% CI)	P-value	n
Has Routine Place	HannumAge (years)	− 0.26 (− 1.87, 1.35)	0.70	− 0.25 (− 1.82, 1.32)	0.72	− 0.39 (− 1.71, 0.92)	0.49	2343
Has Routine Place	HorvathAge (years)	− 0.19 (− 1.53, 1.14)	0.73	− 0.19 (− 1.48, 1.1)	0.74	− 0.27 (− 1.59, 1.04)	0.62	2343
Has Routine Place	SkinBloodAge (years)	− 0.20 (− 1.28, 0.89)	0.67	− 0.19 (− 1.23, 0.85)	0.68	− 0.26 (− 1.33, 0.82)	0.57	2343
Has Routine Place	PhenoAge (years)	− 0.33 (− 2.99, 2.34)	0.77	− 0.29 (− 2.95, 2.38)	0.80	− 0.36 (− 2.45, 1.73)	0.68	2343
Has Routine Place	GrimAge2 (years)	− 1.44 (− 2.66, − 0.22)	*0.03*	− 1.41 (− 2.61, − 0.22)	*0.03*	− 1.33 (− 2.66, 0.01)	0.05	2343
Has Routine Place	DNAmTL (kb)	0.03 (− 0.06, 0.12)	0.40	0.03 (− 0.05, 0.12)	0.40	0.03 (− 0.05, 0.1)	0.39	2343
Has Routine Place	DunedinPoAm	− 0.02 (− 0.04, 0.004)	0.09	− 0.02 (− 0.04, 0.004)	0.09	− 0.02 (− 0.04, 0.01)	0.19	2343
Routine Place Not ED	HannumAge (years)	− 0.34 (− 1.89, 1.21)	0.60	− 0.28 (− 1.72, 1.16)	0.66	0.05 (− 1.24, 1.34)	0.93	2162
Routine Place Not ED	HorvathAge (years)	− 0.06 (− 1.39, 1.26)	0.91	− 0.05 (− 1.31, 1.22)	0.93	0.3 (− 1.36, 1.97)	0.67	2162
Routine Place Not ED	SkinBloodAge (years)	− 0.42 (− 2.03, 1.2)	0.54	− 0.38 (− 1.95, 1.18)	0.58	− 0.03 (− 2.08, 2.02)	0.98	2162
Routine Place Not ED	PhenoAge (years)	− 0.13 (− 3.66, 3.41)	0.93	0.07 (− 3.30, 3.44)	0.96	0.08 (− 3.34, 3.5)	0.96	2162
Routine Place Not ED	GrimAge2 (years)	0.27 (− 1.72, 2.25)	0.75	0.42 (− 1.39, 2.23)	0.60	0.43 (− 1.35, 2.21)	0.57	2162
Routine Place Not ED	DNAmTL (kb)	0.05 (− 0.07, 0.16)	0.38	0.04 (− 0.07, 0.16)	0.39	0.01 (− 0.08, 0.11)	0.73	2162
Routine Place Not ED	DunedinPoAm	0.0002 (− 0.04, 0.04)	0.99	0.002 (− 0.03, 0.04)	0.88	0.001 (− 0.03, 0.03)	0.94	2162
≥ 10 Visits Last Yr	HannumAge (years)	0.45 (− 0.69, 1.59)	0.36	0.56 (− 0.55, 1.66)	0.27	0.06 (− 0.96, 1.09)	0.88	2342
≥ 10 Visits Last Yr	HorvathAge (years)	0.44 (− 0.68, 1.57)	0.37	0.47 (− 0.66, 1.59)	0.35	0.11 (− 0.97, 1.19)	0.81	2342
≥ 10 Visits Last Yr	SkinBloodAge (years)	0.26 (− 0.78, 1.3)	0.56	0.30 (− 0.72, 1.32)	0.50	− 0.12 (− 1.11, 0.87)	0.77	2342
≥ 10 Visits Last Yr	PhenoAge (years)	0.24 (− 1.01, 1.48)	0.66	0.55 (− 0.67, 1.78)	0.32	− 0.05 (− 1.22, 1.11)	0.92	2342
≥ 10 Visits Last Yr	GrimAge2 (years)	0.36 (− 0.4, 1.11)	0.29	0.58 (− 0.12, 1.29)	0.09	0.18 (− 0.78, 1.14)	0.66	2342
≥ 10 Visits Last Yr	DNAmTL (kb)	− 0.05 (− 0.09, − 0.01)	*0.02*	− 0.05 (− 0.09, − 0.01)	*0.02*	− 0.03 (− 0.07, 0.003)	0.06	2342
≥ 10 Visits Last Yr	DunedinPoAm	0.01 (− 0.01, 0.02)	0.38	0.01 (− 0.005, 0.02)	0.16	0.01 (− 0.01, 0.02)	0.22	2342
Hospitalized Last Yr	HannumAge (years)	0.26 (− 1.12, 1.64)	0.65	0.37 (− 1.01, 1.76)	0.54	0.64 (− 0.52, 1.81)	0.22	2342
Hospitalized Last Yr	HorvathAge (years)	0.65 (− 0.48, 1.78)	0.21	0.67 (− 0.47, 1.81)	0.20	0.96 (− 0.21, 2.13)	0.09	2342
Hospitalized Last Yr	SkinBloodAge (years)	− 0.08 (− 1.06, 0.91)	0.85	− 0.02 (− 1.00, 0.96)	0.96	0.26 (− 0.84, 1.36)	0.58	2342
Hospitalized Last Yr	PhenoAge (years)	− 0.29 (− 1.63, 1.05)	0.62	0.04 (− 1.34, 1.43)	0.94	0.2 (− 1.22, 1.61)	0.74	2342
Hospitalized Last Yr	GrimAge2 (years)	0.28 (− 0.64, 1.21)	0.48	0.51 (− 0.42, 1.44)	0.23	0.68 (− 0.20, 1.56)	0.11	2342
Hospitalized Last Yr	DNAmTL (kb)	− 0.04 (− 0.08, 0.01)	0.07	− 0.04 (− 0.08, 0.004)	0.07	− 0.05 (− 0.08, − 0.01)	*0.02*	2342
Hospitalized Last Yr	DunedinPoAm	0.01 (− 0.01, 0.03)	0.35	0.01 (− 0.01, 0.03)	0.21	0.01 (− 0.01, 0.03)	0.15	2342

^†Models adjusted for chronological age, chronological age², sex, race/ethnicity, self-rated health, alcohol intake, BMI, education, occupation, physical activity, PIR, health insurance, and smoking. Models with additional adjustments for estimated leukocyte proportions or without adjustments for self-rated health status are noted
P < 0.007: Bonferroni significant
P < 0.05: marginally significant and highlighted in bold italic

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