Epigenetic aging is associated with clinical and experimental pain in community-dwelling older adults

Gerontological research reveals considerable interindividual variability in aging phenotypes, which has motivated research efforts to identify "aging biomarkers." Aging biomarkers are used to calculate biological age, which are better predictors of disease risk and residual lifespan when compared to chronological age alone. Emerging evidence using the epigenetic clock as an aging biomarker supports highly reliable individualized predictions about future health. This study aimed to determine whether an epigenetic aging biomarker was associated with chronic pain in older adults (60-83 years old). A subset of participants (n = 29) in the Neuromodulatory Examination of Pain and Mobility Across the Lifespan study underwent a blood draw, demographic, psychological, cognitive, and pain assessments. We estimated Horvath's epigenetic clock and calculated the difference between epigenetic age and chronological age that has been previously reported to predict overall mortality risk. Older individuals without chronic pain (n = 9) had significantly "younger" epigenetic age compared to those with chronic pain (n = 20, p < 0.05). Older epigenetic age was associated with greater pain during daily activities (r = 0.494, p = 0.010) and anatomical pain sites (r = 0.741, p < 0.001) but not pain frequency/duration. An older epigenetic age was also associated with higher vibratory detection thresholds (r = 0.490, p = 0.021), heat pain thresholds (r = -0.478, p = 0.028), and pressure pain thresholds at the trapezius (r = -0.571, p = 0.006) but not thermal detection, pressure pain at the quadriceps or pain inhibition (p's > 0.05). Epigenetic aging was associated with greater emotional stability (r = -0.461, p = 0.027), conscientiousness (r = -0.549, p = 0.007), and lower extraversion (r = 0.414, p = 0.049) but not depression or affect (p's > 0.05). Epigenetic aging was also associated with lower episodic (r = -0.698, p = 0.001) and working memory (r = -0.760, p < 0.001). Our findings suggest that chronic pain is associated with accelerated epigenetic aging in healthy, community-dwelling older individuals, and future studies with larger samples are needed to confirm our findings. An aging biomarker such as the epigenetic clock may help identify people with chronic pain at greater risk of functional decline and poorer health outcomes.