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AbstractBrain ageis a widely used index for quantifying individuals’ brain health as deviation from a normative brain aging trajectory. Higher than expectedbrain ageis thought partially to reflect above-average rate of brain aging. We explicitly tested this assumption in two large datasets and found no association between cross-sectionalbrain ageand steeper brain decline measured longitudinally. Rather,brain agein adulthood was associated with early-life influences indexed by birth weight and polygenic scores. The results call for nuanced interpretations of cross-sectional indices of the aging brain and question their validity as markers of ongoing within-person changes of the aging brain. Longitudinal imaging data should be preferred whenever the goal is to understand individual change trajectories of brain and cognition in aging.

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