Mid-life Epigenetic Age, Neuroimaging Brain Age, and Cognitive Function: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Yinan Zheng*, Mohamad Habes, Mitzi Gonzales, Raymond Pomponio, Ilya Nasrallah, Sadiya Khan, Douglas E. Vaughan, Christos Davatzikos, Sudha Seshadri, Lenore Launer, Farzaneh Sorond, Sanaz Sedaghat, Derek Wainwright, Andrea Baccarelli, Stephen Sidney, Nick Bryan, Philip Greenland, Donald Lloyd-Jones, Kristine Yaffe, Lifang Hou

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


The proportion of aging populations affected by dementia is increasing. There is an urgent need to identify biological aging markers in mid-life before symptoms of age-related dementia present for early intervention to delay the cognitive decline and the onset of dementia. In this cohort study involving 1,676 healthy participants (mean age 40) with up to 15 years of follow up, we evaluated the associations between cognitive function and two classes of novel biological aging markers: blood-based epigenetic aging and neuroimaging-based brain aging. Both accelerated epigenetic aging and brain aging were prospectively associated with worse cognitive outcomes. Specifically, every year faster epigenetic or brain aging was on average associated with 0.19-0.28 higher (worse) Stroop score, 0.04-0.05 lower (worse) RAVLT score, and 0.23-0.45 lower (worse) DSST (all false-discovery-rate-adjusted p <0.05). While epigenetic aging is a more stable biomarker with strong long-term predictive performance for cognitive function, brain aging biomarker may change more dynamically in temporal association with cognitive decline. The combined model using epigenetic and brain aging markers achieved the highest accuracy (AUC: 0.68, p<0.001) in predicting global cognitive function status. Accelerated epigenetic age and brain age at midlife may aid timely identification of individuals at risk for accelerated cognitive decline and promote the development of interventions to preserve optimal functioning across the lifespan.

Original languageEnglish (US)
Pages (from-to)1691-1712
Number of pages22
Issue number4
StatePublished - 2022


  • Brain age
  • Cognitive function
  • Dna methylation
  • Epigenetic age
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Aging
  • Cell Biology


Dive into the research topics of 'Mid-life Epigenetic Age, Neuroimaging Brain Age, and Cognitive Function: Coronary Artery Risk Development in Young Adults (CARDIA) Study'. Together they form a unique fingerprint.

Cite this