New Blood Test Predicts Who Will Most Likely Live Longer

As people age, it becomes increasingly difficult to determine who is likely to maintain stable health and who may face serious decline. Traditional indicators such as age, cholesterol, and physical activity do not always accurately predict short-term survival risk. Identifying early biological signals of vulnerability could help guide interventions and promote healthier aging. Now, a new study shows that small RNA molecules circulating in the blood can predict whether older adults are likely to survive at least two more years, raising the possibility of a simple blood test to assess short-term survival risk.

In research led by Duke Health (Durham, NC, USA), in collaboration with the University of Minnesota (Minneapolis, MN, USA), investigators analyzed blood samples from adults aged 71 and older to measure levels of small RNA molecules known as piRNAs, which are involved in regulating development, regeneration, and immune function. Using causal artificial intelligence (AI) and machine learning techniques, the team evaluated 187 clinical factors and 828 small RNAs across more than 1,200 blood samples.

The samples came from a large North Carolina-based cohort established in a previous Duke-led study, and survival outcomes were determined by linking participants to national mortality records. Advanced statistical modeling identified a group of six piRNAs that, alone, predicted two-year survival with an accuracy of up to 86%. Lower levels of certain piRNAs were consistently associated with longer survival. The findings were validated in a second independent group of older adults.

The study showed that piRNAs outperformed age, cholesterol, physical activity, and more than 180 other clinical measures in predicting short-term survival. For longer-term outcomes, lifestyle factors became more important, but piRNAs continued to provide insight into underlying biological processes. The results, published in Aging Cell, suggest that circulating piRNAs could serve as minimally invasive biomarkers to identify short-term survival risk in older adults. A simple blood test based on these molecules may help clinicians intervene earlier, tailor treatments, and monitor biological aging more precisely. Researchers plan to investigate whether lifestyle changes, medications, or emerging therapies such as GLP-1–based treatments can alter piRNA levels. They also aim to compare piRNA concentrations in blood and tissues to better understand how these molecules influence longevity.

“These small RNAs are like micromanagers in the body, helping control many processes that affect health and aging,” said Virginia Byers Kraus, M.D., Ph.D., senior author of the study. “We are only beginning to understand how powerful they are. This research suggests we should be able to identify short-term survival risk using a practical, minimally invasive blood test—with the ultimate goal of improving health as we age.”

Related Links:
Duke Health
University of Minnesota