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Measures to quantify changes in the pace of biological aging in response to intervention are needed to evaluate geroprotective interventions for humans. We report an advance on our original measure (Belsky et al. 2020 eLife). We used an expanded dataset from the Dunedin Study 1972-3 birth cohort tracking within-individual decline in 19 indicators of organ-system integrity across four time points spanning two decades to model Pace of Aging. We then distilled this two-decade Pace of Aging into a single-time-point DNA methylation blood test using elastic-net regression. We restricted the DNA methylation dataset to exclude probes with low test-retest reliability. We evaluated the resulting measure, named DunedinPACE, in five additional datasets. DunedinPACE showed high test-retest reliability, was associated with functional decline, morbidity, and mortality, and indicated accelerated Pace of Aging in young adults with childhood adversity. DunedinPACE effect-sizes were similar to or larger than effect-sizes for benchmark methylation clocks.