Predicting Age Using Neuroimaging:Innovative Brain Ageing Biomarkers

The brain changes as we age and these changes are associated with functional deterioration and neurodegenerative disease. It is vital that we better understand individual differences in the brain ageing process; hence, techniques for making individualised predictions of brain ageing have been developed. We present evidence supporting the use of neuroimaging-based ‘brain age’ as a biomarker of an individual's brain health. Increasingly, research is showing how brain disease or poor physical health negatively impacts brain age. Importantly, recent evidence shows that having an ‘older’-appearing brain relates to advanced physiological and cognitive ageing and the risk of mortality. We discuss controversies surrounding brain age and highlight emerging trends such as the use of multimodality neuroimaging and the employment of ‘deep learning’ methods. Brain age can be predicted in individuals based on neuroimaging data using machine learning approaches to model trajectories of healthy brain ageing. The predicted brain age for a new individual can differ from his or her chronological age; this difference appears to reflect advanced or delayed brain ageing. Brain age has been shown to relate to cognitive ageing and multiple aspects of physiological ageing and to predict the risk of neurodegenerative diseases and mortality in older adults. Various diseases, including HIV, schizophrenia, and diabetes, have been shown to make the brain appear older. Further, brain age is being used to identify possible protective or deleterious factors for brain health as people age. Brain age is being actively developed to combine multiple measures of brain structure and function, capturing increasing amounts of detail on the ageing brain.