LifeLong Digital Twin: A Unified Modeling Paradigm and Agent Harness for Event-Driven Lifelong Health State Trajectories

Abstract

Human health is a continuous, dynamic trajectory shaped by the cumulative interplay of biological processes, clinical events, behaviors and environmental exposures across the life course. Unifying the full breadth of lifelong health information, including longitudinal records, genetic variation, molecular profiles and environmental histories, is essential for whole-person modeling and remains a major challenge. We introduce LifeLong Digital Twin, a unified, event-driven modeling paradigm that organizes Life Events into daily Health States and accumulates them into Lifelong Health Context. An accompanying Agent Harness incorporates multimodal evidence beyond the language model's textual context. We evaluate four language models across 25 disease endpoints on three tasks: Disease Trajectory Forecasting, Disease Risk Ranking and Multi-horizon Disease Prediction. The approach yields marked gains over the reference condition: model-averaged F1 increases by 22.0% for disease identification in trajectory forecasting and 18.3% for five-year disease outcomes; thyroid-disease F1 reaches 0.669. The framework provides a foundation for whole-person digital twins and research on personalized lifelong disease prevention.