An Aging Risk-Factor Scale: Biomarkers of Renal Disease and Anemia are Primary Predictors of Three-Year Survival in Common Marmosets (Callithrix jacchus)

Valid animal models are needed to evaluate how age-related changes in kidney function influence healthspan. Aging marmosets frequently develop renal insufficiency with anemia and exhibit reductions in body mass and metabolic rate. However, it remains unclear which age-related changes predict survival and which thresholds indicate increased mortality risk. We prospectively evaluated age, body composition, resting energy expenditure, hematology, and blood chemistry as predictors of 3-year survival in female and male marmosets (n = 66), 2-16 years of age. Objectives were to identify prognostic markers, define high-risk thresholds, and to develop and test a composite risk-factor scale for mortality screening in captivity. A 10-variable model showed the best predictive performance in multivariable Cox proportional hazards modeling, and was retained for further analysis (concordance = 0.881, p < 0.001). ROC curves using Youdens Index and AUC identified high-risk thresholds for predictors in the multivariable model, and threshold-defined categories were evaluated by Kaplan-Meier survival analysis. The 10 binary risk-factors were combined into a composite scale scored from 0 to 10 and tested with Cox regression. The scale explained approximately 42% of variance in survival and each additional risk factor increased mortality risk 1.75-fold (95% CI: 1.43-2.14, p < 0.001). Marmosets with [≥]7 risk factors exhibited a 19-month reduction in survival, and this high-risk threshold predicted 3-year survival with 89.4% accuracy. Results support the scale as a screening tool for mortality risk and highlight the high prevalence of age-associated renal disease and anemia in marmosets.