Advanced biological aging may increase the risk of OA, independent of OA genetic risk, particularly in individuals aged over 60 years, with PhenoAge acceleration associated with higher odds and incidence of OA while KDMAge acceleration showed cross-sectional but not longitudinal associations.
Accelerated PhenoAge was associated with higher odds of prevalent osteoarthritis in cross-sectional analyses.
Accelerated PhenoAge was associated with a higher risk of incident osteoarthritis in longitudinal analyses, but KDMAge acceleration was not.
Accelerated biological aging showed a more pronounced association with osteoarthritis among individuals over 60 years of age.
No additive or multiplicative interactions were found between OA polygenic risk score (PRS) and biological aging acceleration.
At baseline, the majority of included participants had younger PhenoAge aging acceleration.
Two distinct biological aging measures, PhenoAge and KDMAge, were used and showed partially divergent associations with osteoarthritis.
This research suggests that people whose bodies are aging faster than expected biologically — as measured by two different biological age clocks — are more likely to have osteoarthritis (OA), the most common joint disease. Using data from over 332,000 UK Biobank participants, researchers compared biological age (estimated from blood and clinical test results) to chronological age to identify who was aging faster or slower than typical. They found that people with accelerated biological aging were about 5–12% more likely to have OA at the time of the study, and those with faster aging as measured by one clock (PhenoAge) were 12% more likely to develop new OA over time. Importantly, these associations held up even after accounting for people's genetic predisposition to OA, meaning biological aging and genetics seem to independently raise OA risk. The study also found that the link between faster biological aging and OA was especially strong in people over 60 years old, suggesting that managing biological aging might be particularly important for older adults. Two different biological age calculators were used — PhenoAge and KDMAge — and while both were linked to existing OA, only PhenoAge consistently predicted who would develop OA in the future. This difference suggests the two clocks may capture slightly different aspects of aging. This research suggests that biological age measurements, which can be derived from routine clinical blood tests, could potentially serve as useful tools for identifying people at higher risk of developing osteoarthritis before symptoms appear. If biological aging can be slowed or reversed through lifestyle changes or medical interventions, this could represent a new avenue for reducing OA risk, though this study only establishes an association and does not prove that slowing biological aging would prevent OA.
Liu S, Wang W, Li C, Lai Y, Zhou Z, Han M, et al.. (2026). Cross-Sectional and Longitudinal Association Between Biological Aging Acceleration and the Risk of Osteoarthritis: A Cohort Study From UK Biobank.. International journal of rheumatic diseases. https://doi.org/10.1111/1756-185x.70853