Written by: Dr Prasun Chatterjee
5 min readNew DelhiAug 5, 2025 05:39 PM IST
First published on: Aug 5, 2025 at 01:16 PM IST
When Mr Ravi Johnson walked into my clinic, looking at his gait, the spring in his steps, I could not imagine him to be over the age of 75 years. His Aadhar card said otherwise. He was 95 years old and surprisingly fit. As we do for all our patients, we conducted a Comprehensive Geriatric Assessment (CGA) — to document his mobility, muscle strength, mood, and memory — and found him acing all clinical and functional parameters. Although 95, he was biologically younger than most 70-year-olds I had seen that week.
His main complaint, which prompted him to visit the clinic, was a mild chest pain. While he had no other co-morbidities, the pain in itself was a red flag. It is the traditional presentation for hidden coronary artery disease in the elderly. So, we went ahead and did a CT coronary angiography — a non-invasive but useful diagnostic test to evaluate arterial blockage. As predicted, the scan indicated prominent coronary obstruction.
I referred him to a geriatric cardiologist, stressing in my note that even though Mr Johnson was chronologically 95-years-old, he was biologically significantly younger. He was what you would call a ‘Super-ager.’ Yet, to my dismay, the doctor did not recommend that he undergo additional invasive studies such as angiography or procedures such as stenting and bypass. Something that would surely have been done for a 75-year-old.
A CLOCK FOR AGEING
Just like Mr Johnson, many older persons frequently remain under-investigated and under-treated even when it might benefit them. So, there is a need to move away from the age mention on the ID cards and develop quantitative methods for assessing a person’s biological or functional age. To this end, scientists have developed epigenetic clocks, which measure the chemical changes happening in the DNA with age.
While the first version called the Horvath Clock focused only on DNA changes, the newer models also incorporate blood tests and health data for a more accurate picture of our biological ageing process. DunedinPACE — one of the recent, most advanced epigenetic clock — combines the blood-based markers of changes to the DNA with key clinical assessment of organ systems such as brain, heart and lung.
What sets it apart is its ability to calculate the pace at which a person is ageing. When tested in European and some Asian populations, the researchers found that the people showing signs of accelerated ageing — where their biological age is more than their chronological age — face a higher risk of poor health outcomes, complex diseases, and premature death.
THE INDIA STORY
One of the challenges, however, is that these clocks have been validated in different ethnic and geographically distinct populations. And, no such clock has been developed in India. To address this, the All- India Institute of Medical Sciences (AIIMS) with funding support from ICMR, has launched a pioneer study in the field of biological ageing. Using the data collected over the years through this research, we aim to develop a predictive algorithm to estimate biological age and pace of ageing in the Indian population.
HOW TO SLOW DOWN AGEING
Meanwhile, there are things that people can do to slow down their biological ageing. There is plenty of evidence that restricting calorie intake, following a balanced, nutrient-rich diet focussed on whole foods, and limiting processed and junk foods can help keep our cells younger. Staying active and getting regular exercise is also one of the most reliable ways to slow our biological ageing clock.
Equally important is prioritising quality sleep and managing chronic stress, which is known to accelerate ageing at the cellular level. Relaxation techniques like yoga, meditation and mindfulness can help regulate stress and promote healthy ageing. Avoiding smoking and limiting alcohol consumption are also critical.
Lastly, the role of meaningful human connection is deeply impactful. Strong social bonds and engagement with others go a long way in maintaining emotional resilience and help slow the pace of biological ageing.
With ageing becoming a popular topic, many health and wellness companies have come up with claims of reversing biological ageing. Most of these claims are misleading and not backed by rigorous science. In the absence of the gold-standard randomised control trials, do not let the hype of social media influencers or billionaire celebrities drive your decisions.
(The author is Chief, Geriatric Medicine, Artemis Hospital Gurugram. He was formerly in-charge of the National Centre for Ageing at AIIMS)
Rising longevity must also redefine what “elderly” means. The reverence for the old is a societal norm in India, but imagining them as a resource can be rewarding 
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