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A cross-sectional study of 312 adults aged 35 and older found that a higher score across five lifestyle measures was modestly associated with a lower bio-functional age. The preliminary index is not a validated measure of biological aging or a tool for predicting lifespan, and the study cannot show that the habits caused the differences.
According to the study published in Scientific Reports, a Swiss research team found that a five-part score covering body mass index, physical activity, smoking, sleep quality and satisfaction with sexual life was modestly associated with bio-functional age in adults aged 35 and older. The analysis describes a preliminary way to assess functional health beyond years lived, but it does not establish that the habits cause people to age differently or predict how long they will live.
The researchers reported analyzing 312 participants from a larger study recruited at a university hospital in Switzerland. As described in the paper, data had been collected between 2012 and 2014. The group’s mean age was about 53; 79% were women, 70% reported physical activity and 59% were non-smokers. The original cohort included 630 people, but participants younger than 35 were excluded from this analysis because the researchers’ bio-functional age model required a minimum chronological age.
In the paper, the team assessed functional capacity across physical, sensory, cognitive and social-emotional domains. It calculated a bio-functional age, then compared that estimate with participants’ chronological age. The resulting average was 44.1 year-equivalents, while the average difference between functional and chronological age was minus 8.8 years. These are study-specific estimates, not a clinical diagnosis or a direct measure of cellular aging.
The researchers assigned up to two points for each of five lifestyle measures, producing a 10-point lifestyle index. Their analysis found that a higher overall score was modestly associated with lower bio-functional age, including after adjustment for chronological age. Among the individual measures, physical activity had the strongest association with lower functional age; BMI category and satisfaction with sexual life were also significantly associated. The smoking score showed a positive correlation, which the authors said may reflect the age profile of the relatively few current smokers. Sleep quality was not significantly associated with bio-functional age.
What the Functional Age Score Captures
The distinction made in the study is between chronological age—the number of years a person has lived—and how well they function across physical, mental and social areas. Two people of the same age may have different capacities, and a broader assessment can capture aspects of health that a birth date alone cannot describe.
The paper notes that this distinction matters for research and public health, where healthy aging includes more than the absence of disease. The study’s index also puts several everyday measures together rather than treating each in isolation. However, its association with functional age was modest, and the results do not show that using the score would improve care or change health outcomes. It should not be used to label an individual as biologically older or younger.
The authors’ results are consistent with the general relevance of movement and other health-related behaviors, but this analysis cannot rank lifestyle choices as treatments. It also includes satisfaction with sexual life, a personal and social measure whose relationship with functional health may depend on circumstances not captured by the score. Readers should not interpret the index as a prescription or as a substitute for an individual health assessment.
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How Researchers Defined Functional Age
In the study, bio-functional age means an estimate based on functional capacity, not a molecular test of biological aging. It differs from chronological age and from measures intended to track cellular processes or estimate life expectancy. The researchers derived the estimate from test results across several domains, then compared it with participants’ chronological ages.
As reported in the paper, the analysis drew on German-speaking adults originally enrolled in a separate study at a Swiss university hospital from 2012 to 2014. People who were pregnant, acutely ill or unable to read had been excluded from the original cohort; the present analysis also removed those younger than 35. Participants completed assessments covering lifestyle, social and occupational circumstances, medical history, anxiety, depression, stress and quality of life. The researchers tested associations between these factors and functional age, then built the five-item index from selected lifestyle measures.
The paper’s description of the index’s construction is important to interpreting the results: it is a preliminary composite, not an established measure used to guide treatment. Alcohol consumption was examined separately but was not included in the final index. An initial association involving moderate drinking weakened when the researchers revised the scoring to give abstinence the highest score, which they said was consistent with public health guidance.
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Limits of the Study Sample
The authors describe the study as cross-sectional, meaning lifestyle and functional health were assessed in the same general period. It cannot establish whether a lifestyle measure led to a difference in functional age, whether health status influenced a person’s habits, or whether other factors contributed to both. The authors also described the index as preliminary; its performance needs further evaluation before it can be treated as a dependable assessment tool.
According to the paper, the sample was limited to 312 adults selected from a hospital-based cohort, was predominantly female and included German-speaking participants. The results may not apply to other populations, age groups or settings. The data were collected more than a decade before the report’s publication, and the study does not establish how the score relates to later disability, disease, quality of life or mortality.
The reported average difference of minus 8.8 year-equivalents is a group result, not evidence that each participant was functionally younger than their chronological age. The available report also does not provide enough information to determine how well the index would perform in a new group or whether changing any one of its components would alter the functional-age estimate. Those questions remain open.
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Validation Before Wider Use
The study’s authors identify independent validation in larger and more diverse groups as an important next step. Researchers would need to test whether the score produces consistent results outside this sample and whether it tracks meaningful health outcomes over time. Longitudinal studies could help establish whether changes in the lifestyle measures precede changes in functional capacity, rather than simply occurring alongside them.
Further work could also test the contribution of each index component, examine how social and economic circumstances shape the observed associations, and compare the score with other functional-health assessments. Until those questions are addressed, the study supports describing a preliminary association—not presenting the index as a personal aging test or a forecast of future health.
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Key Questions
What does bio-functional age mean in this study?
As defined by the researchers, it is a research estimate of functional capacity across physical, sensory, cognitive and social-emotional areas. It is not chronological age, a molecular aging test or a prediction of lifespan.
Which lifestyle measures were included in the index?
The study’s preliminary score included BMI, physical activity, smoking, sleep quality and satisfaction with sexual life, with each contributing up to two points to a total of 10.
Did the study show that these habits cause healthier aging?
No. The researchers conducted a cross-sectional analysis and found associations, so the study cannot establish cause and effect or determine whether habits changed functional age.
Can someone use this score to assess their own health?
The study does not establish the index as a validated personal health test. The researchers describe it as a preliminary research measure, and the reported group averages should not be treated as an individual diagnosis or forecast.
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