bioRxiv · Jul 27, 2026
Estimation of biological age using HRV data: comparison of the Klemera-Dubal method with the multiple linear regression method
By Pisaruk A
Abstract The aim of this study was to compare three methods for estimating biological age (BA) based on heart rate variability (HRV) indices recorded in the supine position: multiple linear regression (MLR), MLR corrected for regression-to-the-mean bias using the Dubina method (1984), and the Klemera-Doubal Method (KDM, 2006). A total of 343 subjects were examined (193 women and 150 men aged 20-90 years); nine time- and frequency-domain HRV indices were analyzed (NN, lnSDNN, lnRMSSD, lnVLF, lnLF, lnHF, VLF%, LF%, HF%). The association between HRV indices and chronological age was substantially in women and men (p<0.01). KDM produced the lowest estimation error (MAE=4.34 years in women, 3.67 years in men), whereas uncorrected MLR produced the largest error (MAE=6.57 and 7.47 years, respectively); the Dubina correction substantially improved MLR accuracy (MAE=4.22 and 4.82 years) but relied directly on actual chronological age, which limits its independent diagnostic value. The strengths and limitations of each method and recommendations for their application are discussed.