Chronological age can be defined as the time measured from an individual’s birth to a particular date. Biological age is more complex, since it positions an individual within its own lifespan and probability of survival, meaning that a 67 year old man with a biological age of 60 is more likely to live longer than a 67 year old man with a biological age of 70. These concepts are related and in some cases the values can be equal but they are not the same thing.

Chronological age is simply a number representing the length of someone’s life to a particular point; therefore it is difficult to associate biomarkers to it since any biomarker with any influence in the capacity for survival would immediately be more related to biological age. A strict chronological age biomarker should be a biological feature that changes over an individual lifespan but doesn’t directly affect the probability for survival.

There are several biomarkers currently being used that don’t influence survival greatly and are related to older individuals, these could be easily called “chronological age biomarkers”. Reduction of the coronal pulp cavity (using radiography) is a very common method used in forensic science, however, in adults most signs of aging like wrinkles and silver hair are features that can manifest at different points in someone’s life and won’t be useful to accurately determine someone’s biological age.

When looking for aging biomarkers that will reveal the biological age of an individual, these can be split between functional (macro) and physiological (micro) biomarkers.

Biological Biomarkers

After many decades of research, the scientific community now agrees on 9 hallmarks of aging that relate to physiological processes acting at the cellular level. These are: accumulation of genetic errors due to genomic instability, telomere attrition or degradation, epigenetic alterations, damage of the internal mechanism in charge of quality control for protein synthesis, deregulated nutrient sensing, mitochondrial dysfunction, loss of the capacity to grow and change stem cell exhaustion and altered intercellular communication.

All of the physiological biomarkers considered above provide data about the capacity of the organism to sustain operation of its own processes over time and also about its capacity to withstand different forms of stress.

These nine hallmarks of aging are robust candidates to be considered for any system dedicated to the determination of biological age; however, obtaining accurate measurements of any of them requires a lot of specialized equipment and capable staff, since they cannot be evaluated easily. Some of them like stem cell exhaustion or mitochondrial dysfunction can only be measured by taking a biopsy and performing a longitudinal study in vitro under laboratory conditions, something that most laboratories don’t provide as part of their usual services.

Functional Biomarkers

Fortunately, functional biomarkers are easier to measure and are considered equally valid to measure biological age. These cover both cognitive and physical performance and include visual acuity (Snellen chart), auditory acuity (pure tone audiometry), decision reaction time, grip strength (dynamometers), body mass index (height and weight measurement), blood pressure (systolic and diastolic pressure), lung capacity (spirometer) and memory.

Functional age is a specialized form of biological age, is task-oriented, and can provide valuable information in regards to an individual’s capacity to perform a particular task or its vulnerability within a certain set of conditions.

All biomarkers mentioned in this article have shown correlation with the process of aging in the past, however, a system designed to provide an accurate value for someone´s biological age will have to integrate a large number of these variables at the same time and incorporate an elegant method to accumulate, process and interpret data from a considerable amount of sources.