# Examining the influence of lifestyle variables on the accuracy of skeletal age estimation via the pubic symphysis

## TL;DR

This study explores how lifestyle factors affect the accuracy of estimating age from the pubic symphysis, finding limited influence on skeletal aging.

## Contribution

The study introduces a novel approach using random forest modeling to assess the impact of lifestyle variables on skeletal age estimation.

## Key findings

- Age estimation bias varied by sex when using transition analysis, with males being underaged.
- Body size had a limited and variable influence on skeletal aging according to random forest modeling.
- Inclusion of lifestyle variables did not significantly improve skeletal age estimation accuracy.

## Abstract

This study investigated links between skeletal age estimation error and lifestyle variables to better elucidate sources of interpersonal variability in the rates of skeletal aging. Skeletal age for 180 individuals from the New Mexico Decedent Image Database was estimated by applying the Suchey–Brooks method and transition analysis to 3D models of the pubic symphysis, and age estimates were compared to known age‐at‐death. Age estimation bias and accuracy for both methods were evaluated first with respect to single lifestyle variables, then random forest modeling was used to test variability with respect to all lifestyle variables. Age estimation bias was shown to be significantly different with respect to sex when applying transition analysis, but not when applying Suchey–Brooks, and males tended to be underaged relative to females of the same age. While no statistically significant differences in bias existed for either method between BMI categories, random forest modeling indicated that body size exerts a limited but variable influence on skeletal aging. Additional variables were highlighted as potentially influential to skeletal aging by random forests, such as socioeconomic status, but ultimately, model performance and variable importance plots demonstrated that these influences were slight and nonuniform. These data suggest that including considerations of lifestyle variables in skeletal aging methods would not improve aging estimates.