Forensic Science International 223 (2012) 374.e1–374.

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Forensic Anthropology Population Data

Skeletal age estimation in Hungarian population of known age and sex

K. Wolff a,*, Z. Vas b,c, P. So´ tonyi a, L.G. Magyar a
a
Department of Forensic and Insurance Medicine, Semmelweis University, U¨llo˝i str. 93, 1091 Budapest, Hungary
b
Department of Biomathematics and Informatics, Faculty of Veterinary Sciences, Szent Istva´n University, Istva´n str. 2, 1078 Budapest, Hungary
c
Hungarian Natural History Museum, Ludovika te´r 2, 1083 Budapest, Hungary

A R T I C L E I N F O A B S T R A C
T
Article history:
Received 18 December 2011 Several methods of estimating age on the basis of human skeletal remains are used all over the world, methods that were
Received in revised form 18 May 2012 established using known age and sex databases or during medicolegal autopsies. Over the course of the past several
Accepted 22 August 2012 decades, many tests have been carried out on various populations to confirm the applicability of these methods in age
Available online 10 September 2012 assessment. While the opinions of experts vary regarding the cranial suture closure techniques, morphology of the
sternal end of the fourth rib has been proven to be more accurate as an age assessor. The purpose of this paper is to test
Keywords: the reliability of three age estimation methods on a Central European population. Observation of ecto- and endocranial
Skeletal ageing suture closure after Meindl and Lovejoy and Acsa´ di and Nemeske´ ri (239 individuals in the case of Meindl and Lovejoy
Suture closure and 238 in the case of Acsa´ di and Nemeske´ ri) and morphology of the sternal ends of the third, fourth and fifth ribs
Rib phase analysis in accordance with Is¸ can (116 individuals) was done on a Hungarian sample of known sex and age at death
Hungarian sample at autopsy procedures. According to the observations, (1) the state of ectocranial suture closure was so erratic that
it was not useful in age assessment, (2) obliteration phases of the endocranial sutures yield only a rough estimation, and
(3) age determination from sternal ends of the ribs was the most reliable, especially with the application of slightly
expanded age intervals on the Hungarian population.
2012 Elsevier Ireland Ltd. All rights reserved.

1. Introduction
The age of a person at the time of death is one of the most
important questions that has to be answered in forensic investigations.
Usually there is some information about the decedent, including name,
age, marital status and time of death. But in some cases anthropologists and
forensic physicians face the challenge of identifying unidentified corpses
and skeletons. In addition to determining circumstances such as time of death
and cause of death, it is important to give detailed and accurate
information about the decedent. One of the main questions that has to
be answered is the biological age of the corpse or skeleton.
The roots of the methods for estimating the age of a decedent stretch back
several decades, beginning with macroscopic, mor- phological methods.
In the beginning, observation of the closure of cranial sutures [1,2] and the
morphological changes in the pubic symphysis [3,4] were the primary tools
of skeletal age estimation. In the second half of the 20th century several
new methods were adopted, such as age estimation on the basis of the rib
[5,6], and older methods were developed and tested for accuracy in age
estimation to further historical research [7–18]. Nowadays, due to advanced
molecular technologies, many more precise methods are available to experts
in forensic laboratories for age estimation. These methods are especially
useful in forensic cases. Many authors suggest applying these more
accurate laboratory methods [19,20], such as techniques based on aspartic
acid racemization [21,22], in order to determine the age of a decedent, but
difficulties arise with the standardization of the conditions. While
recommendations have been made as to how to solve the problems in quality
control [23], these difficulties nonetheless continue to constitute one of
the reasons why methods combining morphological indicators are still in
prominent use in age assessment. On the other hand, many additional
factors, such as the available time, the geographical situation, the
financial background, the justice system, the capabilities of molecular
laboratories and experts, and the number of the cases in a given year, can
be influential as well. Until the facilities change, it will continue to be
necessary or at least advisable to test methods on the local population.
The aim of this study therefore was to ascertain the adequacy of the testing
methods when applied to the Hungarian population.
1.1. Cranial suture closure

Although as a method cranial suture closure has been used in age

* Corresponding author. Tel.: +36 204814473.
estimation for probably the longest time, its reliability was always a
E-mail address: wolffkatalin@gmail.com (K. Wolff). matter of dispute. Methods have been developed on the

0379-0738/$ – see front matter 2012 Elsevier Ireland Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.forsciint.2012.08.033
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basis of both endo- and ectocranial suture fusion. Albeit endocranial
union seemed to show closer correlation with age according to some
authors [1,24], it can be used only in wide age ranges [24,25], and
observation of all the sutures in the case of whole, undamaged skulls is
almost impossible [24,26]. Meindl and Lovejoy affirm that their ectocranial
suture closure technique is more appropriate, especially in older individuals
[13]. According to an alternate view, both ecto- and endocranial sites should
be used, though different parts should be used in the cases of younger
(<50 years) and older (>50 years) individuals because they can show
different obliteration patterns [14]. In addition to age estimation
based only on cranial suture closure, the complex method of Acsa´ di and
Nemeske´ ri uses endocranial suture closure as one of the combined four
indicators [25], and Lovejoy et al. uses ectocranial obliteration as one of the
five [11]. Despite the fact that the founders of these practices recommend
their methods for general use in age estimation, several authors have
questioned their reliability on the basis of empirical experience. Independent
tests on known sex and age populations found considerable variances
in different populations. Some researchers found relevant sexual
dimorphism in the rate of suture closure [24,26–
28], while others observed no differences between genders
[2,14,25,29]. These findings suggest relevant inter-population difference
in the pattern of suture obliteration, and it is therefore understandable that
some practitioners in the field claim that it is an unreliable method of
determining the age of the cranium [26–
28,30–32]. Although lack of high efficiency was often cited as a
shortcoming, some researchers suggest that the problem with most
existing methods is that they use mean closure scores instead of using
individual suture parts (a method that seems to correlate more with the
biological age), and methods should be updated and used together with other
ageing methodologies [24]. Above all, some authors expect correlation
between suture fusion and increasing masticatory strain with age, and
they conjecture that such mechanical factors can also have an effect,
especially on ectocranial suture closure [30]. Despite the many studies
and findings on the behaviour of cranial sutures, their real nature is still
unknown, and further investigations, even in the field of genetics, are required
in order to arrive at a better understanding.
1.2. The rib phase method
Is¸ can et al. has introduced a sex specific age estimation technique using
the sternal extremity of the fourth rib [5,6] based on earlier observations that
indicated that rib ends changed their shape due to the process of ageing
[33,34]. In further publications they tested the reliability of the system and
found negligible inter-observer error and good effectiveness in application
[7]. They found significant differences between whites and blacks [35],
while others ascertained no significant differences in the case of
conclusions reached regarding the ages of black male decedents in the
accuracy of the rib phase method established on white males [16]. In
subsequent decades many other researchers carried out independent tests of
the method and found it to be accurate in the case of other populations [36–
38]. Although the method was based on metamorphic changes in the
costochondral joints of the fourth rib from the right side, authors
hypothesized [5,6] and later research supported that ribs 3 and 5 would be
applicable for age determination as well [38,39]. As earlier studies suggested,
the method seems to be accurate both in the case of other populations and on
the left and right sides [36,38], although some observers found differences in
the application of the contralateral second and third ribs [38]. Despite
inter-population variations, most of the independent tests found the rib phase
method useful in as a method of age estimation. On the other hand, critical
studies have been published that suggest that the reproducibility and
repeatability of the technique is poor, and recommend the
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improvement of the method, both from the perspective of its statistical
reliability and its application in practice [40].
2. Materials and methods
Three methods were tested in the autopsy room of the Department of Forensic and
Insurance Medicine at the Faculty of Medicine, Semmelweis University, Budapest.
Methods were chosen despite the fact that some of them – especially those based on
cranial suture closure – have been continuously criticized, methods that are still routinely
used in the everyday work in both historical and forensic anthropological investigations
in Hungary.
After having obtained the permission of the local ethical committee, practi- tioners
proceeded with examination of the ossification of internal and external sutures on
skulls and the alterations of sternal ends of the third, fourth and fifth ribs from the left side
decedents of a known sex and age.
To avoid inter-observer error, all age assessments were taken by the first author. All
the crania were scored twice on the day of the autopsy, first during the autopsy procedures
and then a few hours later, using photo-documentations. After a couple of months a third
examination was done according to the photo-documentations before evaluation of the
results. Ribs were scored immediately after having been cleaned and dried, and once
again several months later after the autopsy. No significant intra-observer error was
found, neither in cranial suture closure, nor in the rib phase ageing method (paired t-test;
p > 0.05).
2.1. Cranial suture closure
In case of the skulls, after practitioners had opened the cranium during the
autopsy procedures, the bone was cleaned around the sutures inside and outside and photo
documentation was made of the closure status of the observed sutures. The ossification
of the cranial sutures was ascertained both ectocranially in 239 adult individuals and
endocranially in 238. In one case observation could not be performed because the soft
tissues adhered to the endocranial surface so strongly that the sutures were not adequately
observable for assessment. Ectocranial suture closure was scored according to Meindl and
Lovejoy’s vault system [28]. In the case of each individual seven vault landmarks were
scored in a scale from 0 to 3 –
0 = completely open, 1 = 1–50% fusion, 2 = 51–99% fusion, 3 = complete fusion –
based on the amount of the obliteration. These scores were summed for each
cranium, producing a final score from 0 to 21. On bilateral suture sites, where
closures were in different phases, scores were averaged for further calculations.
Endocranially the scale of ossification was scored according to Acsa´di and
Nemeske´ri [8,25]. The following scores were used in this article: 1 = opened,
2 = incipient closure, 3 = closure in process, 4 = advanced closure, 5 = closed. These scores
are based on the classification presented by Martin and Saller [41]. Mean closure scores
were calculated from 16 endocranial suture sites. Cadavers with further trauma or
pathological changes, where the observation or the fusion of the sutures could have been
influenced, were not included in the investigation.
2.2. The rib phase method
According to Is¸ can et al. [5,6], the sternal ends of the ribs were collected and
observed from 118 adult individuals autopsied at the Department of Forensic and
Insurance Medicine. In addition to the forth, the third and fifth ribs were removed from
the left side. The decision was made to collect the neighbouring ribs and consider
their applicability in age assessment as well, since in some cases it is hard or even
impossible to identify the forth rib when the skeleton is incomplete or damaged due
to post-mortem human or soil activities, or investigative procedures. The ribs were
separated first from most of the adherent soft tissues during the autopsy. They were
then soaked in water for several weeks. During the putrification, the rib ends were cleaned,
sometimes under flowing water with a brush. At the end of the procedure they were
boiled cautiously for an hour and disinfected in a hydrogen peroxide bath. All soft
tissues were then removed, including the costal cartilage. Sometimes, in the case of older
decedents, it was not possible to separate the entire cartilage, because it had become too
hard due to calcification. According to the authors, females show different morphological
changes during their lifetime [6], thus slightly different application was developed for men
and women. On the basis of these findings, analyses were carried out separately for both
sexes.
Actual ages were furnished by the police and were not known during the age estimation
procedures. All individuals under investigation were Hungarian citizens, and the
information concerning their identities was accurate. R statistical software [42,43] was
used for data analysis. The distributional assumptions of the test were checked graphically
(e.g. quantile comparison plot).
Care was taken to be as gentle as possible when handling the corpses.
3. Results
3.1. Ectocranial suture closure
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Table 1 shows the age distributions of the samples where the ectocranial
suture closures were observed. The age intervals are
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Table 1 Table 3 shows the average inaccuracy and bias for cranial suture closing
Age distribution of specimens in ectocranial and endocranial suture closure by age groups. Bias shows that the method overages adults under 30 years of
observation (in one case the endocranial examination was not possible).
age and underages them when they are over
Age intervals Males (N) Females (N) 40 years of age. Age estimation was most accurate between 31 and
40 years of age (n = 19). Inaccuracy ranged from as low as 4.35 to as high as
17–30 18 (11.7%) 7 (8.2%)
31–40 15 (9.7%) 4 (4.7%) 45.57 years for the oldest individuals. The technique had large fluctuations
41–50 19 (12.3%) 4 (4.7%) in its accuracy for age estimation, and after
51–60 30 (19.5%) 20 (23.5%) 50 years of age it seemed unusable, contrary to the recommenda- tions of
61–70 29/28 (18.8%/18.3%) 13 (15.3%) Meindl and Lovejoy [13]. Altogether, only in the case of 74 of the total 239
71–80 24 (15.6%) 16 (18.8%) individuals was the chronological age clearly predictable, which means
81–100 19 (12.3%) 21 (24.7%)
only 30.96% efficiency in age estimation. Taking into consideration the fact
Total 154/153 (100.0%) 85 (100.0%) that the age intervals of the method are too large and overlapping,
the results are not sufficiently precise to be applicable.
Age range 18–91 17–97

3.2. Endocranial suture closure

well represented in males, but in females under the age of 50 the
representation is lower. The age distribution of men was more even than
that of women, especially between ages 30 and 90, which may be the
result of the random collection of the sample over the course of several
months. Table 2 shows the main descriptive statistics and 95% confidence
intervals of the mean age for all phases in the Hungarian sample. The original
data on which the Meindl and Lovejoy vault technique was based are
represented in Table 2 as well. Mean age did not increase with the progression
of the phases, and 95% confidence intervals overlap greatly.
Sometimes one phase interval concurs completely another. Although
the variability was extremely high in all former phases, phase 4 exhibits the
greatest variability. Standard deviations are always above 10, and 95%
confidence intervals are greater than
30 years in almost every phase. Considerable differences between the
original data reported by Meindl and Lovejoy and the Hungarian
data were found. Standard deviations in almost all the phases and mean
ages in every phase are much higher in the Hungarians samples. Only some
similarities at the minimum age in the age ranges between phase 2 to phase 6
was observable.
Kendall’s rank correlation was used to test the expected
correlation between the known age and the extent of obliteration and to
estimate the variance in age explained by obliteration. As we expected, a
significant positive correlation (N = 239; p < 000.1) was found. However,
the correlation coefficient was quite low (tau = 0.21). Additionally, the
slope of this regression line did not differ significantly between the sexes (p
= 0.150) in a linear model, hence the two sexes could be pooled together
to obtain a larger sample for statistical analysis.
According to the 95% confidence intervals, in Fig. 1 one sees that age
distributions did not always differ between neighbour stages. Sometimes the
overlap was remarkable, and there was a marked decline twice between the
following phases. Using a one-way ANOVA model and Tukey’s post
hoc pairwise tests, significant differences were found in the mean age
of the phases (N = 239; p < 0.0001), but significant differences in the
neighbouring stages were found only between phase 2 (p2) and phase 3
(p3) (p < 0.001). No significant difference was found in separated men’s and
women’s samples.
Table 1 shows the sample distributions by age intervals for
endocranial suture closure observation. The samples and the proportion
of sexes were almost the same as in the ectocranial suture closure
examination, thus the re-discussion of these parts was abandoned. Table 4
shows the main descriptive statistics and
95% confidence intervals of the mean age for phases 1–5 and the original data
based on the Acsa´ di and Nemeske´ ri system. Mean ages increased with the
following phases, but this increase was not consistent. Sometimes a greater
increase was followed by two, more overlapping stages. Standard deviations
were between 14 and 17 and 95% confidence intervals were higher than
four decades in every phase. Age ranges were wider and mean ages
were slightly higher in this study than those found by Acsa´ di and Nemeske´
ri.
95% Confidence intervals and Fig. 1 show that age distribution stages are
overlapping, but there was a slight increase in the subsequent phases.
Significant positive correlation (N = 238; p < 0.0001) was also found
here between the real age and the extent of obliteration using Kendall’s
rank correlation, with a higher correlation coefficient (tau = 0.435). The
slope of the regression lines did not differ significantly between
sexes (p = 0.802) in a linear model, thus the two sexes could be treated
together, allowing for larger samples for statistical analysis.
One-way ANOVA model and Tukey’s post hoc pairwise tests showed
significant differences in mean age of the phases (N = 238; p < 0.0001), and
significant differences were found between the first (p1) and second (p2)
phases (p = 0.0066), the third (p3) and fourth (p4) phases (p = 0.02) and
the fourth (p4) and fifth (p5) phases (p = 0.03). Significant differences
were not found in separated men’s and women’s samples.
In Table 3 bias demonstrates the same pattern that was found in the Meindl
and Lovejoy technique with a slight difference. The ages of the individuals
were overestimated in the cases of decedents who were under 50 years
of age and underestimated in the cases of decedents who were over 51
years of age. Inaccuracy in endocranial closure phases was around 10 years
for all phases in

Table 2
Descriptive statistics in ectocranial suture closure observation.

Meindl and Lovejoy vault system (N = 236) Hungarian sample (N = 239)

Phase Closure score N Mean age S.D. Range N Mean age S.D. Median 95% Confidence interval Range

1 0 24 NA NA –49 5 38.20 14.31 40.0 21.6–55.1 21–56

2 1–2 12 30.5 9.6 18–45 19 34.84 18.96 29.0 17.5–73.1 17–74
3 3–6 30 34.7 7.8 22–48 90 60.17 17.39 60.0 26.9–86.0 22–91
4 7–11 50 39.4 9.1 24–60 72 62.04 17.01 63.5 23.8–90.8 23–97
5 12–15 50 45.2 12.6 24–75 30 69.83 18.12 71.5 34.7–91.0 26–91
6 16–18 31 48.8 10.5 30–71 16 70.13 20.49 78.0 36.8–91.9 33–93
7 19–20 26 51.5 12.6 23–76 6 54.83 11.62 56.5 42.0–69.8 42–71
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8 21 13 NA NA 40– 1 61.00 NA 61.0 NA NA

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Fig. 1. Age distributions according to phases in ectocranial and endocranial suture closure examination and in rib phase method in both sexes and all the ribs.
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Table 3 3.3. Rib ageing technique

Bias and inaccuracy in ectocranial and endocranial suture closure age estimation. Age

intervals Ectocranial Endocranial Table 5 presents the sample distribution of the age intervals, where
the sternal ends of the ribs were observed. All age intervals are represented in
17–30
males, but some of them are underrepresented in females, and there are
Bias 8.95 10.88
Inaccuracy 8.99 11.60 more than twice as many male than female subjects. In addition to the
31–40 fourth rib, the third and fifth ribs were collected, though sometimes there was
Bias 0.26 6.00 a lack of some ribs (especially the fifth) due to the autopsy procedure, or
Inaccuracy 4.35 8.32 later due to the preparation. This resulted in a greater number of third
41–50 and fourth ribs.
Bias 6.07 5.39
The following tables (Tables 6–8) show the occurrence for phases 1–
Inaccuracy 8.53 12.70
7 and descriptive statistics for the three ribs in both sexes. Only seven
51–60
Bias 17.20 4.24 phases were used in this article. The first ones were above 16 years in women
Inaccuracy 17.20 12.16 and 20 years in men, because there were no younger individuals in the
61–70 research.
Bias 25.74 7.29 Despite the low numbers of occurrence in younger individuals, there was
Inaccuracy 26.21 11.59 a continuous increase in mean ages in males in all ribs with a range of
71–80
approximately 22–73 years, whereas with increasing ages, phases’ 95%
Bias 36.96 15.00
confidence intervals overlap with each other even more, but did not overlap
Inaccuracy 36.96 15.00
81–100 as much as they did in cranial suture closure. In females the low
Bias 45.57 23.63 appearance in earlier phases and especially in rib III and IV (the fifth rib was
Inaccuracy 45.57 23.63 not available in this case), reversed the first two age groups and disturbed the
gradual increase of the mean ages, in part because in the case of one
individual the real age was in fact much higher than the estimated age.
the cases of decedents under 71 years of age, but it then increased and reached Unfortunately the lower number of female subjects
23.63 years for the oldest. Altogether, the method was suitable for a rough
prediction of age at time of death in 172 of the total 238 individuals (72.27%).

Table 4
Descriptive statistics in endocranial suture closure observation.

Phase Acsa´di and Nemeske´ri system (N = 285) Hungarian sample (N = 238)

Closure score N Mean age S.D. Range N Mean age S.D. Median 95% Confidence interval Range

1 0.4–1.5 16 28.6 13.1 15–40 24 33.04 14.72 29.0 19.2–65.0 18–73

2 1.6–2.5 29 43.7 14.5 30–60 21 49.05 16.33 48.0 21.0–76.5 18–80
3 2.6–2.9 17 49.1 16.4 35–65 42 53.17 16.35 52.5 27.1–81.0 17–84
4 3.0–3.9 162 60.0 13.2 45–75 57 62.88 16.60 63.0 29.6–89.6 23–91
5 4.0 61 65.4 14.1 50–80 94 70.56 15.02 72.0 41.3–92.4 24–97

Table 5
Age distribution of specimens in age assessment from the sternal ends of the ribs.

Age intervals in ribs Males Females Males Females Males Females

Rib III Rib IV Rib V

20–30 10 (11.9%) 6 (18.8%) 9 (11.0%) 6 (20.0%) 9 (12.7%) 5 (20.0%)

31–40 9 (10.7%) 0 (0.0%) 9 (11.0%) 0 (0.0%) 9 (12.7%) 0 (0.0%)
41–50 14 (16.7%) 6 (18.8%) 14 (17.1%) 6 (20.0%) 11 (15.5%) 5 (20.0%)
51–60 14 (16.6%) 5 (15.6%) 14 (17.1%) 4 (13.3%) 13 (18.3%) 3 (12.0%)
61–70 17 (20.2%) 6 (18.8%) 17 (20.7%) 6 (20.0%) 14 (19.7%) 6 (24.0%)
71–80 16 (19.0%) 5 (15.6%) 16 (19.5%) 4 (13.3%) 12 (16.9%) 3 (12.0%)
81–100 4 (4.8%) 4 (12.5%) 3 (3.7%) 4 (13.3%) 3 (4.2%) 3 (12.0%)

Total 84 (100.0%) 32 (100.0%) 82 (100.0%) 30 (100.0%) 71 (100.0%) 25 (100.0%)

Age range (years) 22–91 20–89 22–91 20–89 22–91 20–89

Table 6
Descriptive statistics for males and females in age assessment from the sternal ends of the third rib.

Phase rib III Males (N = 84) Females (N = 30)

N Mean age S.D. Median 95% Confidence interval N Mean age S.D. Median 95% Confidence interval

1 0 2 25.0 7.07 25.0 20.3–29.8

2 3 23.0 1.00 23.0 22.1–24.0
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3 3 27.7 4.93 30.0 22.4–31.0 3 25.7 1.53 26.0 24.1–27.0

4 11 34.3 6.02 35.0 26.0–43.0 4 53.5 10.72 50.0 45.2–67.7
5 26 50.5 10.47 51.0 29.3–71.5 12 54.4 15.95 52.0 32.1–81.7
6 20 66.2 11.26 66.0 44.4–85.8 4 68.8 2.50 68.5 66.2–71.8
7 21 71.9 10.06 73.0 52.0–87.5 7 77.3 8.85 78.0 65.9–88.7
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Table 7
Descriptive statistics for males and females in age assessment from the sternal ends of the fourth rib.

Phase rib IV Males (N = 82) Females (N = 30)

N Mean age S.D. Median 95% Confidence interval N Mean age S.D. Median 95% Confidence interval

1 1 22.0 NA 22.0 2 25.0 7.07 25.0 20.3–29.8

2 3 23.0 1.00 23.0 22.1–24.0 1 24.0 NA 24.0
3 2 28.5 3.54 28.5 26.1–30.9 2 26.5 0.71 26.5 26.0–27.0
4 11 38.6 12.89 35.0 27.0–66.5 3 55.3 12.3 52.0 45.4–68.2
5 27 50.2 9.40 52.0 29.5–64.2 12 53.8 16.04 49.5 32.1–81.7
6 20 67.5 11.31 66.0 44.4–85.8 2 69.0 4.24 69.0 66.2–71.9
7 18 71.3 9.88 72.5 51.1–86.6 8 75.9 9.02 74.5 65.5–88.7

Table 8
Descriptive statistics for males and females in age assessment from the sternal ends of the fifth rib.

Phase rib V Males (N = 71) Females (N = 25)

N Mean age S.D. Median 95% Confidence interval N Mean age S.D. Median 95% Confidence interval

1 1 22.0 NA 22.0 1 20.0 NA 20.0

2 3 23.0 1.00 23.0 22.1–24.0 2 25.0 1.41 25.0 24.1–26.0
3 2 28.5 3.54 28.5 26.1–30.9 1 27.0 NA 27.0
4 12 39.5 12.65 37.0 27.1–67.1 5 55.0 20.68 52.0 29.7–79.8
5 25 51.5 11.23 53.0 29.0–72.8 7 52.6 13.45 48.0 43.2–77.7
6 17 67.7 9.96 66.0 51.2–86.6 3 69.0 3.00 69.0 66.2–71.9
7 11 73.3 11.55 77.0 50.8–88.0 6 74.8 9.11 73.5 65.4–87.9

Table 9 Furthermore paired-samples Wilcoxon tests were performed to search for

Levels of significance and correlation coefficients in real age and age assessment from the significant differences among assessed phase scores in an individual’s
sternal ends of ribs using Kendall’s rank correlation.
different ribs. Significant differences were found between the observed
Kendall’s rank correlation between age and phases in rib III and rib V (p = 0.005) and rib IV and rib V (p = 0.02), caused
phases by the differences in males, while in females no significant difference between
p-Value Tau
the ribs was observed. In the case of the male individuals, all rib III and IV (p
= 0.006), rib III and rib V (p = 0.0004) and rib IV and rib V (p = 0.04)
Males
differed significantly from one another.
Third rib p < 0.001 0.695
Average bias and inaccuracy for all age groups can be seen in Table 11.
Fourth rib p < 0.001 0.641
Fifth rib p < 0.001 0.674 In males, especially for rib V bias shows that the ageing method overages
Females individuals under 50 years of age and under- estimates the ages of
Third rib p < 0.001 0.624 individuals over 50. The highest inaccuracy ranged from 5 to 14.97 years for
Fourth rib p < 0.001 0.605 rib IV. In females similar patterns were not observable. Females showed
Fifth rib p < 0.01 0.584 greater variability then males. Inaccuracy ranged from 4.2 to 25.83 years
for rib V, and some examples indicated 0.42 bias but 16.75 years inaccuracy
for rib IV. This variability can be explained by the lower proportion of women
and quite high extents of standard deviations prevent us from being able and their greater individual variation, affected by such different factors
to offer any substantial conclusions. Fig. 1 shows age distributions for as diet, stress and hormonal changes over the course of life. Altogether,
each phase in each rib and sex. the age was predictable in men in 54.8% in the case of the third rib, 54.9% in
Table 9 presents Kendall’s rank correlations and Table 10 shows the one- the case of the fourth and 53.5% in the case of the fifth rib. The results in
way ANOVA and Tukey’s post hoc pairwise test results in the rib ageing women were 65.6% in case of the third rib, 58.6% in the case of the fourth
method. Highest correlations between age and phases were found in the and 57.7% in the case of the fifth.
case of the third ribs in both sexes, while in the case of men even the fifth rib The accuracy of the method was examined if the original age intervals of
had better rates than the fourth (Table 9). Significant differences were found the Is¸ can’s phase method were expanded by 3 and
among men between phase 4 (p4) and phase 5 (p5) and between phase 5 (p5) 5 years. Age intervals are always extended in forensic expert
and phase
6 (p6) in all ribs, while among woman such differences were found only once,
between phases 3 (p3) and 4 (p4) in the third rib, which can be seen in Table
10.

Table 10
Level of significance in the following phases using a one-way ANOVA model and Tukey’s post hoc pairwise tests.

Significancy level Significant differences in the neighbouring phases

p1–p2 p2–p3 p3–p4 p4–p5 p5–p6 p6–p7

Males
Rib III p < 000.1 p = 0.0002 p < 0.0001
Rib IV p < 000.1 p = 0.0329 p < 0.001
Rib V p < 000.1 p = 0.0349 p < 0.001
Females
Rib III p < 000.1 p = 0.0486
Rib IV p < 000.1
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Rib V p < 00.1

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Table 11 Nemeske´ ri [25], Todd and Lyon [1,2] and Hrdlicka [29], no
Bias and inaccuracy of third, fourth and fifth rib ageing. significant differences between the two genders were found in the Hungarian
Age intervals in ribs Rib III Rib IV Rib V sample in the case of both ecto- and endocranially sutures. On the
contrary, Key maintained remarkable sexual dimorphism in the degree
Males Females Males Females Males Females
of ectocranial closure stages during her work on the Spitalfields sample in
20–30 London [24], and like the latter author, in observations of Indian individuals,
Bias 7.90 2.42 7.11 1.42 7.11 0.80 Sahni et al. showed sexual differences in cranial suture obliteration patterns
Inaccuracy 8.10 7.42 7.22 7.08 7.22 4.20
[26]. In the observation of ectocranial sutures, Key’s experiences were
31–40
Bias 3.11 3.11 3.11
similar to the observations of the Hungarian population. Some people’s
Inaccuracy 5.00 5.00 5.00 sutures close quite early in their young adulthood, and some live long
41–50 lives with completely open sutures [24]. Sahni et al. found analogous cases,
Bias 5.89 1.67 5.89 3.50 4.82 2.90 both ecto- and endocranial, in northwest Indian males [26]. The Spitalfields
Inaccuracy 7.11 6.33 7.11 5.33 8.27 5.10 sample showed an increasing trend in mean age, but Key found
51–60 significant differences only between stage 1 and stage 6 (here: phases 2
Bias 2.21 5.10 3.64 5.00 5.77 5.17
and 7), and no significant difference in the neighbouring stages [24],
Inaccuracy 6.21 5.10 7.07 5.00 5.77 5.17
61–70
which concurs with what was found in the Hungarian sample between phases
Bias 2.06 6.08 1.24 0.42 3.29 2.83 2 and 3. Endocranially, similar to the Hungarian data, Key did not find
Inaccuracy 11.12 12.58 8.06 16.75 7.86 14.33 significant differences in the rate of obliteration between males and
71–80 females, and showed correlation between mean ages and suture closure
Bias 5.06 6.20 7.22 4.38 8.54 1.33 [24]. In the Spitalfields sample, only a poor relationship between known
Inaccuracy 13.06 9.00 14.97 7.88 14.54 6.00 age and closure score was found, and the authors came to the same
81–100
conclusion as the authors in this paper, namely that the Acsa´ di–Nemeske´
Bias 10.75 17.25 13.33 17.25 13.33 25.83
Inaccuracy 10.75 17.25 13.33 17.25 13.33 25.83
ri system is not useless in age estimation, but it can be used only to predict
very broad and overlapping age stages [24]. Contrary to Spitalfields

Table 12
Rates of correct age assessments using the sternal ends of the ribs for age
estimation.

Original Original Original Original data, ossification of the sutures was more delayed, and no significant
3 years 5 years 5 if age 50 years; difference was found between the three main observed sutures endocranially
+5 if age >50 years
in Hungarians. Key showed that most of the
Males individuals had closed coronal and sagittal sutures at the age of 30–

Rib III 54.8% 73.8% 79.8% 76.2%

Rib IV 54.9% 74.4% 79.3%
76.8% Rib V 53.5% 73.2% 78.9%
In agreement with Perizonius [14] who studied suture closure on a Dutch
77.5% collection from Amsterdam, and others like Acsa´ di and
Females
Rib III 65.6% 75.0% 78.1%
Rib IV 58.6% 72.4% 75.9%
Rib V 57.7% 76.9% 84.6%

opinions, especially when only few methods can be used or the results are
controversial in age assessment. With these modifications, correct age estimation
was found in far more cases (Table 12). There was an increase of at least 34% in
men and 14% in women. According to the results, in general the method
overages the males under 50 years and underages males over 51 years of age.
This means that a good assessment rate can be reached in men, with the
expansion of the age intervals, under 50 years with 5 years and over 50
with +5 years (Table 12). After these corrections, accuracy reaches rates of
76.2%,
76.8% and 77.5% in rib III, IV and V. Similar patterns were not observable
in women.

4. Discussion

Several studies in the last hundred years have been undertaken in the
service of determining the age at death of skeletonized individuals.
Meanwhile in the application of most of the methods all over the world,
inter-population differences have been revealed. The purpose of this
study was to verify some age determination methods that are routinely
used in everyday observation of human skeletal remains in Hungary.
Furthermore, results have been compared with other experts’ observations
in this section.

4.1. Cranial suture closure

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35 years, and completed lambdoid closure by 50 years of age [24]. In the case
of the Hungarian decedents, total closures began only after 40 years of age.

4.2. The rib phase method

Application of the fourth rib has proven to be a more accurate tool in age
estimation of skeletonized individuals. Russell presents an independent study
of independent performed on two samples of the Hamann–Todd collection
[16]. They asked two judges to classify and predict the age stages according
to morphology of the sternal end of the fourth rib in the second sample, which
included
41 white and 39 black males [16]. Comparing the Hungarian and the
American white males, bias shows similar pattern in age estimation,
namely, the method overages younger and underages older individuals. The
inaccuracy of the method is higher in almost all age groups in Russel’s
observation [16], except in the youngest in the assessment of the first judge
and in the cases of the oldest individuals. Comparing the Hungarians with
Turkish individuals from the work of Yavuz et al. [37], some differences
have to be mentioned. Standard deviation rates are higher and 95%
confi- dence interval ranges are mostly much wider in Hungarians, which
suggests that the composition of this Central-European population is more
diverse than in the composition of the Turks. Differences in the mean ages
were the greatest in phases 2 and 6 in males and phases 1, 4 and 6 in
females, although discrepancies could have been the result of
differences in sample sizes and sample distribution, because the
Turkish sample was much bigger and all age phases were well represented
in both sexes [37].
Loth et al. examined a modern autopsy sample in order to determine
whether neighbouring ribs can be used for age estimation according to the
same standards based on the right fourth rib [39]. They found that more than
the 79% of the three ribs can be classified in the same phase [39]. The
Hungarian cases showed similar patterns, more than 78% of the total sample
fell into one phase. In men this rate
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was about 82%. Yoder et al. examined 231 individuals, most of them from
the Terry collection, and found that left and right ribs IV–IX did not differ
significantly from each other, while ribs II and III were significantly
different on the right and left sides, but only left rib III was significantly
different from the right rib IV [38]. On the right side in case of rib III, IV and
V only females showed significant differences between the rib phase scores
[38]. Compared with ribs III, IV and V in the Hungarian sample, greater
differences in males were found, contrary to the findings of Yoder.
Although the sample sizes were not balanced, only in males were significant
differences found in all of the ribs under observation.
5. Conclusion
According to the observations, the following conclusions can be reached.
Ectocranial suture closure pattern has an extreme variability, and has
no correlation with the age in Hungarians. Individuals of age 65 were
found with opened or barely closed sutures, and people under 50 were also
found with closed sutures. In the first case, dental status was more useful for
a rough orientation. Endocranial suture closure seems to associate more with
age at time of death, but the method was useable only for rough age
estimation. Taking into consideration the fact that the age intervals of
the Acsa´di–Nemeske´ri method are too large and overlapping, the results are
not sufficiently precise to be applicable, especially in forensic investigations.
Morphological changes of the sternal ends of the ribs seem to correlate the
most with age, but only with expanded age intervals did the estimation reach
an acceptable rate. In males scores from rib III, IV and V were significantly
different and the method overages male decedents under 50 years and
underages male decedents over 51 years of age. Altogether, results
were not sufficiently accurate in either method under examination to merit
their reliable use, so the authors of this article recommend the application
of more morphological and more precise molecular methods in the
practise of age determination in skeletonized individuals (especially in
forensic investigations).
Acknowledgement
We would like to express our gratitude to Dr. Thomas Cooper (Eszterha´
zy Ka´ roly College, Dept. of American Studies) for the linguistic
corrections.
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