Improving biological age gap may help protect long-term brain health

Improving the gap between your biological age and your chronological age is associated with a lower risk of stroke and improvements in signs of damage in the brain, according to a preliminary study released March 5, 2026, that will be presented at the American Academy of Neurology's 78^th Annual Meeting taking place April 18-22, 2026, in Chicago and online.

The study does not prove that improving the age gap is the cause of brain health improvements; it only shows an association.

It's exciting to think that working to modify our biological age could be a pathway to preserving brain health. Lifestyle habits that support cardiovascular and metabolic health, like a healthy diet, regular exercise, adequate sleep and good blood pressure control, may help narrow the biological age gap, though we did not evaluate lifestyle programs in this study."

Cyprien Rivier, MD, MSc, study author of Yale University and member of the American Academy of Neurology

For the study, researchers analyzed the biological age of 258,169 people from a health care research database. They measured 18 biomarkers in the blood, such as cholesterol, average red blood cell volume and white blood cell count, to determine biological age at the start of the study and again six years later for a subset of participants. After an average of 10 years, researchers identified participants who had a stroke. A subset of participants also took tests of memory and thinking skills and had brain scans to look at signs of damage in the brain.

At the start of the study, participants had an average biological age of 54, compared to their actual age of 56. Six years later, they had an average biological age of 58, compared to their actual age of 62.

People with a biological age older than their chronological age had less favorable brain scans by the end of the study, as well as worse scores on the cognitive tests. They also had a 41% higher risk of stroke.

People who improved the gap between their biological and chronological ages between the start of the study and the repeat assessment were 23% less likely to have a stroke during the follow-up period.

Those with improvements also had a lower volume of white matter hyperintensities, which is a sign of damaged white matter tissue, by the end of the study than those who did not improve their biological age gaps. Their total volume of damage was 13% lower for each standard deviation in improvement.

These results took into account other factors that could affect the risk of stroke and brain damage, such as high blood pressure and other vascular conditions and socioeconomic factors.

"More research is needed, testing whether lowering people's biological age gap can be demonstrated to reduce the risk of stroke and later-life brain injury," Rivier said.

A limitation of the study was that while it found links, it was not designed to prove cause and effect. Also, only a smaller group had repeat blood tests, which limits what researchers could conclude about changes over time, particularly regarding cognitive tests.

The study was supported by the American Academy of Neurology/American Heart Association Ralph L. Sacco Scholarship in Brain Health, which was awarded to Rivier in 2024.