{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:40:30Z","timestamp":1785328830765,"version":"3.55.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01ES031259"],"award-info":[{"award-number":["R01ES031259"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01MD011721"],"award-info":[{"award-number":["R01MD011721"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01MD011721"],"award-info":[{"award-number":["R01MD011721"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["GeroScience"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Sensory impairments are common with aging, but studies examining the relationships of these impairments with DNA methylation\u2013based biomarkers of aging, strong predictors of morbidity and mortality, remain sparse. We investigated whether subjective measures of sensory impairment are associated with epigenetic age biomarkers. We conducted a cross-sectional analysis in a representative sample of 2344 U.S. adults from the 1999\u20132000 and 2001\u20132002 cycles of the National Health and Nutrition Examination Survey (NHANES). We examined the relationships of self-rated auditory and vision function with seven epigenetic aging biomarkers: HannumAge, HorvathAge, SkinBloodAge, PhenoAge, GrimAge2, DNA methylation telomere length, and DunedinPoAm. We adjusted for potential confounders including chronological age, other demographics, lifestyle factors, and general health. In adjusted survey-weighted models, self-reported deafness was associated with a significantly higher GrimAge2 (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20094.19-years, 95% CI 2.29, 6.09,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.004) and DunedinPoAm (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.07, 95% CI 0.04, 0.09,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.002) compared to good hearing. Deafness was also associated with significantly higher GrimAge2 estimates of TIMP1 (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u2009459.51, 95% CI 287.00, 632.03\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.002) and marginally higher estimated levels of ADM (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u200910.06, 95% CI 1.76, 18.36,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.03), CRP (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.34, 95% CI 0.11, 0.56,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.01), and cigarette pack-years (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20096.55, 95% CI 2.62, 10.47,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.01). No associations were observed with self-rated vision. We describe associations of self-rated deafness with accelerated epigenetic aging, as measured by GrimAge2 and DunedinPoAm. These results provide a foundation for future research exploring epigenetic biomarkers as tools for predicting and understanding the biological processes underlying sensory impairments like deafness.\n                  <\/jats:p>","DOI":"10.1007\/s11357-025-01706-6","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T11:24:05Z","timestamp":1747999445000},"page":"1037-1050","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sensory impairments and epigenetic aging: insights from self-rated hearing and vision in United States adults"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0356-4867","authenticated-orcid":false,"given":"Jamaji C.","family":"Nwanaji-Enwerem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Khodasevich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Gladish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanyang","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne K.","family":"Bozack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saher","family":"Daredia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda L.","family":"Needham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Rehkopf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Cardenas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"issue":"2","key":"1706_CR1","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1111\/jgs.13955","volume":"64","author":"C Correia","year":"2016","unstructured":"Correia C, Lopez KJ, Wroblewski KE, et al. Global sensory impairment in older adults in the United States. J Am Geriatr Soc. 2016;64(2):306\u201313.","journal-title":"J Am Geriatr Soc"},{"issue":"2","key":"1706_CR2","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1001\/jama.2022.20954","volume":"329","author":"AR Huang","year":"2023","unstructured":"Huang AR, Jiang K, Lin FR, Deal JA, Reed NS. Hearing loss and dementia prevalence in older adults in the US. JAMA. 2023;329(2):171\u20133.","journal-title":"JAMA"},{"issue":"7","key":"1706_CR3","doi-asserted-by":"publisher","first-page":"e2326320","DOI":"10.1001\/jamanetworkopen.2023.26320","volume":"6","author":"NS Reed","year":"2023","unstructured":"Reed NS, Garcia-Morales EE, Myers C, et al. Prevalence of hearing loss and hearing aid use among US Medicare beneficiaries aged 71 years and older. JAMA Netw Open. 2023;6(7):e2326320.","journal-title":"JAMA Netw Open"},{"issue":"3","key":"1706_CR4","doi-asserted-by":"publisher","first-page":"e211558","DOI":"10.1001\/jamanetworkopen.2021.1558","volume":"4","author":"P-L Kuo","year":"2021","unstructured":"Kuo P-L, Huang AR, Ehrlich JR, et al. Prevalence of concurrent functional vision and hearing impairment and association with dementia in community-dwelling Medicare beneficiaries. JAMA Netw Open. 2021;4(3):e211558.","journal-title":"JAMA Netw Open"},{"issue":"6","key":"1706_CR5","doi-asserted-by":"publisher","first-page":"gnad169","DOI":"10.1093\/geront\/gnad169","volume":"64","author":"ET Remillard","year":"2024","unstructured":"Remillard ET, Koon LM, Mitzner TL, Rogers WA. Everyday challenges for individuals aging with vision impairment: technology implications. The Gerontologist. 2024;64(6):gnad169.","journal-title":"The Gerontologist"},{"issue":"5","key":"1706_CR6","doi-asserted-by":"publisher","first-page":"e2214610","DOI":"10.1001\/jamanetworkopen.2022.14610","volume":"5","author":"V Varadaraj","year":"2022","unstructured":"Varadaraj V, Ehrlich JR, Swenor BK. Vision impairment has implications for aging and health outcomes, beyond ophthalmology. JAMA Netw Open. 2022;5(5):e2214610.","journal-title":"JAMA Netw Open"},{"issue":"2","key":"1706_CR7","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1001\/jamaophthalmol.2022.5840","volume":"141","author":"OJ Killeen","year":"2023","unstructured":"Killeen OJ, De Lott LB, Zhou Y, et al. Population prevalence of vision impairment in US adults 71 years and older: the National Health and Aging Trends Study. JAMA Ophthalmology. 2023;141(2):197\u2013204.","journal-title":"JAMA Ophthalmology"},{"key":"1706_CR8","doi-asserted-by":"crossref","unstructured":"Medeiros FA, Varma A, Jammal AA, Tseng H, Scott WK. Accelerated epigenetic aging is associated with faster glaucoma progression: a DNA methylation study. Ophthalmology 2024.","DOI":"10.1101\/2024.10.12.24315371"},{"key":"1706_CR9","doi-asserted-by":"publisher","first-page":"e54870","DOI":"10.7554\/eLife.54870","volume":"9","author":"DW Belsky","year":"2020","unstructured":"Belsky DW, Caspi A, Arseneault L, et al. Quantification of the pace of biological aging in humans through a blood test, the DunedinPoAm DNA methylation algorithm. Elife. 2020;9:e54870.","journal-title":"Elife"},{"issue":"2","key":"1706_CR10","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.molcel.2012.10.016","volume":"49","author":"G Hannum","year":"2013","unstructured":"Hannum G, Guinney J, Zhao L, et al. Genome-wide methylation profiles reveal quantitative views of human aging rates. Mol Cell. 2013;49(2):359\u201367.","journal-title":"Mol Cell"},{"issue":"10","key":"1706_CR11","doi-asserted-by":"publisher","first-page":"R115","DOI":"10.1186\/gb-2013-14-10-r115","volume":"14","author":"S Horvath","year":"2013","unstructured":"Horvath S. DNA methylation age of human tissues and cell types. Genome Biol. 2013;14(10):R115.","journal-title":"Genome Biol"},{"issue":"23","key":"1706_CR12","first-page":"9484","volume":"14","author":"AT Lu","year":"2022","unstructured":"Lu AT, Binder AM, Zhang J, et al. DNA methylation GrimAge version 2. Aging (Albany NY). 2022;14(23):9484\u2013549.","journal-title":"Aging (Albany NY)"},{"issue":"16","key":"1706_CR13","doi-asserted-by":"publisher","first-page":"5895","DOI":"10.18632\/aging.102173","volume":"11","author":"AT Lu","year":"2019","unstructured":"Lu AT, Seeboth A, Tsai P-C, et al. DNA methylation-based estimator of telomere length. Aging (Albany NY). 2019;11(16):5895\u2013923.","journal-title":"Aging (Albany NY)"},{"issue":"4","key":"1706_CR14","doi-asserted-by":"publisher","first-page":"573","DOI":"10.18632\/aging.101414","volume":"10","author":"ME Levine","year":"2018","unstructured":"Levine ME, Lu AT, Quach A, et al. An epigenetic biomarker of aging for lifespan and healthspan. Aging (Albany NY). 2018;10(4):573\u201391.","journal-title":"Aging (Albany NY)"},{"issue":"3","key":"1706_CR15","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1007\/s40572-018-0203-2","volume":"5","author":"R Dhingra","year":"2018","unstructured":"Dhingra R, Nwanaji-Enwerem JC, Samet M, Ward-Caviness CK. DNA methylation age-environmental influences, health impacts, and its role in environmental epidemiology. Curr Environ Health Rep. 2018;5(3):317\u201327.","journal-title":"Curr Environ Health Rep"},{"key":"1706_CR16","doi-asserted-by":"crossref","unstructured":"Kuo P-L, Moore AZ, Lin FR, Ferrucci L. Epigenetic age acceleration and hearing: observations from the Baltimore Longitudinal Study of Aging. Front Aging Neurosci. 2021;13.","DOI":"10.3389\/fnagi.2021.790926"},{"issue":"1","key":"1706_CR17","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s13148-024-01723-w","volume":"16","author":"J Chen","year":"2024","unstructured":"Chen J, Yuan X-L, Zhou X, Xu J, Zhang X, Duan X. Mendelian randomization implicates causal association between epigenetic age acceleration and age-related eye diseases or glaucoma endophenotypes. Clin Epigenetics. 2024;16(1):106.","journal-title":"Clin Epigenetics"},{"issue":"6","key":"1706_CR18","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1038\/s41576-018-0004-3","volume":"19","author":"S Horvath","year":"2018","unstructured":"Horvath S, Raj K. DNA methylation-based biomarkers and the epigenetic clock theory of ageing. Nat Rev Genet. 2018;19(6):371\u201384.","journal-title":"Nat Rev Genet"},{"issue":"11","key":"1706_CR19","doi-asserted-by":"publisher","first-page":"14675","DOI":"10.18632\/aging.203126","volume":"13","author":"EE Pearce","year":"2021","unstructured":"Pearce EE, Horvath S, Katta S, et al. DNA-methylation-based telomere length estimator: comparisons with measurements from flow FISH and qPCR. Aging (Albany NY). 2021;13(11):14675\u201386.","journal-title":"Aging (Albany NY)"},{"issue":"7","key":"1706_CR20","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.18632\/aging.101508","volume":"10","author":"S Horvath","year":"2018","unstructured":"Horvath S, Oshima J, Martin GM, et al. Epigenetic clock for skin and blood cells applied to Hutchinson Gilford Progeria Syndrome and ex vivo studies. Aging (Albany NY). 2018;10(7):1758\u201375.","journal-title":"Aging (Albany NY)"},{"key":"1706_CR21","unstructured":"Lumley T, Gao P, Schneider B. Analysis of complex survey samples. 2024."},{"issue":"1","key":"1706_CR22","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1186\/1471-2458-8-383","volume":"8","author":"DH Rehkopf","year":"2008","unstructured":"Rehkopf DH, Berkman LF, Coull B, Krieger N. The non-linear risk of mortality by income level in a healthy population: US National Health and Nutrition Examination Survey mortality follow-up cohort, 1988\u20132001. BMC Public Health. 2008;8(1):383.","journal-title":"BMC Public Health"},{"key":"1706_CR23","unstructured":"Buuren S van, Groothuis-Oudshoorn K, Vink G et al. Mice: multivariate imputation by chained equations. 2023."},{"issue":"24","key":"1706_CR24","doi-asserted-by":"publisher","first-page":"25653","DOI":"10.18632\/aging.203776","volume":"13","author":"JC Nwanaji-Enwerem","year":"2021","unstructured":"Nwanaji-Enwerem JC, Van Der Laan L, Kogut K, et al. Maternal adverse childhood experiences before pregnancy are associated with epigenetic aging changes in their children. Aging (Albany NY). 2021;13(24):25653\u201369.","journal-title":"Aging (Albany NY)"},{"issue":"1","key":"1706_CR25","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1186\/s13148-024-01795-8","volume":"16","author":"Q Wang","year":"2024","unstructured":"Wang Q, Gao Y, Song J, et al. DNA methylation-based telomere length is more strongly associated with cardiovascular disease and long-term mortality than quantitative polymerase chain reaction-based telomere length: evidence from the NHANES 1999\u20132002. Clin Epigenetics. 2024;16(1):177.","journal-title":"Clin Epigenetics"},{"issue":"7","key":"1706_CR26","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1373\/clinchem.2006.067181","volume":"52","author":"SD de Ferranti","year":"2006","unstructured":"de Ferranti SD, Gauvreau K, Ludwig DS, Newburger JW, Rifai N. Inflammation and changes in metabolic syndrome abnormalities in US adolescents: findings from the 1988\u20131994 and 1999\u20132000 National Health and Nutrition Examination Surveys. Clin Chem. 2006;52(7):1325\u201330.","journal-title":"Clin Chem"},{"key":"1706_CR27","doi-asserted-by":"publisher","first-page":"112084","DOI":"10.1016\/j.exger.2023.112084","volume":"173","author":"PCB Lobo","year":"2023","unstructured":"Lobo PCB, de Branco FMS, Pichard C, de Oliveira EP, Pimentel GD. C-reactive protein, but not neutrophil-lymphocyte ratio, is inversely associated with muscle strength only in older men: NHANES 1999\u20132002. Exp Gerontol. 2023;173:112084.","journal-title":"Exp Gerontol"},{"issue":"5","key":"1706_CR28","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/j.tcb.2022.08.005","volume":"33","author":"B Schoeps","year":"2023","unstructured":"Schoeps B, Fr\u00e4drich J, Kr\u00fcger A. Cut loose TIMP-1: an emerging cytokine in inflammation. Trends Cell Biol. 2023;33(5):413\u201326.","journal-title":"Trends Cell Biol"},{"issue":"3","key":"1706_CR29","doi-asserted-by":"publisher","first-page":"1869","DOI":"10.3390\/ijms24031869","volume":"24","author":"FL Andronie-Cioara","year":"2023","unstructured":"Andronie-Cioara FL, Ardelean AI, Nistor-Cseppento CD, et al. Molecular Mechanisms of neuroinflammation in aging and Alzheimer\u2019s disease progression. Int J Mol Sci. 2023;24(3):1869.","journal-title":"Int J Mol Sci"},{"issue":"6","key":"1706_CR30","doi-asserted-by":"publisher","first-page":"e3000307","DOI":"10.1371\/journal.pbio.3000307","volume":"17","author":"W Wang","year":"2019","unstructured":"Wang W, Zhang LS, Zinsmaier AK, et al. Neuroinflammation mediates noise-induced synaptic imbalance and tinnitus in rodent models. PLoS Biol. 2019;17(6):e3000307.","journal-title":"PLoS Biol"},{"issue":"1","key":"1706_CR31","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12974-023-02996-3","volume":"21","author":"F Paciello","year":"2024","unstructured":"Paciello F, Pisani A, Rolesi R, et al. Oxidative stress and inflammation cause auditory system damage via glial cell activation and dysregulated expression of gap junction proteins in an experimental model of styrene-induced oto\/neurotoxicity. J Neuroinflammation. 2024;21(1):4.","journal-title":"J Neuroinflammation"},{"issue":"8","key":"1706_CR32","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1089\/jir.2017.0053","volume":"37","author":"L Eisner","year":"2017","unstructured":"Eisner L, Vambutas A, Pathak S. The balance of tissue inhibitor of metalloproteinase-1 and matrix metalloproteinase-9 in the autoimmune inner ear disease patients. J Interferon Cytokine Res. 2017;37(8):354\u201361.","journal-title":"J Interferon Cytokine Res"},{"issue":"43","key":"1706_CR33","doi-asserted-by":"publisher","first-page":"14927","DOI":"10.1523\/JNEUROSCI.1588-12.2012","volume":"32","author":"BH Hu","year":"2012","unstructured":"Hu BH, Cai Q, Hu Z, et al. Metalloproteinases and their associated genes contribute to the functional integrity and noise-induced damage in the cochlear sensory epithelium. J Neurosci. 2012;32(43):14927\u201341.","journal-title":"J Neurosci"},{"issue":"3","key":"1706_CR34","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1038\/s41440-021-00806-y","volume":"45","author":"T Kita","year":"2022","unstructured":"Kita T, Kitamura K. Translational studies of adrenomedullin and related peptides regarding cardiovascular diseases. Hypertens Res. 2022;45(3):389\u2013400.","journal-title":"Hypertens Res"},{"issue":"4","key":"1706_CR35","first-page":"1003422","volume":"2009","author":"L Agarwal","year":"2009","unstructured":"Agarwal L, Pothier DD. Vasodilators and vasoactive substances for idiopathic sudden sensorineural hearing loss. Cochrane Database Syst Rev. 2009;2009(4):1003422.","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"1706_CR36","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.ypmed.2004.05.011","volume":"40","author":"K Nomura","year":"2005","unstructured":"Nomura K, Nakao M, Morimoto T. Effect of smoking on hearing loss: quality assessment and meta-analysis. Prev Med. 2005;40(2):138\u201344.","journal-title":"Prev Med"},{"issue":"4","key":"1706_CR37","doi-asserted-by":"publisher","first-page":"251","DOI":"10.21101\/cejph.a8218","volume":"32","author":"K Myszel","year":"2024","unstructured":"Myszel K, Skar\u017cy\u0144ski PH. Influence of smoking on human hearing - literature review. Cent Eur J Public Health. 2024;32(4):251\u20135.","journal-title":"Cent Eur J Public Health"},{"key":"1706_CR38","doi-asserted-by":"crossref","unstructured":"Yeh ETH. CRP as a mediator of disease. Circulation. 2004;109(21_suppl_1):II\u201311.","DOI":"10.1161\/01.CIR.0000129507.12719.80"},{"issue":"23","key":"1706_CR39","doi-asserted-by":"publisher","first-page":"e2340","DOI":"10.1212\/WNL.0000000000012997","volume":"97","author":"ELS Conole","year":"2021","unstructured":"Conole ELS, Stevenson AJ, Mu\u00f1oz Maniega S, et al. DNA methylation and protein markers of chronic inflammation and their associations with brain and cognitive aging. Neurology. 2021;97(23):e2340\u201352.","journal-title":"Neurology"},{"issue":"4","key":"1706_CR40","doi-asserted-by":"publisher","first-page":"191","DOI":"10.51329\/mehdiophthal1438","volume":"10","author":"M Al-Namaeh","year":"2022","unstructured":"Al-Namaeh M. Common causes of visual impairment in the elderly. Med Hypothesis Discov Innov Ophthalmol. 2022;10(4):191\u2013200.","journal-title":"Med Hypothesis Discov Innov Ophthalmol"}],"container-title":["GeroScience"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-025-01706-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11357-025-01706-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-025-01706-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T09:24:08Z","timestamp":1773048248000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11357-025-01706-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["1706"],"URL":"https:\/\/doi.org\/10.1007\/s11357-025-01706-6","relation":{},"ISSN":["2509-2723"],"issn-type":[{"value":"2509-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]},"assertion":[{"value":"5 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All NHANES participants gave written informed consent, and the study protocols received approval from the NCHS Research Ethics Review Board (protocol #98\u201312).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Institutional review board (Human Subjects)"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Institutional animal care and use committee (IACUC)"}},{"value":"Not applicable. All authors reviewed and approved the final manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Institutional clearance"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}