High serum glucose levels are associated with a higher perceived age.

Estimating perceived age by facial photographs is a good estimate of health in elderly populations. Previously, we showed that familial longevity is marked by a more beneficial glucose metabolism already at middle age. As glucose is also related to skin aging, this study aimed to investigate the association between glucose metabolism and perceived age. Perceived age was assessed using facial photographs and non-fasted glucose and insulin were measured in 602 subjects from the Leiden Longevity Study. Non-diabetic subjects (n = 569) were divided in three strata according to their glucose levels, and diabetic subjects (n = 33; as a proxy of long-term hyperglycemic exposure) were included as a fourth stratum. Considered confounding factors were gender, chronological age, current smoking, body mass index, photo-damage score, and insulin levels. Perceived age was increased from 59.6 years (SE = 0.3) in the first stratum to 61.2 years (SE = 0.6) in diabetic subjects (p for trend = 0.002). In non-diabetic subjects only, perceived age was increased from 59.6 years (SE = 0.3) in the first stratum to 60.6 years (SE = 0.3) in the third stratum (p for trend = 0.009). Continuously, perceived age increased 0.40 years (SE = 0.14, p = 0.006) per 1 mmol/L increase in glucose level in non-diabetic subjects. The present study demonstrates that, also among non-diabetic subjects, higher glucose levels are associated with a higher perceived age. Future research should be focused on elucidating possible mechanisms linking glucose levels to perceived age.

Facial appearance reflects human familial longevity and cardiovascular disease risk in healthy individuals.

BACKGROUND: As facial appearance can be readily quantified and skin tissue easily accessed, they could be valuable tools for determining how biological mechanisms influence tissue degeneration with age and, consequently, human health and lifespan. It is unknown, however, whether appearance reflects disease risk or lifespan independently of factors already known to associate with both health and appearance. METHODS: In a cross-sectional study, we compared the amount of skin wrinkling on a sun-protected site (upper inner arm) and the facial appearance of 261 offspring (mean age 63.2 y) of nonagenarian siblings with 253 age-matched controls (mean age 62.7 y), all with no reported disease history. We next examined whether any appearance features that significantly associated with familial longevity also associated with the Framingham cardiovascular disease (CVD) risk score. All analyses were adjusted for chronological age, smoking, photodamage, and body mass index. RESULTS: Female and male offspring had reduced upper inner arm skin wrinkling (p = .03 and p < .001, respectively), and the male offspring looked 1.4 y younger than the controls (p = .002). There were no significant associations between CVD risk and upper inner arm skin wrinkling. Women in the lowest quartile of CVD risk looked more than 2 y younger for their age than those in higher risk quartiles (p = .002). Systolic blood pressure was the most significant (p = .004) CVD risk factor that was associated with perceived age in women. CONCLUSIONS: Facial appearance and skin wrinkling at a sun-protected site reflect the propensity to reach an extreme old age, and facial appearance reflects the risk of succumbing to CVD independently of chronological age, smoking, photodamage, and BMI.

Cortisol serum levels in familial longevity and perceived age: the Leiden longevity study.

BACKGROUND: Cortisol levels are strongly associated with a person's health. Familial longevity and age assessment of facial photographs (perceived age) are both associated with morbidity and mortality. The present study aimed to investigate morning cortisol levels in familial longevity and the association of these levels with perceived age. METHODS: Perceived age and serum morning cortisol levels were measured for 138 offspring from long-lived families and 138 partners from the Leiden Longevity Study. Considered confounding factors were chronological age, gender, body mass index, current smoking habits, antidepressant drug use, antihypertensive drugs and diabetes medication. RESULTS: In the fully adjusted model, which was restricted to participants who did not use antidepressant drugs, offspring had similar serum cortisol levels compared to their partners (0.54 and 0.55µmol/L, respectively; p=0.54). Using a similar model taking offspring and partners together, an increase of 0.1µmol/L in morning cortisol levels was associated with an 0.42 (95% CI 0.0-0.84, p=0.048) year increase in perceived age. This association was significantly attenuated in the offspring group (0.01, 95% CI -0.58 to 0.59, p=0.98) compared to the partner group (0.81, 95% CI 0.20-1.41, p=0.009 year increase in perceived age per 0.1µmol/L increase in cortisol respectively) (p for interaction=0.042). CONCLUSION: This study demonstrates that high levels of cortisol are associated with a higher perceived age. This association was attenuated in offspring from long-lived families compared to their partners, suggesting enhanced stress resistance in these subjects. Future research will be aimed at elucidating potential mechanisms underlying the observations in this study.

Environmental and lifestyle factors associated with perceived facial age in Chinese women.

Perceived facial age has been proposed as a biomarker of ageing with 'looking young for one's age' linked to physical and cognitive functioning and to increased survival for Caucasians. We have investigated the environmental and lifestyle factors associated with perceived facial ageing in Chinese women. Facial photographs were collected from 250 Chinese women, aged 25-70 years in Shanghai, China. Perceived facial age was determined and related to chronological age for each participant. Lifestyle and health information was collected by questionnaire. Bivariate analyses (controlling for chronological age) identified and quantified lifestyle variables associated with perceived facial age. Independent predictors of perceived age were identified by multivariate modelling. Factors which significantly associated with looking younger for one's chronological age included greater years of education (p<0.001), fewer household members (p=0.027), menopausal status (p=0.020), frequency of visiting one's doctor (p=0.013), working indoors (p<0.001), spending less time in the sun (p=0.015), moderate levels of physical activity (p=0.004), higher frequency of teeth cleaning (p<0.001) and more frequent use of facial care products: cleanser (p<0.001); moisturiser (p=0.016) or night cream (p=0.016). Overall, 36.5% of the variation in the difference between perceived and chronological age could be explained by a combination of chronological age and 6 independent lifestyle variables. We have thus identified and quantified a number of factors associated with younger appearance in Chinese women. Presentation of these factors in the context of facial appearance could provide significant motivation for the adoption of a range of healthy behaviours at the level of both individuals and populations.

Why some women look young for their age.

The desire of many to look young for their age has led to the establishment of a large cosmetics industry. However, the features of appearance that primarily determine how old women look for their age and whether genetic or environmental factors predominately influence such features are largely unknown. We studied the facial appearance of 102 pairs of female Danish twins aged 59 to 81 as well as 162 British females aged 45 to 75. Skin wrinkling, hair graying and lip height were significantly and independently associated with how old the women looked for their age. The appearance of facial sun-damage was also found to be significantly correlated to how old women look for their age and was primarily due to its commonality with the appearance of skin wrinkles. There was also considerable variation in the perceived age data that was unaccounted for. Composite facial images created from women who looked young or old for their age indicated that the structure of subcutaneous tissue was partly responsible. Heritability analyses of the appearance features revealed that perceived age, pigmented age spots, skin wrinkles and the appearance of sun-damage were influenced more or less equally by genetic and environmental factors. Hair graying, recession of hair from the forehead and lip height were influenced mainly by genetic factors whereas environmental factors influenced hair thinning. These findings indicate that women who look young for their age have large lips, avoid sun-exposure and possess genetic factors that protect against the development of gray hair and skin wrinkles. The findings also demonstrate that perceived age is a better biomarker of skin, hair and facial aging than chronological age.

Perceived age as a biomarker of ageing: a clinical methodology.

In a previous field-based study, how old one looks for one's age (perceived age) was found to be predictive of mortality in elderly individuals. In conjunction, perceived age is of relevance and interest to the layperson. Here, a clinical methodology for generating perceived age as a biomarker of facial ageing is detailed. The methodology utilises facial photographs of subjects to present images to large numbers of age assessors who are primarily nationals of the country of study origin. In five observational studies in five different countries involving 874 female subjects it was found that subject age and assessor gender, nationality, age and ageing expertise had little effect on the perceived age data generated. However, increasing the numbers of age assessors up to 50 substantially increased the reproducibility of the mean perceived age for an image and a minimum of 10 assessors were required to give reproducible data. This methodology was also compared to a methodology that utilises passport-type photographs of subjects typically taken in field studies. Although the perceived age data from the two types of images were more similar to each other than to chronological age, there was a marked difference between the two sets of data. Therefore, to allow meaningful comparisons across perceived age studies, the same type of image should be used for the generation of perceived age. In conclusion, the methodology detailed here has demonstrated that perceived age can be a reproducible measure when large numbers of adult age assessors are used and can be utilised globally in studies to investigate facial ageing.