Time and the metrics of aging

Luigi Ferrucci, Morgan E. Levine, Pei Lun Kuo, Eleanor M. Simonsick

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


The different metrics of aging are mutually and longitudinally correlated, although their trajectories are not synchronous and occur with a certain time lag. In other words, biological aging takes many years before it finally translates into the deterioration of physical and cognitive function. This opportunity for prevention should be eagerly embraced because this has extraordinary translational potential. There is overwhelming evidence that frailty and disability are powerful risk factors for multiple adverse health outcomes, such as nursing home admission, disability, and mortality.20 This is not surprising, considering that functional aging only occurs when the resilience mechanisms of biological and phenotypic aging are exhausted. Concordant with this view, frailty and other measures of functional aging have been successfully used to identify patients most likely to develop severe side effects after aggressive medical and surgical treatments, although technological progress has allowed for invasive interventions-such as hip replacement and aortic valve replacement-to be successful in old and frail patients. In spite of their success as prognostic indicators, frailty and other measures of functional aging are still rarely used in day-to-day medical practice, mostly because of inadequate evidence that frailty can be prevented or reversed. Developing methods to measure the biological mechanisms of aging in humans may enable identification of individuals on a trajectory of accelerated aging early in the process, who then can be screened for subclinical diseases and thereby targeted for future interventions that globally affect the aging rate and effectively delay frailty. Ultimately, interventions that effectively slow or delay the mechanisms of aging in subjects diagnosed with accelerated aging will need to be identified and properly tested. To foster this research agenda, new methods for measuring putative mechanisms of biological aging need to be fully developed, validated, and included in large cohort studies. This is in addition to the major phenotypes of aging, including information on chronic diseases and risk factors, as well as robust and sensitive measures of functional assessment, potentially including response to challenge.

Original languageEnglish (US)
Pages (from-to)740-744
Number of pages5
JournalCirculation research
Issue number7
StatePublished - 2018


  • Aging
  • Frailty
  • Geriatrics
  • Geroscience
  • Health span
  • Humans

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine


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