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This study investigated plasma GDF-15 as a biomarker associated with sarcopenia and frailty in a cohort of mobility-limited older adults. Patients (\u2265\u200965 years) were recruited from a geriatric outpatient clinic for fall assessment. Frailty was identified using the Clinical Frailty Scale with a cut-off\u2009\u2265\u20095. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2. Plasma GDF-15 was analyzed using electrochemiluminescence assays (Meso Scale Discovery, Rockville, MD, USA). Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic accuracy of GDF-15 for identifying frailty and sarcopenia. The optimum GDF-15 cut-off for frailty was determined using Youden\u2019s Index. A total of 429 patients (age 79.6\u2009\u00b1\u20096.2\u00a0years, 64% female) were included. Of these, 16% had sarcopenia and 25% had frailty. Median GDF-15 levels in patients with\/without sarcopenia and with\/without frailty were 1916\u00a0pg\/mL vs. 1569\u00a0pg\/mL (p\u2009=\u20090.035), and 2252\u00a0pg\/mL vs. 1438\u00a0pg\/mL (p\u2009&lt;\u20090.001), respectively. The area under the curve (AUC) for frailty was 0.681 (95% CI: 0.623\u20130.739) with an optimal cut-off of 2047\u00a0pg\/mL. For sarcopenia, AUC was 0.577 (95% CI: 0.501\u20130.653). GDF-15 plasma levels appear to be elevated in mobility-limited older adults with frailty and sarcopenia. The diagnostic accuracy of GDF-15 for frailty appears of moderate magnitude, suggesting a potential clinical role of this biomarker in identifying frailty in mobility-limited older adults. In contrast, the diagnostic accuracy of GDF-15 for sarcopenia was poor. ClinicalTrials.gov Identifier: NCT05795556.<\/jats:p>","DOI":"10.1007\/s11357-025-01946-6","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T03:10:00Z","timestamp":1764040200000},"page":"1955-1966","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["GDF-15 plasma levels are elevated in mobility-limited older adults with frailty and sarcopenia\u2014results from the BIOFRAIL study"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5545-1105","authenticated-orcid":false,"given":"Pernille","family":"Hansen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8609-8755","authenticated-orcid":false,"given":"Hanne","family":"Nygaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Praeger-Jahnsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1259-645X","authenticated-orcid":false,"given":"Martin","family":"Schultz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9970-9535","authenticated-orcid":false,"given":"Flemming","family":"Dela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9773-7361","authenticated-orcid":false,"given":"Per","family":"Aagaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8641-3062","authenticated-orcid":false,"given":"Jesper","family":"Ryg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8063-6508","authenticated-orcid":false,"given":"Charlotte","family":"Suetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"1946_CR1","unstructured":"WHO (2015) World report on aging and health. 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