Biological age gap: How does it impact brain and vascular health?

Evan Walker
Evan Walker TheMediTary.Com |
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Research suggests reducing the biological age gap is linked to better brain health and lower stroke risk. Image credit: Maskot/Getty Images
  • A biological age gap is the difference between a person’s chronological age based on their birthday, and their body’s biological age.
  • Past studies show that having a large biological age gap can increase your risk for a number of health issues, including heart disease and dementia.
  • Your biological age gap can be improved by making healthy lifestyle choices.
  • A new study found that improving your biological age gap may also lower your stroke risk and provide better brain health.

A biological age gap is the difference between a person’s chronological age based on their birthday, and their body’s biological age.

Biological age might age faster than a person’s chronological age for several reasons, including having chronic conditions like diabetes or stress, or unhealthy lifestyle factors such as smoking, leading a sedentary lifestyle, and eating an unhealthy dietary plan.

Past studies show that having a large biological age gap can increase the risk for a number of health issues, including cardiovascular disease, chronic kidney disease, chronic obstructive pulmonary disease (COPD), cancer, and dementia.

However, people can improve their biological age gap through making Healthy lifestyle choices. A new study recently presented at the American Academy of Neurology’s 78th Annual Meeting found that improving that gap may also lower stroke risk and provide better brain Health.

As this is an abstract presented at a meeting, the results of the study have yet to be published in a peer-reviewed scientific journal.

For this study, researchers analyzed health data for more than 258,000 people and measured 18 health-related biomarkers, including cholesterol levels and red blood cell volume, along with brain scans, to determine each participant’s biological age. They also recalculated biological age for roughly 6,000 participants during a follow-up visit.

“Chronological age is the number of years you’ve been alive,” Cyprien Rivier, MD, MSc, instructor in the Department of Neurology at Yale School of Medicine and inaugural Ralph L. Sacco Scholar in Brain Health, and lead author of this study, explained to Medical News Today.

“Biological age reflects how old your body actually functions. We can estimate biological age from routine blood tests most people already get, like cholesterol and blood cell counts.”

“The gap is simply the difference between the two. Some people’s bodies are aging faster than their calendar age suggests; meaning their gap is positive, while others are aging more slowly.”

Rivier said they decided to look at how a person’s biological age gap might impact their brain health and stroke risk because faster biological aging has been linked to poor health outcomes broadly, but its relationship to the brain specifically was under-explored.

“And the more interesting question to us was not just whether the gap matters (we already knew it did), but whether changes in that gap over time predict what happens to the brain years later,” he added.

“That felt like a more actionable question, because it implies biological aging might be something we can modify to improve our brain health and reduce the risk of cognitive decline, stroke, and dementia.”

At the start of the study, participants had an average chronological age of 56 and average biological age of 54. Six years later, study participants had an average chronological age of 62 and average biological age of 58.

Researchers found that participants who improved their biological age gap between the start of the study and the repeat assessment had a 23% lower risk of having a stroke during the follow-up period.

“The important point here is that we’re looking at change over time, not just a snapshot,” Rivier said.

“It is not simply that biologically younger people have fewer strokes, it is that people who moved in the right direction over time (improved their biological age gap) had meaningfully better outcomes a decade later.”

Additionally, scientists found participants with an improved biological age gap also experienced a lower volume of white matter hyperintensities — a sign of white matter tissue damage, which can lead to memory problems and cognitive decline.

Overall, the total volume of damage was 13% lower for each standard deviation in improvement for these participants.

“White matter hyperintensities are spots visible on brain MRI that reflect damage to the brain’s white matter,” Rivier explained.

“They accumulate silently over years and are strongly linked to stroke and cognitive decline. Finding that people who improved their biological age gap had 13% less of this damage per standard deviation of improvement tells us the benefit isn’t limited to stroke risk, it also extends to the structural integrity of the brain itself.”

“That is important because this kind of tissue-level damage often precedes symptoms by years. Detecting a difference at the imaging level suggests we may be capturing something early and meaningful.”

MNT also spoke with Dung Trinh, MD, internist for MemorialCare Medical Group and chief medical officer of Healthy Brain Clinic in Irvine, CA, about this study, who said he found the results to be both encouraging and motivating.

“Encouraging because we saw a consistent link between improving a person’s biological age gap over time and better brain-related outcomes — like lower stroke risk and more favorable brain imaging markers,” Trinh detailed.

“Motivating because it reinforces how closely brain Health is tied to whole-body Health, and it gives us a measurable signal we can study more deeply. At the same time, it is important to emphasize this is an association — this study does not prove that changing biological age directly prevents stroke.”

For readers who may want to work on lowering the gap between their chronological and biological ages to potentially help preserve brain health and lower their stroke risk, Trinh said many of the factors that influence stroke risk and overall cardiometabolic health are also the kinds of factors that are often linked to healthier aging markers.

  • Be physically active in a way that is safe and sustainable — regular movement tends to benefit vascular health, mood, and sleep.
  • Do not smoke and avoid secondhand smoke; if you do smoke, get support to quit.
  • Eat in a heart-healthy pattern (for example, emphasizing vegetables, fruits, legumes, whole grains, nuts, and fish; and limiting ultra-processed foods and excess added sugars).
  • Keep blood sugar and cholesterol in healthy ranges and follow treatment plans if you have diabetes or high cholesterol.
  • Know and manage blood pressure — one of the biggest drivers of stroke risk.
  • Limit alcohol and avoid binge drinking.
  • Maintain a healthy weight and waist circumference, if recommended by your clinician — especially through nutrition, activity, and sleep rather than quick fixes.
  • Prioritize sleep and address sleep apnea or chronic insomnia, which can affect vascular and brain health.
  • Stay socially and cognitively engaged and treat hearing loss and depression — these don’t replace vascular risk control, but they matter for brain health.

– Dung Trinh

“The key message is what is good for the heart and blood vessels is generally good for the brain,” Trinh added.

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