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Fit for WorkResearchAgeWellbeing and health promotionOccupational Health

Link between how old you look and age-related health issues

by Nic Paton 16 Jan 2023
by Nic Paton 16 Jan 2023 Photo: Shutterstock
Photo: Shutterstock

How old you look could be a window into your risk of age-related health issues, research has suggested.

A study published in the  British Journal of Dermatology has shown a link between how old a person looks (their perceived age) and their risk of age-related health issues, including cognitive decline.

This suggests that as our bodies and minds age this is reflected on our faces, the authors have argued.

The study involved 2,679 men and women (with an average age 65.8 years) from the Rotterdam Study, an ongoing large population-based cohort study.

High-resolution facial photographs, from the front and the side, were taken of each person, with any cosmetics, creams or jewellery removed.

An independent panel was then asked to estimate the age of each of the participants using these photographs, with no other information. Each image was scored by 27 assessors on average.

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The perceived age of the participants was scored by taking the difference between their actual age and the age guessed by the independent panel.

For example, somebody with a perceived age score of seven looks seven years younger than their actual chronological age. The higher the perceived age score the younger the person looks.

The researchers, from the Erasmus University Medical Center Rotterdam and Unilever Research and Development, then grouped participants based on their perceived age scores and reviewed lifestyle and health data.

The lifestyle factors included body-mass index (BMI), ultraviolet (UV) exposure, smoking status, and ‘pack-years’ (or how much people have smoked over time).

The health data included renal, cardiovascular and lung conditions since these are strongly associated with age. The researchers also looked at muscle and bone health issues, eye health issues, age-related hearing loss, and a measure of cognitive impairment (adjusted for education level).

The youngest-looking group was estimated on average five years younger than their chronological age and was predominantly male (61%), less often a smoker, and had the highest BMI (probably due to the filler effect of facial fat).

Looking younger was linked with higher cognitive function and a lower risk of chronic obstructive pulmonary disease (even after adjusting for smoking status and pack-years), osteoporosis, cataracts, and age-related hearing loss, the research concluded.

No link was found between perceived age and osteoarthritis, age-related macular degeneration (AMD), or glaucomatous visual field loss (GVFL).

The researchers argued that the concept of perceived age could be used as a diagnostic clue in clinical settings and could even be used to create easy-to-use models that map shared causes of ageing across different organ systems.

Professor Tamar Nijsten, of the Erasmus University Medical Center Rotterdam and the lead author of the research, said: “This research builds on previous studies looking at how visible age can predict health outcomes.

“We specifically investigated the link between looking young and various common age-associated health issues and found that youthful looks are linked with lower measures of systemic ageing. In other words, if you look younger than you are, then the health of your organ systems, body and mind are likely to reflect this.

“Although this study didn’t examine specifically why this is, it is likely that factors which cause changes to tissue structures in the face which make us look older, such as the reduction of subcutaneous fat and the development of wrinkles, also impact tissue at other sites around the body and are linked to corresponding changes in bone density.

“This is not a definitive study, but it is probably the best study so far providing evidence that perceived age also reflects internal ageing. The study clearly demonstrates that something is going on, likely on a biological level and beyond the usual lifestyle factors such as UV exposure or smoking,” said Professor Nijsten.

Matthew Gass of the British Association of Dermatologists (BAD), said: “This study makes a strong case that looking young is not just a matter of vanity, it can be a tell-tale sign of the underlying state of one’s health.

“While some factors which contribute to looking older relate to our environment and lifestyles, sun exposure and smoking being the most obvious, some are just down to the natural ageing process.

“In some cases, the link between looking younger and certain health conditions will likely be a combination of external factors and natural ageing, for instance in the case of glaucoma. However, for some conditions, such as COPD, the link between looking younger remained even when controlling for lifestyle factors.”

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However, as a caveat, the BAD pointed out that one of the key limitations of this study is that the Rotterdam Study group predominantly comprises people from a north-western European background.

Future research therefore might explore if the findings of this study hold true in different population groups, it added.

Nic Paton

Nic Paton is consultant editor at Personnel Today. One of the country's foremost workplace health journalists, Nic has written for Personnel Today and Occupational Health & Wellbeing since 2001, and edited the magazine from 2018.

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