Mortality is Written on the Face

Abstract

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.

Keywords: Clothing; Facial aging; Hair; Longevity; Perceived age; Skin..

Figure 1.

Representative images of twins in their original photographs (top images) and in their swapped images (bottom images). To analyze face controlling for surrounding, perceived ages from vertically opposite images were compared, whereas to analyze the surrounding controlling for face perceived ages from diagonal opposite images were compared. Lighting in the female images and the angle of presentation of the face to the camera in the male images were the two main varying technical parameters between the images; both male faces (upper images) were flipped horizontal (lower images) to compensate for the varying angle. All twins gave written consent for their images to be published.

Figure 2.

Mean perceived age of all 187 twins in the original images Y^faceY^surr and O^faceO^surr and swapped images Y^faceO^surr and O^faceY^surr; the vertical lines represent the 95% CI. Mean perceived ages in years from left to right were Y^faceY^surr 77.1 (95% CI 76.5–77.6), Y^faceO^surr 77.7 (95% CI 77.0–78.4), O^faceY^surr 78.2 (95% CI 77.6–78.8), and O^faceO^surr 80.6 (95% CI 80.1–81.2).