Abstract
The aetiology of frailty remains unknown. It has been hypothesised that individual differences in epigenetic mechanisms, particularly DNA methylation (DNAm), may help to explain why some individuals become frail while others do not. Relating epigenetic measures to transitions in age-related frailty in individual patients requires longitudinal studies over many years. To overcome this barrier, we study associations between DNAm and the Frailty Index in a cohort of adults with kidney failure who experience accelerated transitions of frailty with and without kidney transplantation. While transplantation was associated with reduced frailty, there was minimal evidence for an association between frailty and epigenetic markers.