The study is observational, so causality cannot be established. It is possible that more pronounced increases in biological age are reflected in increased risk for depression/anxiety, or vice versa, or that both are caused by a third factor.
The UK Biobank participants are not representative of the general UK population, tending to be healthier, wealthier, and more likely to be white and middle-aged or older.
Only about 1/3 of enrolled participants participated in the follow-up survey, introducing potential selection bias. This could lead to an underestimate of the true association.
Diagnoses were obtained from hospital records and questionnaires, but many individuals with depression/anxiety do not seek treatment. This could lead to an underestimate of the true prevalence and incidence of these disorders.
Reliance on retrospective reports of childhood adversity in the follow-up survey could be subject to recall bias, limiting the power of this analysis.