EHR aging clocks are chiefly risk scores

Many clinical 'biological age' algorithms built from electronic health records mainly recapitulate chronological‑age‑related risk signals and dataset artifacts, so their cross‑sectional accuracy (e.g., AUCs) does not prove they track a causal, modulable aging process. Deploying them as intervention targets or in hospital systems without longitudinal, within‑person validation risks misdirecting care, regulatory decisions, and research funds. — If true, hospitals, regulators, and consumers may be adopting and paying for tools that don't measure a treatable biological process but instead codify age‑and‑cohort risk, with consequences for clinical practice, health equity, and longevity research prioritization.