Mortality is Written on the Face.
BACKGROUND
It is unknown whether facial or surrounding (eg, hair and clothing) cues have the strongest influence on the perceived age of subjects in photographic images, and which drives links between perceived age and survival.


METHODS
In 2001, 187 Danish twin pairs (n = 374) aged 70+ years were photographed generating passport-type images. The faces of the twins in these images were swapped creating two new images per twin pair (748 images in total). Ten nurses rated the perceived age of the twin from the original and swapped facial images. The survival of the twins was determined through to the end of 2013.


RESULTS
Changing the face or its surrounding significantly changed the perceived age of the images, with only a marginal difference between their effect sizes (difference of 0.5 years, 95% confidence interval CI -0.1 to 1.1). Perceived age, adjusting for chronological age, and sex, was a predictor of survival up to 7 years (hazard ratio 1.17, 95% CI 1.10-1.25) and also 7-12 years (hazard ratio 1.06, 95% CI 1.00-1.12) after the photographs were taken. Where the older looking twin died first they had a significantly older looking face (1.4 years older, 95% CI 0.3-2.6) but not surrounding (0.3 years older, 95% CI -0.8 to 1.4) compared to where the older looking twin died second.


CONCLUSIONS
Facial visual cues but not hair or clothing cues drive the link between perceived age and survival.
Unilever Research and Development, Colworth House, Sharnbrook, Bedfordshire, UK. david.gunn@unilever.com.
David Andrew
DA
Gunn
The Danish Twin Registry and The Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense C, Denmark.
Lisbeth Aagaard
LA
Larsen
Unilever Research and Development, Colworth House, Sharnbrook, Bedfordshire, UK.
Jaspal Singh
JS
Lall
The Danish Twin Registry and The Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense C, Denmark.
Helle
H
Rexbye
The Danish Twin Registry and The Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense C, Denmark.
Kaare
K
Christensen
D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D003718:Denmark / Q000453:epidemiology; D005145:Face; D005149:Facial Expression; D000066499:Facial Recognition; D019066:Facies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010781:Photography / Q000379:methods; D016019:Survival Analysis; D014427:Twins / Q000706:statistics & numerical data
Clothing; Facial aging; Hair; Longevity; Perceived age; Skin.