This study seeks to determine the association between serum uric acid (SUA) and accelerated aging among middle-aged and older adults in China, as well as assess the relationship between SUA trajectories and the risk of accelerated aging.

We utilized data from the China Health and Retirement Longitudinal Study (CHARLS), selecting middle-aged and older participants who completed follow-ups between 2011 and 2015. Biological age was estimated using the Klemera-Doubal method, and accelerated aging was determined by calculating the difference between an individual's biological age and their chronological age. Logistic regression models were employed to analyze the relationship between baseline SUA levels, their trajectories, and accelerated aging, adjusting for potential confounding factors.

A total of 3,520 middle-aged and older participants (average age 59.00 years) were included. The results indicated a significant linear positive correlation between SUA levels and the risk of accelerated aging. Compared to the group with the lowest uric acid levels, those with the highest levels had a markedly increased risk of accelerated aging (OR = 1.5, 95% CI: 1.23–1.83, P < 0.001). Further longitudinal analysis suggested that maintaining low level of SUA associated with a significant reduction in the risk of accelerated aging.

This study indicates that elevated SUA levels constitute a risk factor for accelerated aging in middle-aged and older adults. Maintaining SUA at a low-level help to slow down aging. These findings highlight the importance of monitoring SUA levels in this demographic, providing a scientific basis for developing interventions to delay aging.