Healthy Aging Index Construction

The Healthy Aging Index (HAI) is a simple composite that summarizes the burden of subclinical physiologic decline across several organ systems into a single score. Introduced by Jason Sanders, Anne Newman, and colleagues in 2014 using the Cardiovascular Health Study, it captures the idea that biological aging is a multisystem process rather than the failure of any one organ. The index combines five readily measured markers, one from each of five physiologic systems: systolic blood pressure (vascular), fasting glucose (metabolic), Mini-Mental State Examination score (cognitive), serum creatinine (renal), and forced vital capacity (pulmonary). Each marker is scored 0, 1, or 2 according to which tertile of risk an individual falls into, and the five scores are summed to give a total from 0 to 10, with higher values indicating worse aging. The HAI predicts mortality and was shown to be heritable, supporting its interpretation as a phenotype of biological aging. Its appeal lies in being inexpensive, transparent, and built from routine clinical measurements rather than specialized assays.