Chronic inflammation and multiple dimensions of aging among women in the Philippines

Age-related increases in chronic systemic inflammation are strong predictors of morbidity and mortality in high income countries, but evidence is lacking from lower- and middle-income settings where infectious diseases are more prevalent and rates of overweight and obesity are relatively low. Here we evaluate two complementary measures of chronic inflammation-plasma C-reactive protein (CRP) and a DNA methylation-based surrogate (DNAm-CRP)-measured at baseline as predictors of physical capacity, cognitive function, and cardiometabolic disease seven years later among women in the Philippines (N = 953; 43-75 years at follow-up). Levels of CRP and DNAm-CRP were not strongly associated with age. Both measures predicted subsequent declines in physical and functional capacity, increased incidence of diabetes and hypertension, and poorer cognitive performance, after adjustment for baseline status and other covariates. DNAm-CRP performed comparably to CRP, and was robust to variation in white blood cell composition and acute infectious symptoms at the time of sampling. These findings demonstrate that chronic inflammation is associated with multiple dimensions of aging in a lower-middle income setting, and highlights the utility of inflammatory biomarkers as scalable tools for global aging research.