As aging emerges from the accumulation of a relatively small number of underlying forms of damage and dysfunction, we might expect even very different aspects of aging to correlate with one another. Maybe not a very tight correlation if the two aspects are far removed from one another in terms of the connection of proximate causes and their interactions, but ultimately they arise from the same roots. Here, researchers rely on the interconnected nature of aging in order to make use of retinal aging to assess bone aging. The researchers use an aging clock derived from retinal imagery and show that greater predicted age correlates with greater loss of bone mineral density and risk of fracture resulting from the progression of osteoporosis.
Osteoporosis is a common condition that weakens bones and raises the risk of fractures, especially in older adults. However, many individuals are not diagnosed until after a fracture occurs, in part because the standard diagnostic test, Dual-energy X-ray Absorptiometry (DEXA), is not always readily accessible. We therefore investigated whether retinal photographs, taken from the back of the eye, could help identify people at higher risk of osteoporosis. This possibility arises from the idea that the retina may reflect the body’s overall biological aging.
Hence, we used an artificial intelligence-derived age marker, RetiAGE, to estimate retinal biological age and test the association between retinal age and osteoporosis. In the Singapore study of 1,965 older adults, older retinal biological age was associated with lower bone mineral density (BMD), lower BMD T-scores, and higher fracture risk scores. In the UK Biobank study of 43,938 participants, older retinal biological age also predicted a higher risk of developing osteoporosis over time, even after accounting for major risk factors. These findings suggest that retinal biological aging may reflect broader aging processes related to skeletal health. Retinal imaging may therefore provide a simple, non-invasive, and accessible way to support opportunistic screening for osteoporosis risk.
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