Age

Foundation models (FMs) promise to extract unified representations that generalize across downstream tasks. They have emerged across fields, including electroencephalography (EEG), but it is less clear how effective they are in this particular field. Published evaluations differ in datasets, in the EEG-specific preprocessing that might influence reported results, and in the reported metrics, frequently obscuring the clinical relevance in EEG. We introduce NeuroAtlas, the largest EEG benchmark to date: 42 datasets and 260k hours covering clinical EEG (epilepsy, sleep medicine, brain age estimation) and brain-computer interfaces, and include multiple datasets per task along with bespoke clinical evaluation metrics. Besides evaluating EEG-FMs with respect to supervised baselines, we present results from generic time-series FMs. We report three findings. First, EEG-specific FMs do not consistently outperform time-series FMs, which have neither EEG-focused architectures nor been pretrained on EEG. Second, standard machine learning metrics are insufficient to assess clinical utility: thus, we thoroughly evaluate more appropriate measures such as the quality of event-level decision-making, hypnogram-derived features, and the brain-age gap in the domains of epilepsy, sleep, and brain age, respectively. Third, model rankings and performance can vary substantially within domains. We conclude that pretrained models perform largely on par, with only narrow advantages for a few, and that current models do not yet deliver on the promise of an out-of-the-box unified EEG model. NeuroAtlas exposes this gap and provides the datasets and metrics for the next generation of unified EEG FMs.

Epigenetic clocks based on DNA methylation have emerged as powerful tools for estimating biological age, with broad applications in aging research, age-related disease studies, and longevity science. Despite advances across machine learning approaches to epigenetic age prediction, spanning penalised linear regression, deep feedforward networks, residual architectures, and graph neural networks, no existing method jointly models co-methylation graph structure and site-specific DNA sequence context within a unified framework. We propose a unified sequence--graph integration framework for epigenetic age prediction that addresses this gap, integrating eight-dimensional DNA sequence statistical features through a lightweight gated modulation mechanism that adaptively scales each site's methylation signal according to its sequence-determined biological relevance prior to graph convolution. Evaluated on 3,707 blood methylation samples against a comprehensive set of baselines, our method achieves a test MAE of 3.149 years, a 12.8% improvement over the strongest graph-based baseline. Biologically informed statistical features outperform CNN-based sequence encoding, demonstrating that handcrafted sequence features are more effective than end-to-end learned representations in this data regime. Post-hoc interpretability analysis identifies CpG density and local adenine frequency as features with age-dependent importance shifts, consistent with known mechanisms of age-related hypermethylation at CpG-dense promoter regions. Our code is at https://github.com/yaoli2022/graphage-seq.

This work investigates whether knowledge-driven large language model (LLM)-based storytelling can support purposeful narrative interaction with a digital companion for older adults. To address known limitations of LLMs, including hallucinations and limited transparency, we present a reflective storytelling agent integrating knowledge graphs, user modelling, argumentation theory, and argument mining to guide and inspect narrative generation. The study consisted of two phases. Phase I employed participatory design involving 11 domain experts in a formative evaluation that informed iterative refinement. The resulting system generates narratives grounded in structured user models representing health-promoting activities and motivations. Phase II involved 55 older adults evaluating persona-based narratives across four prompts and two creativity levels. Participants assessed perceived purpose, usefulness, cultural relatability, and inconsistencies. The system additionally computed hallucination-risk indicators to evaluate generated narratives. Participants recognised personally relevant purposes in roughly two thirds of narratives, while argument-based purposes were identified in around half of these cases. Cultural recognisability strongly influenced willingness to use the functionality, whereas minor inconsistencies were often tolerated when narratives remained understandable and personally relevant. Narratives with higher hallucination-risk indicators were more often perceived as inconsistent, while higher argument-quality indicators tended to co-occur with higher clarity and meaningfulness ratings. Overall, the study positions argument mining as a reflective inspection mechanism for comparing formal grounding signals with human evaluations in health-oriented LLM storytelling for older adults.

Aging clocks aim to estimate biological age, a measure of physiological state distinct from chronological age, from observable biomarkers, and are widely used for health assessment and disease analysis. DNA methylation is a particularly informative biomarker due to its stability and strong association with aging, and recent learning-based approaches have improved predictive performance. However, most existing methods treat CpG sites as independent features, overlooking the complex and heterogeneous biological relationships among them. We propose RelAge-GNN, a multi-relational graph neural network framework for DNA methylation-based age prediction. Our method constructs three complementary graphs capturing co-methylation patterns, genomic co-localization, and gene-level associations among CpG sites. Each graph is modeled by an independent GNN branch, and a learnable gating mechanism adaptively fuses the resulting representations. Experiments on large-scale datasets show that RelAge-GNN achieves competitive accuracy and stronger correlation with chronological age compared to state-of-the-art methods. Moreover, the model exhibits improved sensitivity in detecting age acceleration across diverse disease cohorts, highlighting its potential utility for disease characterization. Finally, through post hoc interpretability analyses, we quantify the contributions of different relational structures and CpG sites, providing biologically meaningful insights and suggesting potential directions for aging-related research. Our code is available at: https://anonymous.4open.science/r/RelAge-GNN-F1E3/.

A natural intuition about the economics of AI agents is that, because agents can be replicated at very low marginal cost, agent labor may be supplied highly elastically, placing downward pressure on cognitive-labor wages when it closely substitutes for human labor. We argue this framing is wrong in mechanism but partially correct in conclusion, and that the correction matters for both theory and policy. \textbf{Agents are not labor; they are a production technology that converts compute capital $K_c$ into effective units of cognitive labor $L_A$.} Once this is recognized, the elastic-supply margin that anchors the equilibrium wage migrates from the labor market to the compute capital market. Building on the classic factor-pricing framework \citep{mankiw2020}, we derive a \emph{Compute-Anchored Wage} (CAW) bound stating that, on tasks where human and agent-produced cognitive labor are substitutes, the competitive human wage is bounded above by $λ\cdot k \cdot r_c$, where $r_c$ is the rental rate of compute capital, $k$ is the compute intensity of one effective agent-produced cognitive labor unit, and $λ$ is the relative human-to-agent productivity. We generalize the result through constant elasticity of substitution (CES) aggregation, separate substitutable from complementary tasks, and discuss factor-share consequences. The conclusion is concise: \emph{the price-setter for cognitive labor is no longer the labor market.}

Recovering 3D human pose and shape from a single image remains a cornerstone of human-centric vision, yet most methods assume adult subjects and optimize each person independently. These assumptions fail in real-world, all-age scenes, where body proportions and depth must be resolved jointly. We introduce Anny-Fit, a multi-person, camera-space optimization framework for all-age 3D human mesh recovery (HMR). Unlike existing per-person fitting methods, Anny-Fit jointly optimizes all individuals directly in the camera coordinate system, enforcing global spatial consistency. At the core of our approach is the use of multiple forms of expert knowledge -- including metric depth maps, instance segmentation, 2D keypoints, and, VLM-derived semantic attributes such as age and gender -- each obtained from dedicated off-the-shelf networks. These complementary signals jointly guide the optimization, constraining the depth-scale ambiguity characteristic of all-age scenes. Across diverse datasets, Anny-Fit consistently improves 2D reprojection accuracy (+13 to 16), relative depth ordering (+6 to 7), 3D estimation error (-9 to -29) and shape estimation (+25 to +82), producing more coherent scenes. Finally, we show that VLM-based semantic knowledge can be distilled into an HMR model via the pseudo-ground-truth annotations produced by Anny-Fit on training data, enabling it to learn semantically meaningful shape parameters while improving HMR performance. Our approach bridges adult-only and all-age modeling by enabling zero-shot adaptation of adult-trained HMR pipelines to the full age spectrum without retraining. Code is publicly available at https://github.com/naver/anny-fit.

Electrocardiogram (ECG) biometrics have emerged as a promising modality for continuous, liveness-aware authentication in wearable systems. However, many prior studies report overly optimistic results due to data leakage (e.g., random splits within the same session). To address this issue, we introduce ECG-biometrics-bench, a modular, reproducible benchmarking framework that standardizes preprocessing, segmentation, and evaluation across seven widely used public ECG datasets spanning clinical, ambulatory, and large-scale cohort settings. The framework supports both closed-set and open-set (i.e., subject-disjoint generalization in this work) evaluation, as well as progressively realistic protocols including cross-session and long-term temporal separation. To facilitate reproducible research in the community, the ECG-biometrics-bench repository will be made publicly accessible on GitHub upon the acceptance of this manuscript. Through a comprehensive multi-dataset analysis, we expose the Random Split Fallacy, demonstrating that intra-session evaluation protocols artificially inflate performance while masking severe degradation caused by temporal drift and unseen identities. Furthermore, by evaluating multiple architectures, including DeepECG, ResNet1D, and CNN-LSTM, we show that these failures are not model-specific but are likely inherent to current supervised feature-learning paradigms. Finally, we demonstrate that performance degradation due to temporal aging can be partially mitigated through a heavy enrollment, lightweight authentication strategy based on dynamic multi-session template fusion. These findings establish a more realistic baseline for ECG biometrics and highlight critical challenges that must be addressed for reliable real-world deployment.

Older adults living alone have a number of challenges, and robots can help with some of them--by providing reminders, initiating activity, or offering comfort. As part of developing a cat robot with limited assistive functions, we designed a set of nonverbal communication signals, both auditory (cat sounds) and visual (icons on a small display). To evaluate these signals we used a mixed-methods, user-centered approach. After a pilot study, a focus group with older adults suggested revisions to the initial signal set. A large-sample online experiment then tested whether adults over the age of 65 could accurately infer the robot's communicative intentions. When both visual and auditory signals were present, accuracy was high. When visual signals were absent, accuracy often decreased; when auditory signals were absent, accuracy sometimes increased. So the auditory signals were less helpful, except when the robot conveyed strong sentiments (e.g., purring while being petted).

Generative AI (GenAI) is transforming workplaces at a rapid pace. This disproportionately affects vulnerable communities, including older workers (OWs) who re-enter the workforce through bridge employment prior to final retirement. Through in-depth semi-structured interviews with 21 professionals, we examine how OWs navigate GenAI-driven disruptions while pursuing bridge roles, focusing on their concerns about GenAI integration and their responses to these changes. Our findings show that OWs experienced both temporal and structural disruptions across all stages of the bridge employment decision-making process due to GenAI. In response, they reconfigured their tasks through different forms of boundary work aimed at restoring stability and continuity. We conceptualize these responses as AI resilience, which reshaped OWs' bridge employment decision-making into an ongoing process of negotiation and adaptation. We conclude by offering recommendations to reduce burnout among OWs by balancing individual-level AI resilience strategies with meso-level AI resilience collectives and macro-level adversarial and contestable AI-mediated organizational structures.

Large Language Model (LLM)-based agents exhibit systemic failures in compositional generalization, limiting their robustness in interactive environments. This work introduces AGEL-Comp, a neuro-symbolic AI agent architecture designed to address this challenge by grounding actions of the agent. AGEL-Comp integrates three core innovations: (1) a dynamic Causal Program Graph (CPG) as a world model, representing procedural and causal knowledge as a directed hypergraph; (2) an Inductive Logic Programming (ILP) engine that synthesizes new Horn clauses from experiential feedback, grounding symbolic knowledge through interaction; and (3) a hybrid reasoning core where an LLM proposes a set of candidate sub-goals that are verified for logical consistency by a Neural Theorem Prover (NTP). Together, these components operationalize a deduction--abduction learning cycle: enabling the agent to deduce plans and abductively expand its symbolic world model, while a neural adaptation phase keeps its reasoning engine aligned with new knowledge. We propose an evaluation protocol within the \texttt{Retro Quest} simulation environment to probe for compositional generalization scenarios to evaluate our AGEL agent. Our findings clearly indicate the better performance of our AGEL model over pure LLM-based models. Our framework presents a principled path toward agents that build an explicit, interpretable, and compositionally structured understanding of their world.

Falls among older adults are a significant public health concern, leading to severe injuries, loss of independence, and increased healthcare costs. This study evaluates the effectiveness of various models, including a Geometric approach, XGBoost, SVM, and several deep learning architectures, in classifying walker usage, standing vs. sitting, and posture for smart walkers used. Geometric and XGBoost were the top performers. XGBoost achieved near-perfect training accuracy in binary classification tasks, with 99.84% for walker choice and 99.69% for standing vs. sitting. For posture classification, Geometric approach attained 89.9% accuracy for 8 postures, and XGBoost obtained 99.24% during training for 17 postures. Deep learning models such as the 4-layer CNN and Encoder-Decoder CNN also demonstrated strong performance in binary classification, with accuracies above 98%. This study underscores the potential of machine learning to enhance human-robot interaction in smart walkers, particularly for fall prevention.

Disease progression varies with age and is influenced by underlying genetic, biochemical, and hormonal etiologies, suggesting the need for tailored monitoring, care, and medication beyond standard clinical guidelines. Specifically, in autoimmune diseases like type 1 diabetes (T1D), where patients depend on exogenous insulin to compensate for insulin deficiency, medication dosing and the physiological response reflected in vital signs can differ. Insulin therapy can lead to hypoglycemia, a dangerous condition characterized by decreased blood glucose levels ($\leq$70). This risk can be mitigated through improved diabetes management supported by data analytics. Notably, leveraging data from continuous glucose monitoring (CGM) devices, hypoglycemia onset can be predicted. However, while glucose variability, auto-antibody levels, and hypoglycemia occurrence differ across age groups, hypoglycemia classification most often only relies on population-based models specialized in specific age ranges. In this work, we classify hypoglycemia 0, 5-15, 20-45, and 50-120 minutes before onset using DiaData, a large CGM dataset of patients with T1D ranging from children to seniors. In particular, we investigate: 1) the generalizability of a population-based model including all age groups, 2) the impact of age-segmented models trained separately per age group, and 3) the effect of model individualization through transfer learning. The results show that a global population-based model yields similar or superior performance compared to age-segmented models. These findings suggest that data from children, teenagers, and adults can be combined for training models on hypoglycemia classification. While glucose variation differs across age groups, short-term hypoglycemic patterns are similar. However, data of children obtain their best recall with age specialized model.

Machine generation of symbolic music and digital audio are hot topics but there have been relatively few digital musical instruments that integrate generative AI. Present musical AI tools are not artist centred and do not support experimentation or integrating into musical instruments or practices. This work introduces an inexpensive generative AI instrument platform based on a single board computer that connects via MIDI to other musical devices. The platform uses artist-collected datasets with models trained on a regular computer. This paper asks what the design space of intelligent musical instruments might look like when accessible and portable AI systems are available for artistic exploration. I contribute five examples of instruments created and tested through a two-year first-person artistic research process. These show that (re)mapping can replace retraining for discovering AI interaction, that fast input interleaving is a new co-creative strategy, that small-data AI models can be a transportable design resource, and that cheap hardware can lower barriers to inclusion. This work could enable artists to explore new interaction and performance schemes with intelligent musical instruments.

While Central Pattern Generators (CPGs) and Multi-Layer Perceptrons (MLP) are widely used paradigms in robot control, few systematic studies have been performed on the relative merits of large parameter spaces. In contexts where input and output spaces are small and performance is bounded, having more parameters to optimize may actively hinder the learning process instead of empowering it. To empirically measure this, we submit a given robot morphology, with limited proprioceptive capabilities, to controller optimization under two bio-inspired paradigms (CPGs and MLPs) with evolutionary- and reinforcement- trainer protocols. By varying parameter spaces across multiple reward functions, we observe that shallow MLPs and densely connected CPGs result in better performance when compared to deeper MLPs or Actor-Critic architectures. To account for the relationship between said performance and the number of parameters, we introduce a Parameter Impact metric which demonstrates that the additional parameters required by the reinforcement technique do not translate into better performance, thus favouring evolutionary strategies.

The accurate quantification of brain age from MRI has emerged as an important biomarker of brain health. However, existing approaches are often restricted to narrow age ranges and single-modality MRI data, limiting their capacity to capture the coordinated macro- and microstructural changes that unfold across the human lifespan. To address these limitations, we develop a multi-modal brain age framework to characterize the integrated evolution of brain morphology and white matter organization. Our model adopts a two-stage architecture, where modalities are processed independently and integrated via late fusion in both stages: first to estimate a probability distribution over six developmental stages, and then to predict age via probability-weighted stage-specialized experts. Experiments on nine datasets spanning fetal to elderly stages demonstrate competitive in-domain performance and out-of-domain generalization, with our method reducing MAE by 13% and 78% over existing baselines and multi-modal integration yielding 12-13% gains. Analysis of ADNI clinical groups further suggests the potential of the predicted brain age gap to characterize Alzheimer's-related brain aging.

Personal AI assistants are changing how individuals use advice. We study how an advisor should design its recommendation in anticipation of stochastic consultation with personal AI whose recommendation is predictable. Personal AI enters through two dimensions: consultation probability and relative trust, which captures the relative influence personal AI receives when consulted. In the baseline model, the advisor optimally counteracts the personal AI signal. Counteraction increases with consultation probability but is hump-shaped in relative trust. The advisor's minimized loss is hump-shaped in consultation probability, vanishing when personal AI is never or always consulted. Greater relative trust in personal AI increases the irreducible loss arising from stochastic consultation. We extend the analysis to partial predictability and costly recommendation adjustment, characterizing their effects on optimal recommendations and minimized loss. The framework also accommodates richer information structures, including settings in which personal AI is perceived as having access to private information relevant to the task. We introduce an online forecasting experiment that examines how participants obtain personal AI advice and combine it with an advisor's recommendation and their initial judgments. Participants place weight on all three inputs. When access requires an additional action, some participants do not seek personal AI advice, while some others attempt to obtain it without success. Together, these findings highlight two distinct aspects of personal AI use: whether advice is obtained and how much weight it receives when available.

Synthetic faces from text-to-image (T2I) models pervade digital media, yet their demographic biases under emotionally conditioned prompts remain poorly understood. We aim to systematically audit how emotionally conditioned prompts affect demographic and perceived-attractiveness biases in synthetic faces generated by T2I models, with particular attention to intersectional patterns and cross-ecosystem differences across model families. We audited eight (4 Western and 4 Chinese) T2I models and generated 56,000 faces under seven prompt conditions: a neutral baseline and six emotion conditions. We quantified biases in gender, race, age, and perceived attractiveness using information-theoretic divergence metrics. We further conducted intersectional analyses across combined demographic attributes and compared patterns between the Western and Chinese model groups to assess cross-ecosystem consistency and divergence in bias behavior. All models show strong overrepresentation of young faces, and most also overrepresent White-coded individuals. Intersectional analysis reveals compound underrepresentation or near-erasure of specific demographic combinations, such as young x female x Black faces, which are largely absent across models and are not captured by single-attribute audits. Emotion prompts act as additional demographic selectors: negatively valenced emotions (including sadness and fear) consistently shift outputs toward White, middle-aged, male-coded faces. This produces a valence-driven mapping that is also associated with lower perceived attractiveness in generated faces. These findings indicate that demographic bias in T2I face generation is both pervasive and shaped by emotional conditioning. They underscore the need for intersectional, emotion-conditioned, and multilingual demographic audits as part of standard pre-deployment evaluation practices.

Generative AI systems increasingly enable the production of highly realistic synthetic media. Civitai, a popular community-driven platform for AI-generated content, operates a monetized feature called Bounties, which allows users to commission the generation of content in exchange for payment. To examine how this mechanism is used and what content it incentivizes, we conduct a longitudinal analysis of all publicly available bounty requests collected over a 14-month period following the platform's launch. We find that the bounty marketplace is dominated by tools that let users steer AI models toward content they were not trained to generate. At the same time, requests for content that is "Not Safe For Work" are widespread and have increased steadily over time, now comprising a majority of all bounties. Participation in bounty creation is uneven, with 20% of requesters accounting for roughly half of requests. Requests for "deepfake" - media depicting identifiable real individuals - exhibit a higher concentration than other types of bounties. A nontrivial subset of these requests involves explicit deepfakes despite platform policies prohibiting such content. These bounties disproportionately target female celebrities, revealing a pronounced gender asymmetry in social harm. Together, these findings show how monetized, community-driven generative AI platforms can produce gendered harms, raising questions about consent, governance, and enforcement.

Deep learning (DL) has transformed neuroimaging by delivering state-of-the-art performance with reduced computation times. Yet, the numerical uncertainty inherent to DL training remains largely underexplored despite its potential to significantly impact the reliability of model outcomes. We show that training the FastSurfer segmentation model introduces substantial numerical uncertainty that exceeds its non-DL counterpart (FreeSurfer 7.3.2) in cortical regions, potentially impacting downstream clinical results. We also characterize this training-time uncertainty using random seed perturbations and demonstrate that seed-induced variability is structurally comparable to numerical variability. We then show that seed variability can be leveraged as a data augmentation technique through ensembling to improve downstream brain age regression performance. These findings position numerical uncertainty during DL training as a substantive factor in neuroimaging reliability, with measurable consequences for downstream tasks, and demonstrate that it can simultaneously be harnessed as a data augmentation technique.

$\textbf{Objective:}$ Brain-predicted age difference (BrainAGE) is a neuroimaging biomarker reflecting brain health. However, training robust BrainAGE models requires large datasets, often restricted by privacy concerns. This study evaluates the performance of federated learning (FL) for BrainAGE estimation in ischemic stroke patients treated with mechanical thrombectomy, and investigates its association with clinical phenotypes and functional outcomes. $\textbf{Methods:}$ We used FLAIR brain images from 1674 stroke patients across 16 hospital centers. We implemented standard machine learning and deep learning models for BrainAGE estimates under three data management strategies: centralized learning (pooled data), FL (local training at each site), and single-site learning. We reported prediction errors and examined associations between BrainAGE and vascular risk factors (e.g., diabetes mellitus, hypertension, smoking), as well as functional outcomes at three months post-stroke. Logistic regression evaluated BrainAGE's predictive value for these outcomes, adjusting for age, sex, vascular risk factors, stroke severity, time between MRI and arterial puncture, prior intravenous thrombolysis, and recanalisation outcome. $\textbf{Results:}$ While centralized learning yielded the most accurate predictions, FL consistently outperformed single-site models. BrainAGE was significantly higher in patients with diabetes mellitus across all models. Comparisons between patients with good and poor functional outcomes, and multivariate predictions of these outcomes showed the significance of the association between BrainAGE and post-stroke recovery. $\textbf{Conclusion:}$ FL enables accurate age predictions without data centralization. The strong association between BrainAGE, vascular risk factors, and post-stroke recovery highlights its potential for prognostic modeling in stroke care.

We establish a formal connection between the decades-old surrogate outcome model in biostatistics and economics and the emerging field of prediction-powered inference (PPI). The connection treats predictions from pre-trained models, prevalent in the age of AI, as cost-effective surrogates for expensive outcomes. Building on the surrogate outcomes literature, we develop recalibrated prediction-powered inference, a more efficient approach to statistical inference than existing PPI proposals. Our method departs from the existing proposals by using flexible machine learning techniques to learn the optimal ``imputed loss'' through a step we call recalibration. Importantly, the method always improves upon the estimator that relies solely on the data with available true outcomes, even when the optimal imputed loss is estimated imperfectly, and it achieves the smallest asymptotic variance among PPI estimators if the estimate is consistent. Computationally, our optimization objective is convex whenever the loss function that defines the target parameter is convex. We further analyze the benefits of recalibration, both theoretically and numerically, in several common scenarios where machine learning predictions systematically deviate from the outcome of interest. We demonstrate significant gains in effective sample size over existing PPI proposals via three applications leveraging state-of-the-art machine learning/AI models.

BrainAGE is a promising imaging-derived biomarker of neurobiological ageing and disease risk, yet current approaches rely predominantly on T1-weighted structural MRI, overlooking functional vascular changes that may precede tissue damage and cognitive decline. DeepCBV maps, synthesized from non-contrast MRI, offer a scalable alternative to contrast-enhanced perfusion imaging by capturing vascular information relevant to early neurodegeneration. We developed a multimodal BrainAGE framework that combines predictions from two separate three-dimensional convolutional neural networks: one trained only on structural MRI scans and another trained only on DeepCBV maps. Each model was trained and validated on 2851 scans from 13 open-source datasets and was evaluated for concordance with MCI and AD. The combined model achieved the most accurate brain age gap for CN controls, with a mean absolute error of 3.95 years, outperforming models trained on MRI or DeepCBV alone. Saliency maps revealed complementary modality contributions: MRI emphasized white matter and cortical atrophy, while DeepCBV highlighted vascular-rich and periventricular regions implicated in hypoperfusion and early cerebrovascular dysfunction, consistent with known patterns of normal ageing. Next, we observed that BrainAGE increased stepwise across diagnostic strata (CN < MCI < AD) and correlated with cognitive impairment. DeepCBV-based BrainAGE showed a particularly strong separation between stable versus progressive MCI, suggesting sensitivity to prodromal vascular changes that precede overt atrophy. Integrating structural MRI with deep learning-derived vascular measures substantially enhances BrainAGE estimation and improves sensitivity to MCI and AD progression, supporting its potential role in risk stratification, early detection and monitoring of therapeutic response.