Duke-EPESE participants with more advanced Klemera–Doubal method (KDM) Biological Age were at increased risk of mortality during follow-up. Graph survival for participants in the lowest (sold line) and highest (dashed line) quintiles of biological age advancement for KDM Biological Age (A), homeostatic dysregulation (B), and Levine method (LM) Biological Age (C). (D) Incident rate ratios (IRRs) from Cox regressions of survival on biological aging quintiles. Effect sizes are reported for a 1-quintile increase in biological age advancement.