Epigenetic-based age acceleration in a representative sample of older Americans: Associations with aging-related morbidity and mortality

Jessica D. Faul, Jung Ki Kim, Morgan E. Levine, Bharat Thyagarajan, David R. Weir, Eileen M. Crimmins

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Biomarkers developed from DNA methylation (DNAm) data are of growing interest as predictors of health outcomes and mortality in older populations. However, it is unknown how epigenetic aging fits within the context of known socioeconomic and behavioral associations with aging-related health outcomes in a large, population-based, and diverse sample. This study uses data from a representative, panel study of US older adults to examine the relationship between DNAm-based age acceleration measures in the prediction of cross-sectional and longitudinal health outcomes and mortality. We examine whether recent improvements to these scores, using principal component (PC)-based measures designed to remove some of the technical noise and unreliability in measurement, improve the predictive capability of these measures. We also examine how well DNAm-based measures perform against well-known predictors of health outcomes such as demographics, SES, and health behaviors. In our sample, age acceleration calculated using “second and third generation clocks,” PhenoAge, GrimAge, and DunedinPACE, is consistently a significant predictor of health outcomes including cross-sectional cognitive dysfunction, functional limitations and chronic conditions assessed 2 y after DNAm measurement, and 4-y mortality. PC-based epigenetic age acceleration measures do not significantly change the relationship of DNAm-based age acceleration measures to health outcomes or mortality compared to earlier versions of these measures. While the usefulness of DNAm-based age acceleration as a predictor of later life health outcomes is quite clear, other factors such as demographics, SES, mental health, and health behaviors remain equally, if not more robust, predictors of later life outcomes.

Original languageEnglish (US)
Article numbere2215840120
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number9
StatePublished - Feb 28 2023

Bibliographical note

Funding Information:
ACKNOWLEDGMENTS. This work was supported by the National Institute on Aging (R01 AG060110, R01 AG068937, and R01 AG071071). The HRS is supported by the National Institute on Aging U01 AG009740. Thank you to Em Arpawong,Albert Higgins-Chen,and Jonah Fisher for help calculating the clocks. Thank you to Helen Meier and Colter Mitchell for help with interpretation.

Publisher Copyright:
Copyright © 2023 the Author(s). Published by PNAS.


  • DNA methylation
  • aging
  • biological aging
  • epigenetic clocks
  • geroscience


Dive into the research topics of 'Epigenetic-based age acceleration in a representative sample of older Americans: Associations with aging-related morbidity and mortality'. Together they form a unique fingerprint.

Cite this