Exploring the moderating effects of SIRT1 protein expression and gene polymorphisms rs7895833 on the relationship between hemoglobin levels and physical frailty in elderly adults with comorbid chronic diseases. A moderated mediation analysis Dedi Ardinata ¹ , Novita Sari Harahap ² , Nenni Dwi Aprianti Lubis ³ , Tetty Aman Nasution⁴ ¹ Department of Physiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. ²Department of Sport Science, Faculty of Sport Science, Universitas Negeri Medan, Medan, Indonesia ³ Department of Nutrition, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. ⁴ Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

Hemoglobin levels in the blood decrease with age, which might affect elderly people who also have chronic diseases. Higher levels of SIRT1 and the SNP genotype AG-GG can both contribute to this. However, the interactions between these variables are complex, necessitating more research to fully comprehend the mechanisms underlying the development of physical frailty in the aging population.