How to Assess Your Biological Age: The Markers That Matter

Biological age assessment has historically required expensive laboratory testing including epigenetic clocks and telomere length measurement. While these are becoming more accessible, a clinically meaningful and practical biological age assessment can be constructed from a combination of functional tests and standard biomarkers that are either available through the NHS or through private testing at modest cost.

Functional Tests That Predict Biological Age

• Grip strength: measured with a dynamometer. Population reference ranges by age and sex allow precise percentile ranking. Low grip strength is one of the strongest predictors of functional decline and mortality
• VO2 max estimation: a 6-minute walk test or submaximal exercise test provides an estimate of cardiovascular fitness, one of the most powerful longevity biomarkers
• Single-leg stance time: standing on one leg with eyes closed for longer than 10 seconds indicates good balance and proprioception. Inability to maintain 10 seconds is associated with significantly elevated mortality risk
• Sit-to-stand test: the ability to get up from the floor without using hands is associated with longevity, and the test method specifically predicts cardiovascular and all-cause mortality
• Resting heart rate: a resting heart rate below 60 beats per minute indicates strong cardiovascular fitness. Above 80 is associated with elevated cardiovascular risk

Biomarkers Worth Measuring

• HbA1c: reflects average blood glucose over the previous three months, predicts diabetes risk and biological ageing
• Fasting insulin: more sensitive than blood glucose for identifying insulin resistance at an early stage
• hsCRP: high-sensitivity C-reactive protein measures systemic inflammation, a primary driver of accelerated biological ageing
• IGF-1: reflects growth hormone activity and declines with age, with both very low and very high levels associated with adverse health outcomes
• Vitamin D: deficiency is associated with accelerated biological ageing, reduced muscle function, and increased mortality risk