What's Your Brain’s ECG Age? (And Why It Matters)

What if a simple test you've likely already had—one that's been around for over a century—could reveal your brain’s biological age… and even your risk for cognitive decline?

Thanks to artificial intelligence, a routine heart test is suddenly doing something extraordinary: peering into the future of your brain’s function. And the results are more revealing than anyone expected.

Key Takeaways

• AI-enhanced ECGs can now measure biological age, offering a powerful new way to assess overall health beyond cardiovascular function.
• A higher ECG-age is linked to poorer cognitive performance, suggesting early warning signs of cognitive decline and even dementia.
• ECG testing is already widely available, making this a low-cost option for identifying at-risk people.

Is Your Brain Older Than You Think? This Test Might Know

Since its invention in 1901, the electrocardiogram (ECG) has become a mainstay of cardiovascular medicine. Yet the value of this common diagnostic tool has been underestimated, only coming to light when it was combined with artificial intelligence.

That’s when it revealed amazing results going well beyond monitoring heart health to include the health of the whole body and brain.

In a groundbreaking study, an ECG assessed an individual’s risk of cognitive decline. It’s called ECG age (electrocardiogram-predicted biological age), and it’s a cutting-edge tool that uses artificial intelligence (AI) to estimate a person’s biological age based on heart data. Here’s how it works…

A 12-lead electrocardiogram provides detailed information about the heart’s electrical activity from 12 different angles using 10 electrodes placed on the chest and limbs. Modern machine learning and AI can process and analyze vast amounts of data, so the information provided by an ECG needn’t be restricted to the heart's functioning alone.

For instance, studies show it can predict potassium levels in the blood serum and even whether the patient is a cocaine user. As readings differ between men and women and change over time due to normal aging, doctors tried the test for another purpose.

ECG-age Detects Accelerated Aging

After being trained on half a million patients and tested for accuracy on another 275,000, the model accurately determined a patient's gender 90.4 % of the time and their age to within seven years of their actual age. The estimate was higher than their actual age if they had a heart problem, such as a heart attack or coronary heart disease, and lower than their age if they experienced few or no adverse events.

Suraj Kapa, M.D., assistant professor of medicine at the Mayo Clinic, said the findings were “surprising and exciting” because it suggests an ECG can be used to determine a patient’s biological age – the age of body cells and tissues as distinct from age since birth – and therefore “more accurately assess overall health status.”

A follow-up study confirmed these findings but went another step further.
When scientists analyzed ECGs from another 25,000 people, they found similar results: These readings could estimate a person's age with surprising accuracy, typically coming within just 46 weeks of their actual birthdate. What's fascinating, though, is what happened when someone's "heart age" didn't match their calendar age.

Over the next 12 years of following these individuals, researchers discovered that people whose ECGs made their hearts appear significantly older than their actual age faced higher risks of dying from heart problems or any cause. On the flip side, those lucky individuals whose hearts appeared electrically "younger" than their chronological age enjoyed better survival odds.

This finding feels particularly meaningful because it suggests our hearts might be telling a deeper story about our health than just our birthdate. It's like having a hidden biological clock that potentially reveals how well we're aging on the inside, where it truly matters.

Senior author Francisco Lopez-Jimenez, M.D, said: “Our results validate and expand on our prior observations that ECG-age using AI may detect accelerated aging by proving that those with older-than-expected age by ECG die sooner, particularly from heart disease. We know that mortality rate is one of the best ways to measure biological age, and our model proved that.”

Higher Biological Age – Poorer Cognitive Performance

Since there’s a strong connection between heart health and brain health, researchers considered the tantalizing possibility that ECG-age could predict who is more likely to suffer from cognitive decline and dementia, so they designed a study to find out.

Researchers analyzed 63,800 British people with an average age of 65. They performed ECG tests and eight tests for cognition. They used the AI model to determine ECG age, after which they divided participants into three groups according to whether ECG age closely matched their birth age or was five years or more higher (older) or five years or more lower (younger) than their birth age.

The results, presented at the American Stroke Association’s International Stroke Conference in February, found that compared with the normal aging group, those with a younger ECG-age performed better on six of the eight cognitive tests, but those with an older ECG-age performed worse on six of the eight tests.

Bernard Ofosuhene at the UMass Chan Medical School in Worcester, Massachusetts, who presented the findings, said “ECG-age reflects the functional status of the heart and potentially the entire organism at the tissue level, providing insights into aging and health status. I encourage health care professionals to use [ECG] data to look for signs of cognitive decline. Doing so may help with early diagnosis and timely intervention.”

The distinguished neurologist Fernando D. Testai at the University of Illinois College of Medicine in Chicago, who was not involved in the study, commented: “If this study is validated, it could have several important outcomes. For instance, ECG data collected in a doctor's office or remotely with wearables could help assess cognition at home or in rural areas lacking neuropsychiatric specialists.

“Additionally, using ECG data and AI might be quicker and more objective than traditional neuropsychological assessments. However, one important question remains: can ECG data predict future cognitive decline? Answering this could lead to valuable treatments since some ECG issues can be fixed.”

Is ECG Age Testing Available at Your Doctor’s Office?

While it's still emerging in clinical practice, new research shows it may one day help predict the risk of cognitive decline and dementia, years before symptoms appear. While standard ECGs are routine in clinics and hospitals, ECG-Age requires:

• AI analysis software trained on vast datasets
• Integration with medical records or research tools

That means most primary care doctors or cardiologists don’t yet offer ECG age scoring, which may change as the research grows and tools become more accessible.

What You Can Do Now

You can ask your doctor for a standard ECG if you have risk factors for heart disease or cognitive decline. You can also monitor your biological age with available tools like fitness trackers, heart rate variability apps, or at specialized anti-aging clinics.

Most importantly, focus on the health of your brain and heart by getting regular exercise and good sleep, managing your blood pressure and cholesterol levels, as well as following an anti-inflammatory, anti-aging diet and supplement regimen.

Summary

A groundbreaking discovery has shown that when paired with artificial intelligence, the standard 12-lead electrocardiogram (ECG) can reveal far more than just heart rhythm issues. Researchers found that AI can calculate a person's ECG-age, a marker of biological aging that correlates with mortality risk and cognitive performance. Those with an ECG-age older than their actual age were more likely to show signs of cognitive decline and even dementia. This exciting breakthrough suggests that a widely used, low-cost test could soon become vital in identifying premature aging and protecting brain health long before symptoms emerge.

Frequently Asked Questions

What is an ECG-age?

ECG-age is an estimate of biological age derived from AI analysis of a standard ECG reading, which can reflect the health of your body and brain.

How does ECG-age relate to brain health?

Studies show that people with older ECG-ages perform worse on cognitive tests, making it a potential tool for early detection of brain decline.

Can ECG-age predict dementia?

While more research is needed, ECG-age has shown promise in identifying those at higher risk of cognitive impairment and potential future dementia.

Is this test already available?

Yes — standard ECGs are widely used and AI models are being developed to integrate this analysis into routine care.

Can ECG-age be improved?

Yes. Since ECG-age reflects biological aging, improving cardiovascular health through exercise, diet, and stress reduction may lower your ECG-age.

For the complete reference list, please see the separate references document.