The Aging Epigenome: Integrative Analyses Reveal Functional Overlap with Alzheimer's Disease

Aging is the strongest risk factor for Alzheimer's disease (AD), yet the role of age-associated DNA methylation (DNAm) changes in blood and their relevance to AD remains poorly understood. In this study, we performed a meta-analysis of blood DNAm samples from 475 dementia-free subjects aged over 65 years across two independent cohorts, the Framingham Heart Study (FHS) at Exam 9 and the Alzheimer's Disease Neuroimaging Initiative (ADNI). After adjusting for age, sex, and immune cell type proportions, and correcting for batch effects and genomic inflation, we identified 3758 CpGs and 556 differentially methylated regions (DMRs) consistently associated with aging in both cohorts at a 5% false discovery rate. Our pathway enrichment analyses highlighted immune response, metabolic regulation, and synaptic plasticity, all of which are key biological processes implicated in AD. Moreover, our colocalization analysis revealed 32 genomic regions where shared genetic variants influenced both DNAm and dementia risk. Adjusting for age and other covariate variables, we found roughly one-third of aging-associated CpGs are also associated with AD or AD neuropathology in independent studies external to the ADNI and FHS datasets. Finally, we prioritized 9 aging-associated CpGs, located in promoter regions of PDE1B, ELOVL2, PODXL2, and other genomic regions, that showed strong positive blood-to-brain methylation concordance, as well as association with AD or AD neuropathology in independent studies, after adjusting for age and other covariates. Our findings provided insights into the functional overlap between the aging processes and AD, and nominated promising blood-based biomarkers for future AD research.