Table 3.

Mediation analysis for associations detected between biological aging (Δage) and SES trajectories in the Moli-sani cohort (n = 4772).

(a)
Potential Mediators	Total Effect β [95% CI]	Pure Natural Direct Effect β [95% CI]	Pure Natural Indirect Effect β [95% CI]	% Mediation [95% CI] (p-Value)
LIS score	1.28 [0.74; 1.78]	1.15 [0.63; 1.65]	0.14 [0.07; 0.21]	10.6 (5.4; 20.0)% p < 0.001
DIS score	1.28 [0.73; 1.78]	1.21 [0.65; 1.72]	0.07 [0.03; 0.12]	5.3 (2.1; 11.7)% p = 0.002
MDS	1.28 [0.70; 1.78]	1.25 [0.68; 1.75]	0.03 [0.003; 0.075]	2.7 (0.3; 6.5)% p = 0.028
Smoke	1.28 [0.71; 1.81]	1.28 [0.72; 1.82]	−0.002 [−0.06; 0.06]	−0.2 (−6.2; 4.9)% p = 0.92
Physical activity	1.28 [0.74; 1.84]	1.28 [0.74; 1.84]	0.004 [−0.009; 0.022]	0.3 (−0.7; 1.9)% p = 0.57
Alcohol drinking	1.29 [0.73; 1.85]	1.27 [0.70; 1.84]	0.02 [0.14; 0.77]	1.2 (−8.6; 11.1)% p = 0.77
BMI	1.28 [0.74; 1.82]	1.07 [0.52; 1.62]	0.22 [0.14; 0.31]	16.8 (9.7; 32.1)% p < 0.001
SF36 physical	1.28 [0.70; 1.90]	1.02 [0.43; 1.62]	0.27 [0.17; 0.38]	20.7 (11.7; 40.3)% p < 0.001
SF36 mental	1.28 [0.73; 1.83]	1.29 [0.72; 1.84]	−0.003 [−0.019; 0.009]	−0.3 (−1.7; 0.1)% p = 0.65
ALL	1.27 [0.75; 1.84]	0.81 [0.26; 1.41]	0.46 [0.29; 0.67]	36.2 (20.4; 67.0)% p < 0.001
(b)
Potential Mediators	Total Effect β [95% CI]	Pure Natural Direct Effect β [95% CI]	Pure Natural Indirect Effect β [95% CI]	% Mediation [95% CI] (p-Value)
LIS score	0.75 [0.26; 1.27]	0.57 [0.07; 1.06]	0.18 [0.11; 0.27]	24.6 (12.2; 70.1)% p = 0.004
DIS score	0.75 [0.25; 1.28]	0.68 [0.19; 1.22]	0.07 [0.03; 0.12]	9.2 (3.4; 28.2)% p = 0.004
MDS	0.75 [0.22; 1.24]	0.70 [0.18; 1.20]	0.05 [0.01; 0.09]	6.2 (1.7; 21.0)% p = 0.010
Smoke	0.77 [0.21; 1.22]	0.79 [0.25; 1.25]	−0.01 [−0.10; 0.02]	−1.7 (−26.7; 2.7)% p = 0.23
Physical activity	0.75 [0.25; 1.23]	0.74 [0.23; 1.21]	0.01 [−0.02; 0.04]	1.4 (−2.4; 8.3)% p = 0.50
Alcohol drinking	0.74 [0.25; 1.26]	0.76 [0.26; 1.29]	−0.02 [−0.12; 0.10]	−2.5 (−24.7; 17.5)% p = 0.86
BMI	0.75 [0.27; 1.27]	0.49 [0.03; 1.01]	0.26 [0.18; 0.35]	34.3 (17.7; 89.8)% p = 0.002
SF36 physical	0.75 [0.23; 1.25]	0.44 [−0.10; 0.94]	0.31 [0.19; 0.44]	41.0 (19.7; 121.7)% p = 0.014
SF36 mental	0.75 [0.24; 1.24]	0.74 [0.24; 1.24]	0.006 [−0.006; 0.025]	0.8 (−0.8; 4.2)% p = 0.036
ALL	0.72 [0.23; 1.28]	0.25 [−0.29; 0.78]	0.48 [0.31; 0.70]	66.3 (34.6; 212.6)% p = 0.002

The association β and the proportion of association mediated are reported for (a) the educational and material downward and (b) the stably low SES trajectory, for each potential mediator tested, along with 95% confidence intervals, as computed through the CMAverse package [32]. β represents the counterfactual effect conditional on covariates specified in the fully adjusted linear model (Model 2). % mediation was computed as Direct Effect × (Indirect Effect − 1)/(Total Effect − 1). Significant mediations (p < 0.05) are highlighted in bold. No exposure–mediator interaction was assumed, since no significant evidence of such an interaction was detected. Abbreviations: DIS = dietary inflammatory score; LIS = lifestyle inflammatory score; MDS = Mediterranean diet score; BMI = body mass index.