{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:57:27Z","timestamp":1790002647211,"version":"4.0.1"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"NIH","award":["R01HL088884"],"award-info":[{"award-number":["R01HL088884"]}]},{"DOI":"10.13039\/501100003977","name":"Israeli Science Foundation","doi-asserted-by":"crossref","award":["1065\/16"],"award-info":[{"award-number":["1065\/16"]}],"id":[{"id":"10.13039\/501100003977","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003976","name":"Israel National Institute for Health Policy Research","doi-asserted-by":"publisher","award":["2018\/202"],"award-info":[{"award-number":["2018\/202"]}],"id":[{"id":"10.13039\/501100003976","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Rina Brick Memorial Foundation","award":["2019"],"award-info":[{"award-number":["2019"]}]},{"DOI":"10.13039\/501100005717","name":"University of Haifa","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005717","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["GeroScience"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Aging is a risk factor for the development of chronic diseases; however, it is heterogeneous. Measuring aging in midlife, commonly done using laboratory markers and statistical methods for estimation of biological age (BA), cannot directly inform behavioral intervention goals aiming to promote healthier aging. The Midlife Aging and Performance Study (MAPS) examined the association between an extended, inclusive assessment of physical capacity (PC), as a behavioral marker of aging, and BA, estimated using the Klemera-Doubal method from 11 laboratory and physiological biomarkers, in 112 individuals aged 42\u201346 (47% women). PC was comprehensively measured by a battery covering five domains: muscle strength, endurance, balance, agility and flexibility. Better performance in strength, endurance, balance, and flexibility domains was correlated with younger BA (Pearson\u2019s\n                    <jats:italic>r<\/jats:italic>\n                    0.33\u20130.49,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). A lower composite PC score based on all five domains was significantly associated with an accelerated aging state in which BA was greater than chronological age. In a logistic regression, a composite PC score had an odds ratio of 0.40 (95% CI 0.25\u20130.64), demonstrating each incremental rise in PC corresponds with a 60% odds reduction of being in an accelerated aging state. The proposed PC battery could be used as a functional behavioral assessment for aging state, relevant for population wide risk-screening assessments, communicating intervention goals, and as a means to evaluate temporal changes in health, independent of laboratory tests.\n                  <\/jats:p>","DOI":"10.1007\/s11357-025-01803-6","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T18:03:51Z","timestamp":1754417031000},"page":"2851-2861","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Midlife aging and performance study (MAPS): evaluating biological aging through a physical capacity battery"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0474-1888","authenticated-orcid":false,"given":"Roy","family":"Tzemah-Shahar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilona","family":"Shapiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einat","family":"Kodesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merav","family":"Asher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yechiel","family":"Friedlander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagit","family":"Hochner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1855-1199","authenticated-orcid":false,"given":"Maayan","family":"Agmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"issue":"3","key":"1803_CR1","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1111\/jgs.17011","volume":"69","author":"L Ferrucci","year":"2021","unstructured":"Ferrucci L, Kuchel GA. Heterogeneity of aging: individual risk factors, mechanisms, patient priorities, and outcomes. J Am Geriatr Soc. 2021;69(3):610\u20132. https:\/\/doi.org\/10.1111\/jgs.17011.","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"1803_CR2","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1038\/s43587-021-00044-4","volume":"1","author":"ML Elliott","year":"2021","unstructured":"Elliott ML, Caspi A, Houts RM, Ambler A, Broadbent JM, Hancox RJ, et al. Disparities in the pace of biological aging among midlife adults of the same chronological age have implications for future frailty risk and policy. Nature Aging. 2021;1(3):295\u2013308. https:\/\/doi.org\/10.1038\/s43587-021-00044-4.","journal-title":"Nature Aging"},{"key":"1803_CR3","doi-asserted-by":"publisher","unstructured":"Guest PC. Reviews on biomarker studies in aging and anti-aging research. Adv Exp Med Biol. 2019. https:\/\/doi.org\/10.1007\/978-3-030-25650-0","DOI":"10.1007\/978-3-030-25650-0"},{"issue":"1","key":"1803_CR4","doi-asserted-by":"publisher","first-page":"e12861","DOI":"10.1111\/acel.12861","volume":"18","author":"V Atella","year":"2019","unstructured":"Atella V, Piano Mortari A, Kopinska J, Belotti F, Lapi F, Cricelli C, et al. Trends in age-related disease burden and healthcare utilization. Aging Cell. 2019;18(1): e12861. https:\/\/doi.org\/10.1111\/acel.12861.","journal-title":"Aging Cell"},{"key":"1803_CR5","doi-asserted-by":"publisher","first-page":"263","DOI":"10.3389\/fgene.2019.00263","volume":"10","author":"SM Jazwinski","year":"2019","unstructured":"Jazwinski SM, Kim S. Examination of the dimensions of biological age. Front Genet. 2019;10:263. https:\/\/doi.org\/10.3389\/fgene.2019.00263.","journal-title":"Front Genet"},{"key":"1803_CR6","doi-asserted-by":"publisher","unstructured":"Mitnitski A, Rockwood K. The problem of integrating of biological and clinical markers of aging. healthy ageing and longevity; 2019. pp. 399\u2013415. https:\/\/doi.org\/10.1007\/978-3-030-24970-0_23","DOI":"10.1007\/978-3-030-24970-0_23"},{"key":"1803_CR7","doi-asserted-by":"publisher","first-page":"111242","DOI":"10.1016\/j.exger.2021.111242","volume":"146","author":"M Cesari","year":"2021","unstructured":"Cesari M, Cherubini A, Guralnik JM, Beresniak A, Rodriguez-Ma\u00f1as L, Inzitari M, et al. Early detection of accelerated aging and cellular decline (AACD): a consensus statement. Exp Gerontol. 2021;146: 111242.","journal-title":"Exp Gerontol"},{"key":"1803_CR8","doi-asserted-by":"publisher","DOI":"10.1038\/s41576-024-00807-w","author":"AE Teschendorff","year":"2025","unstructured":"Teschendorff AE, Horvath S. Epigenetic ageing clocks: statistical methods and emerging computational challenges. Nat Rev Genet. 2025. https:\/\/doi.org\/10.1038\/s41576-024-00807-w.","journal-title":"Nat Rev Genet"},{"key":"1803_CR9","doi-asserted-by":"publisher","unstructured":"Lohman T, Bains G, Berk L, Lohman E. Predictors of biological age: the implications for wellness and aging research.\u00a0Gerontol Geriatr Med. 2021; 7. https:\/\/doi.org\/10.1177\/23337214211046419","DOI":"10.1177\/23337214211046419"},{"key":"1803_CR10","doi-asserted-by":"publisher","first-page":"1074274","DOI":"10.3389\/fpubh.2023.1074274","volume":"11","author":"Z Li","year":"2023","unstructured":"Li Z, Zhang W, Duan Y, Niu Y, Chen Y, Liu X, et al. Progress in biological age research. Front Public Health. 2023;11:1074274. https:\/\/doi.org\/10.3389\/fpubh.2023.1074274.","journal-title":"Front Public Health"},{"issue":"3","key":"1803_CR11","doi-asserted-by":"publisher","first-page":"583","DOI":"10.14336\/AD.2022.1107","volume":"14","author":"A Salih","year":"2023","unstructured":"Salih A, Nichols T, Szabo L, Petersen SE, Raisi-Estabragh Z. Conceptual overview of biological age estimation. Aging Dis. 2023;14(3):583\u20138. https:\/\/doi.org\/10.14336\/AD.2022.1107.","journal-title":"Aging Dis"},{"issue":"3","key":"1803_CR12","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.mad.2005.10.004","volume":"127","author":"P Klemera","year":"2006","unstructured":"Klemera P, Doubal S. A new approach to the concept and computation of biological age. Mech Ageing Dev. 2006;127(3):240\u20138. https:\/\/doi.org\/10.1016\/j.mad.2005.10.004.","journal-title":"Mech Ageing Dev"},{"issue":"1","key":"1803_CR13","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s12874-024-02181-x","volume":"24","author":"MH Sluiskes","year":"2024","unstructured":"Sluiskes MH, Goeman JJ, Beekman M, Slagboom PE, Putter H, Rodriguez-Girondo M. Clarifying the biological and statistical assumptions of cross-sectional biological age predictors: an elaborate illustration using synthetic and real data. BMC Med Res Methodol. 2024;24(1):58. https:\/\/doi.org\/10.1186\/s12874-024-02181-x.","journal-title":"BMC Med Res Methodol"},{"issue":"8","key":"1803_CR14","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1038\/s43587-024-00646-8","volume":"4","author":"S Fong","year":"2024","unstructured":"Fong S, Pabis K, Latumalea D, Dugersuren N, Unfried M, Tolwinski N, et al. Principal component-based clinical aging clocks identify signatures of healthy aging and targets for clinical intervention. Nat Aging. 2024;4(8):1137\u201352. https:\/\/doi.org\/10.1038\/s43587-024-00646-8.","journal-title":"Nat Aging"},{"key":"1803_CR15","doi-asserted-by":"crossref","unstructured":"Erema VV, Yakovchik AY, Kashtanova DA, Bochkaeva ZV, Ivanov MV, Sosin DV, et al. Biological age predictors: the statusQuo and future Trends.\u00a0Int J Mol Sci. 2022; 23(23):15103.","DOI":"10.3390\/ijms232315103"},{"issue":"1","key":"1803_CR16","doi-asserted-by":"publisher","first-page":"0","DOI":"10.1136\/bmjhci-2019-000012","volume":"26","author":"S Robinson","year":"2019","unstructured":"Robinson S, Reed M, Quevillon T, Hirvi E. Patient perceptions and interactions with their web portal-based laboratory results. BMJ Health Care Inform. 2019;26(1):0. https:\/\/doi.org\/10.1136\/bmjhci-2019-000012.","journal-title":"BMJ Health Care Inform"},{"issue":"6","key":"1803_CR17","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1007\/s40520-021-02037-0","volume":"34","author":"A Szychowska","year":"2022","unstructured":"Szychowska A, Drygas W. Physical activity as a determinant of successful aging: a narrative review article. Aging Clin Exp Res. 2022;34(6):1209\u201314. https:\/\/doi.org\/10.1007\/s40520-021-02037-0.","journal-title":"Aging Clin Exp Res"},{"key":"1803_CR18","doi-asserted-by":"publisher","first-page":"105339","DOI":"10.1016\/j.archger.2024.105339","volume":"120","author":"T Vasilopoulos","year":"2024","unstructured":"Vasilopoulos T, Drozda D, Vincent HK. Physical activity positively impacts disability outcomes during transition from midlife to early older age irrespective of body mass index. Arch Gerontol Geriatr. 2024;120: 105339. https:\/\/doi.org\/10.1016\/j.archger.2024.105339.","journal-title":"Arch Gerontol Geriatr"},{"issue":"2","key":"1803_CR19","first-page":"126","volume":"100","author":"CJ Caspersen","year":"1985","unstructured":"Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126.","journal-title":"Public Health Rep"},{"issue":"1","key":"1803_CR20","doi-asserted-by":"publisher","first-page":"4773","DOI":"10.1038\/s41467-021-24956-2","volume":"12","author":"L Grevendonk","year":"2021","unstructured":"Grevendonk L, Connell NJ, McCrum C, Fealy CE, Bilet L, Bruls YMH, et al. Impact of aging and exercise on skeletal muscle mitochondrial capacity, energy metabolism, and physical function. Nat Commun. 2021;12(1):4773. https:\/\/doi.org\/10.1038\/s41467-021-24956-2.","journal-title":"Nat Commun"},{"key":"1803_CR21","doi-asserted-by":"publisher","unstructured":"Patrizio E, Calvani R, Marzetti E, Cesari M. Physical functional assessment in older adults. J Frailty Aging. 2020; p. 1\u20139. https:\/\/doi.org\/10.14283\/jfa.2020.61.","DOI":"10.14283\/jfa.2020.61"},{"key":"1803_CR22","doi-asserted-by":"publisher","unstructured":"Bautmans I, Knoop V, Amuthavalli Thiyagarajan J, Maier AB, Beard JR, et al. WHO working definition of vitalitycapacity for healthy longevity monitoring.\u00a0Lancet Healthy Longev. 2022; 3(11), e789\u2013e796. https:\/\/doi.org\/10.1016\/s2666-7568(22)00200-8","DOI":"10.1016\/s2666-7568(22)00200-8"},{"key":"1803_CR23","doi-asserted-by":"publisher","first-page":"101609","DOI":"10.1016\/j.arr.2022.101609","volume":"77","author":"R Tzemah-Shahar","year":"2022","unstructured":"Tzemah-Shahar R, Hochner H, Iktilat K, Agmon M. What can we learn from physical capacity about biological age? A systematic review Ageing Res Rev. 2022;77: 101609. https:\/\/doi.org\/10.1016\/j.arr.2022.101609.","journal-title":"A systematic review Ageing Res Rev"},{"issue":"3","key":"1803_CR24","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.jshs.2017.01.010","volume":"8","author":"EJ Latorre-Rojas","year":"2019","unstructured":"Latorre-Rojas EJ, Prat-Subirana JA, Peirau-Teres X, Mas-Alos S, Beltran-Garrido JV, Planas-Anzano A. Determination of functional fitness age in women aged 50 and older. J Sport Health Sci. 2019;8(3):267\u201372. https:\/\/doi.org\/10.1016\/j.jshs.2017.01.010.","journal-title":"J Sport Health Sci"},{"key":"1803_CR25","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1007\/s11357-011-9225-5","volume":"34","author":"M Kimura","year":"2012","unstructured":"Kimura M, Mizuta C, Yamada Y, Okayama Y, Nakamura E. Constructing an index of physical fitness age for Japanese elderly based on 7-year longitudinal data: sex differences in estimated physical fitness age. Age. 2012;34:203\u201314.","journal-title":"Age"},{"issue":"7","key":"1803_CR26","doi-asserted-by":"publisher","first-page":"e0219217","DOI":"10.1371\/journal.pone.0219217","volume":"14","author":"L \u0160tefan","year":"2019","unstructured":"\u0160tefan L, Parad\u017eik P, Spori\u0161 G. Sex and age correlations of reported and estimated physical fitness in adolescents. PLoS ONE. 2019;14(7): e0219217.","journal-title":"PLoS ONE"},{"issue":"2","key":"1803_CR27","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1249\/JES.0000000000000335","volume":"52","author":"J Piasecki","year":"2024","unstructured":"Piasecki J, Skarabot J, Spillane P, Piasecki M, Ansdell P. Sex differences in neuromuscular aging: the role of sex hormones. Exerc Sport Sci Rev. 2024;52(2):54\u201362. https:\/\/doi.org\/10.1249\/JES.0000000000000335.","journal-title":"Exerc Sport Sci Rev"},{"key":"1803_CR28","doi-asserted-by":"publisher","unstructured":"de Carvalho EL. Mid-life: a critical window for intervention during aging. Asia-Pacific J Surg Exp Pathol. 2025. https:\/\/doi.org\/10.32948\/ajsep.2025.01.08.","DOI":"10.32948\/ajsep.2025.01.08"},{"issue":"7","key":"1803_CR29","doi-asserted-by":"publisher","first-page":"e448","DOI":"10.1016\/S2666-7568(24)00110-7","volume":"5","author":"FY Hsiao","year":"2024","unstructured":"Hsiao FY, Chen LK. Intrinsic capacity assessment works-let\u2019s move on actions. Lancet Healthy Longev. 2024;5(7):e448\u20139. https:\/\/doi.org\/10.1016\/S2666-7568(24)00110-7.","journal-title":"Lancet Healthy Longev"},{"issue":"12","key":"1803_CR30","doi-asserted-by":"publisher","first-page":"2007","DOI":"10.1113\/EP088548","volume":"105","author":"P Ansdell","year":"2020","unstructured":"Ansdell P, Thomas K, Hicks KM, Hunter SK, Howatson G, Goodall S. Physiological sex differences affect the integrative response to exercise: acute and chronic implications. Exp Physiol. 2020;105(12):2007\u201321.","journal-title":"Exp Physiol"},{"issue":"6","key":"1803_CR31","doi-asserted-by":"publisher","first-page":"2795","DOI":"10.1007\/s11357-021-00480-5","volume":"43","author":"D Kwon","year":"2021","unstructured":"Kwon D, Belsky DW. A toolkit for quantification of biological age from blood chemistry and organ function test data: BioAge. Geroscience. 2021;43(6):2795\u2013808. https:\/\/doi.org\/10.1007\/s11357-021-00480-5.","journal-title":"Geroscience"},{"issue":"1","key":"1803_CR32","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1186\/1471-2458-14-1057","volume":"14","author":"K H\u00f8j","year":"2014","unstructured":"H\u00f8j K, Skriver MV, Hansen A-LS, Christensen B, Maindal HT, Sandb\u00e6k A. Effect of including fitness testing in preventive health checks on cardiorespiratory fitness and motivation: study protocol of a randomized controlled trial. BMC Public Health. 2014;14(1):1057. https:\/\/doi.org\/10.1186\/1471-2458-14-1057.","journal-title":"BMC Public Health"},{"issue":"3","key":"1803_CR33","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1111\/j.1365-3016.2007.00799.x","volume":"21","author":"S Harlap","year":"2007","unstructured":"Harlap S, Davies AM, Deutsch L, Calderon-Margalit R, Manor O, Paltiel O, et al. The Jerusalem Perinatal Study cohort, 1964\u20132005: methods and a review of the main results. Paediatr Perinat Epidemiol. 2007;21(3):256\u201373. https:\/\/doi.org\/10.1111\/j.1365-3016.2007.00799.x.","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"1","key":"1803_CR34","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1002\/oby.23288","volume":"30","author":"S Talisman","year":"2022","unstructured":"Talisman S, Friedlander Y, Hochner H. Perinatal socio-behavioral and obstetric predictors of metabolically healthy and unhealthy obesity in adult offspring. Obesity. 2022;30(1):209\u201320.","journal-title":"Obesity"},{"key":"1803_CR35","unstructured":"National Center for Health Statistics (NCHS)(CDC). National health and nutrition examination survey data. Hyattsville, MD:U.S. Department of Health and Human Services."},{"issue":"2","key":"1803_CR36","doi-asserted-by":"publisher","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","volume":"49","author":"JM Guralnik","year":"1994","unstructured":"Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85\u201394.","journal-title":"J Gerontol"},{"issue":"12","key":"1803_CR37","doi-asserted-by":"publisher","first-page":"3356","DOI":"10.1519\/JSC.0000000000003844","volume":"34","author":"RG Lockie","year":"2020","unstructured":"Lockie RG, Dawes JJ, Dulla JM, Orr RM, Hernandez E. Physical fitness, sex considerations, and academy graduation for law enforcement recruits. The Journal of Strength & Conditioning Research. 2020;34(12):3356\u201363.","journal-title":"The Journal of Strength & Conditioning Research"},{"issue":"2","key":"1803_CR38","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s11332-022-00936-x","volume":"19","author":"J Grgic","year":"2023","unstructured":"Grgic J. Test\u2013retest reliability of the EUROFIT test battery: a review. Sport Sciences for Health. 2023;19(2):381\u20138.","journal-title":"Sport Sciences for Health"},{"key":"1803_CR39","doi-asserted-by":"publisher","unstructured":"Cooper R, Strand BH, Hardy R, Patel KV, Kuh D. Physical capability in mid-life and survival over 13 years offollow-up: British birth cohort study. BMJ. 2014; g2219\u2013g2219. https:\/\/doi.org\/10.1136\/bmj.g2219","DOI":"10.1136\/bmj.g2219"},{"issue":"9S","key":"1803_CR40","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1249\/01.mss.0000875252.60934.1c","volume":"54","author":"RL Herron","year":"2022","unstructured":"Herron RL, Bonilla CP, Ryan GA, Casey JC, Spradley BD. Relationship between visual analog scales and commonly-used scales of perceived readiness and exertion. Med Sci Sports Exerc. 2022;54(9S):15\u20136. https:\/\/doi.org\/10.1249\/01.mss.0000875252.60934.1c.","journal-title":"Med Sci Sports Exerc"},{"issue":"10","key":"1803_CR41","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.1093\/gerona\/glz146","volume":"75","author":"X Zhong","year":"2019","unstructured":"Zhong X, Lu Y, Gao Q, Nyunt MSZ, Fulop T, Monterola CP, et al. Estimating biological age in the Singapore longitudinal aging study. J Gerontol: Ser A. 2019;75(10):1913\u201320. https:\/\/doi.org\/10.1093\/gerona\/glz146.","journal-title":"J Gerontol: Ser A"},{"issue":"4","key":"1803_CR42","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1159\/000335738","volume":"58","author":"H Jee","year":"2012","unstructured":"Jee H, Jeon BH, Kim YH, Kim H-K, Choe J, Park J, et al. Development and application of biological age prediction models with physical fitness and physiological components in Korean adults. Gerontology. 2012;58(4):344\u201353.","journal-title":"Gerontology"},{"key":"1803_CR43","doi-asserted-by":"publisher","first-page":"1241250","DOI":"10.3389\/fpubh.2023.1241250","volume":"11","author":"J Ras","year":"2023","unstructured":"Ras J, Smith DL, Kengne AP, Soteriades ES, Leach L. Physical fitness, cardiovascular and musculoskeletal health, and occupational performance in firefighters. Front Public Health. 2023;11:1241250. https:\/\/doi.org\/10.3389\/fpubh.2023.1241250.","journal-title":"Front Public Health"},{"key":"1803_CR44","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1146\/annurev-publhealth-052620-091107","volume":"43","author":"S Dogra","year":"2022","unstructured":"Dogra S, Dunstan DW, Sugiyama T, Stathi A, Gardiner PA, Owen N. Active aging and public health: evidence, implications, and opportunities. Ann Rev Public Health. 2022;43:439\u201359. https:\/\/doi.org\/10.1146\/annurev-publhealth-052620-091107.","journal-title":"Ann Rev Public Health"},{"issue":"11","key":"1803_CR45","doi-asserted-by":"publisher","first-page":"3216","DOI":"10.1519\/JSC.0000000000002292","volume":"32","author":"C Castagna","year":"2018","unstructured":"Castagna C, Bizzini M, D\u2019Ottavio S, P\u00f3voas SCA. Sex differences in aerobic fitness in top-class soccer referees. J Strength Cond Res. 2018;32(11):3216\u201321.","journal-title":"J Strength Cond Res"},{"issue":"8","key":"1803_CR46","doi-asserted-by":"publisher","first-page":"e0237423","DOI":"10.1371\/journal.pone.0237423","volume":"15","author":"M Lesinski","year":"2020","unstructured":"Lesinski M, Schmelcher A, Herz M, Puta C, Gabriel H, Arampatzis A, et al. Maturation-, age-, and sex-specific anthropometric and physical fitness percentiles of German elite young athletes. PLoS ONE. 2020;15(8): e0237423.","journal-title":"PLoS ONE"},{"key":"1803_CR47","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s00421-010-1506-7","volume":"110","author":"BA Parker","year":"2010","unstructured":"Parker BA, Kalasky MJ, Proctor DN. Evidence for sex differences in cardiovascular aging and adaptive responses to physical activity. Eur J Appl Physiol. 2010;110:235\u201346.","journal-title":"Eur J Appl Physiol"},{"key":"1803_CR48","doi-asserted-by":"publisher","first-page":"567","DOI":"10.2165\/00007256-200434090-00002","volume":"34","author":"AW Sheel","year":"2004","unstructured":"Sheel AW, Richards JC, Foster GE, Guenette JA. Sex differences in respiratory exercise physiology. Sports Med. 2004;34:567\u201379.","journal-title":"Sports Med"},{"issue":"9","key":"1803_CR49","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1080\/02640410500457109","volume":"24","author":"JM Sheppard","year":"2006","unstructured":"Sheppard JM, Young WB. Agility literature review: classifications, training and testing. J Sports Sci. 2006;24(9):919\u201332.","journal-title":"J Sports Sci"},{"key":"1803_CR50","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s40695-020-00054-z","volume":"6","author":"RT Brown","year":"2020","unstructured":"Brown RT, Covinsky KE. Moving prevention of functional impairment upstream: is middle age an ideal time for intervention? Womens Midlife Health. 2020;6:4. https:\/\/doi.org\/10.1186\/s40695-020-00054-z.","journal-title":"Womens Midlife Health"},{"key":"1803_CR51","doi-asserted-by":"crossref","unstructured":"Sierra F. The emergence of geroscience as an interdisciplinary approach to the enhancement of health span and life span. Cold Spring Harbor perspectives in medicine. 2016;6(4).","DOI":"10.1101\/cshperspect.a025163"},{"key":"1803_CR52","doi-asserted-by":"publisher","unstructured":"Sierra, F. The emergence of geroscience as an interdisciplinary approach to the enhancement of health span and life span.\u00a0Cold Spring Harb Perspect Med. 2016; 6(4). https:\/\/doi.org\/10.1101\/cshperspect.a025163","DOI":"10.1101\/cshperspect.a025163"},{"issue":"6","key":"1803_CR53","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1093\/aje\/kwx346","volume":"187","author":"DW Belsky","year":"2018","unstructured":"Belsky DW, Moffitt TE, Cohen AA, Corcoran DL, Levine ME, Prinz JA, et al. Eleven telomere, epigenetic clock, and biomarker-composite quantifications of biological aging: do they measure the same thing? Am J Epidemiol. 2018;187(6):1220\u201330. https:\/\/doi.org\/10.1093\/aje\/kwx346.","journal-title":"Am J Epidemiol"},{"issue":"7","key":"1803_CR54","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.1016\/j.pec.2020.12.030","volume":"104","author":"E Van Der Pol-Harney","year":"2021","unstructured":"Van Der Pol-Harney E, Turner R, McCaffery K, Bonner C. The effects of communicating cardiovascular disease risk as\u2019 fitness age\u2019on behavioral intentions and psychological outcomes. Patient Educ Couns. 2021;104(7):1704\u201311.","journal-title":"Patient Educ Couns"},{"issue":"1","key":"1803_CR55","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s12966-019-0896-0","volume":"16","author":"R Mulchandani","year":"2019","unstructured":"Mulchandani R, Chandrasekaran AM, Shivashankar R, Kondal D, Agrawal A, Panniyammakal J, et al. Effect of workplace physical activity interventions on the cardio-metabolic health of working adults: systematic review and meta-analysis. Int J Behav Nutr Phys Act. 2019;16(1):134. https:\/\/doi.org\/10.1186\/s12966-019-0896-0.","journal-title":"Int J Behav Nutr Phys Act"},{"key":"1803_CR56","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.ebiom.2017.03.046","volume":"21","author":"J Jylh\u00e4v\u00e4","year":"2017","unstructured":"Jylh\u00e4v\u00e4 J, Pedersen NL, H\u00e4gg S. Biological age predictors EBioMedicine. 2017;21:29\u201336. https:\/\/doi.org\/10.1016\/j.ebiom.2017.03.046.","journal-title":"Biological age predictors EBioMedicine"},{"key":"1803_CR57","doi-asserted-by":"publisher","first-page":"101050","DOI":"10.1016\/j.arr.2020.101050","volume":"60","author":"F Galkin","year":"2020","unstructured":"Galkin F, Mamoshina P, Aliper A, de Magalh\u00e3es JP, Gladyshev VN, Zhavoronkov A. Biohorology and biomarkers of aging: current state-of-the-art, challenges and opportunities. Ageing Res Rev. 2020;60: 101050.","journal-title":"Ageing Res Rev"},{"issue":"2","key":"1803_CR58","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/bf03324754","volume":"20","author":"A Oksuzyan","year":"2008","unstructured":"Oksuzyan A, Juel K, Vaupel JW, Christensen K. Men: good health and high mortality Sex differences in health and aging. Aging Clin Exp Res. 2008;20(2):91\u2013102. https:\/\/doi.org\/10.1007\/bf03324754","journal-title":"Aging Clin Exp Res"},{"key":"1803_CR59","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.mad.2019.02.004","volume":"179","author":"E Gordon","year":"2019","unstructured":"Gordon E, Hubbard R. Do sex differences in chronic disease underpin the sex-frailty paradox? Mech Ageing Dev. 2019;179:44\u201350.","journal-title":"Mech Ageing Dev"},{"key":"1803_CR60","doi-asserted-by":"publisher","first-page":"112619","DOI":"10.1016\/j.exger.2024.112619","volume":"198","author":"B Arosio","year":"2024","unstructured":"Arosio B, Picca A. The biological roots of the sex-frailty paradox. Exp Gerontol. 2024;198: 112619. https:\/\/doi.org\/10.1016\/j.exger.2024.112619.","journal-title":"Exp Gerontol"},{"key":"1803_CR61","doi-asserted-by":"publisher","DOI":"10.1038\/s43587-025-00883-5","author":"M Fuentealba","year":"2025","unstructured":"Fuentealba M, Rouch L, Guyonnet S, Lemaitre JM, de Souto BP, Vellas B, et al. A blood-based epigenetic clock for intrinsic capacity predicts mortality and is associated with clinical, immunological and lifestyle factors. Nat Aging. 2025. https:\/\/doi.org\/10.1038\/s43587-025-00883-5.","journal-title":"Nat Aging"}],"container-title":["GeroScience"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-025-01803-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11357-025-01803-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11357-025-01803-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T09:40:40Z","timestamp":1773049240000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11357-025-01803-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":61,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["1803"],"URL":"https:\/\/doi.org\/10.1007\/s11357-025-01803-6","relation":{},"ISSN":["2509-2723"],"issn-type":[{"value":"2509-2723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]},"assertion":[{"value":"3 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Ethics Committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa (#407\/20) and the Hadassah Hospital Institutional Review Board (#10\u201301.04.05) provided ethical approval for the performed extension of the Jerusalem Perinatal Study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors consent to the publication of the manuscript. All research subjects gave written consent to participate in the study and to the publication of the study results.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}