BIOLOGICAL AGE QUESTIONNAIRE
or how to evaluate your biological age in twenty questions.

We have all observed the differences that may exist between a person's apparent age and their chronological age (determined beginning from their date of birth). Our chronological age in fact only partially reflects our personal ageing process.

Our biological age therefore defines a real "functional and organic status", a state of form, of balance, of resistance to the environment and to the factors that are present due to the ageing process and that come from it.
 
Our biological age is equally an essential bio-marker that we can use in order to measure the short or medium term effects of potentially effective agents on the ageing process.
 
The measurement of biological age should be a real priority as, currently, doctors who are specialised in ageing have no way of objectively evaluating their actions in the short, medium or long term.
 
In order to find out if your biological age risks being the same, less than or more than your chronological age, complete this test. Careful, this test is merely indicative, only the consultant who is specialised in "anti-ageing medicine and ageing prevention" can tell you this in a more precise manner and give you a prescription which is exactly suited to your personal needs.
 
What is your sex?
Male
Female

What is your level of education?
Primary school
Left school at the age of 16
Left school at the age of 18
University level

Did either of your parents or grandparents live over the age of 75?
Neither of them
One
Two
More than two

In your opinion, is your weight
Good
Too thin
Too heavy
I often go on diets

With relation to your weight 5 years ago, have you lost or gained
- By 5%
6 to 10%
10 to 20%
+ By 20%

In your opinion is your blood pressure
Good
Quite low
Too high
I am receiving treatment for this

Do you regularly practice - at least twice a week - an intensive physical activity (exercise bike, step, rowing machine, and mat exercises…) that make your heart beat more than 100 times a minute for at least twenty minutes?
No
Occasionally
More than twice a week
More than three times a week

Do you smoke?
I have never smoked
I gave up after less than 10 years
Less than 10 cigarettes a day
More than 10 cigarettes a day

NOTE: an average cigar = 3 cigarettes        a pipe = 5 strong cigarettes

Do you drink alcohol (including wine)?
(A glass of wine = two beers, an appetiser = 2 glasses of wine)
Never
Less than one glass per day
From two to three glasses per day
More than three

Do you have memory problems?
Rarely or never
I forget people's first names
I can never find the right word
I only remember far off events

How many pieces of fruit do you eat per day?
None
1
2
More than two

How many varieties of vegetables do you eat per day?
None
1
2
More than two

Do you eat meat?
Never
Once or twice a week
Twice or three times a week
More than three times a week

Do you eat oily fish (tuna, sardines, salmon, herring, or cod…)?
Never
Once a week
Twice a week
Three times a week

Are you emotional, do you cry easily?
Never
Rarely
Often
I have received treatment for this

Have you suffered a stressful event during the past three years?
No
The death of a parent, a trial, loss of employment, or divorce
Two
More than two

Is your sleep satisfactory and relaxing? Determine your reply on a scale from 1 to 10
Less than 3
3 to 5
6 to 7
More than 7

Is your sex life satisfactory? Determine your reply on a scale from 1 to 10
Less than 3
3 to 5
6 to 7
More than 7

SI IF YOU ARE A WOMAN

During your life have you ever had trouble with your menstrual cycle or your periods?
Never
Rarely
Often
Both

Have you ever taken the contraceptive pill?
Never
For less than 5 years
For 5 to 10 years
For over ten years

IF YOU ARE A MAN

Do you experience night-time erections?
Never
Rarely
Twice a week
More than twice a week

Do you experience difficulty urinating during the day or do you feel the need to urinate during the night?
Never
Rarely
Often
I am receiving treatment for this