Brain-age in midlife is associated with accelerated biological aging and cognitive decline in a longitudinal birth-cohort

Abstract

An individuals brain-age is the difference between chronological age and age predicted from machine-learning models of brain-imaging data. Brain-age has been proposed as a biomarker of age-related deterioration of the brain. Having an older brain-age has been linked to Alzheimers, dementia and mortality. However, these findings are largely based on cross-sectional associations which can confuse age differences with cohort differences. To illuminate the validity of brain-age a biomarker of accelerated brain aging, a study is needed of a large cohort all born the same year who nevertheless vary on brain-age. In a population-representative 1972-73 birth cohort we measured brain-age at age 45, as well as the pace of biological aging and cognitive decline in longitudinal data from childhood to midlife (N=869). In this cohort, all chronological age 45 years, brain-age was measured reliably (ICC=.81) and ranged from 24 to 72 years. Those with older midlife brain-ages tended to have poorer cognitive function in both adulthood and childhood, as well as impaired brain health at age 3. Furthermore, those with older brain-ages had an accelerated pace of biological aging, older facial appearance and early signs of cognitive decline from childhood to midlife. These findings help to validate brain-age as a potential surrogate biomarker for midlife intervention studies that seek to measure treatment response to dementia-prevention efforts in midlife. However, the findings also caution against the assumption that brain-age scores represent only age-related deterioration of the brain as they may also index central nervous system variation present since childhood.