Cited by 593Genetics, Aging, and Longevity in Model OrganismsTelomeres, Telomerase, and SenescenceEpigenetics and DNA Methylation

The DOI matches its Crossref record; 201 of the 201 references it cites were found in a registry or an index; 30 of the 237 sources its claims cite were checked for support.

Measuring biological age using omics data

Open access
Rutledge, Jarod, Oh, Hamilton, Wyss-Coray, Tony·2022·Nature Reviews Genetics

Abstract

Age is the key risk factor for diseases and disabilities of the elderly. Efforts to tackle age-related diseases and increase healthspan have suggested targeting the ageing process itself to 'rejuvenate' physiological functioning. However, achieving this aim requires measures of biological age and rates of ageing at the molecular level. Spurred by recent advances in high-throughput omics technologies, a new generation of tools to measure biological ageing now enables the quantitative characterization of ageing at molecular resolution. Epigenomic, transcriptomic, proteomic and metabolomic data can be harnessed with machine learning to build 'ageing clocks' with demonstrated capacity to identify new biomarkers of biological ageing.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review surveys machine-learning ‘ageing clocks’ built from epigenomic, transcriptomic, proteomic and metabolomic data, arguing that they can estimate biological age but often capture different, partly non-causal ageing signals. It calls for clocks tailored to specific tissues/applications, multi-omic and longitudinal designs, and training beyond chronological age.

Key findings

  • DNA methylation clocks: the first, in 2011, used about 100 saliva samples and predicted chronological age within ~5 years; the Hannum clock used 71 CpGs in 656 whole-blood samples, and the Horvath pan-tissue clock used 353 CpGs in 8,000 samples across 51 tissue/cell types. First-generation epigenetic age gaps correlate only mildly with each other (r = 0.1–0.5), and a meta-analysis in 14 cohorts found that improving chronological-age accuracy to very high levels reduced associations with mortality risk.
  • Second-generation methylation clocks (PhenoAge, GrimAge, DunedinPoAm) were designed to associate with mortality or ageing rate. DunedinPoAm used a 1-year birth cohort (n = 810) tracking 18 clinical chemistry and physiological biomarkers at ages 26, 32 and 38, and showed stronger associations with physical functioning, cognition, self-rated health and mortality than PhenoAge.
  • Transcriptomic, proteomic and metabolomic clocks: transcriptomic clocks are noisy; Meyer et al. reported that binarized transcriptomic data improved human fibroblast chronological age prediction to r² = 0.92 and mean error of 6.63 years. SomaLogic aptamer proteomics can reliably quantify over 7,000 proteins, and a metabolomic clock from 56 plasma metabolites was associated with cardiovascular risk factors, cardiovascular disease risk and all-cause mortality.
  • Cross-omics comparisons show limited concordance: Tanaka et al.’s plasma proteomic age gap had no correlation with Horvath and low correlation with GrimAge/PhenoAge; Robinson et al.’s metabolomic age gap had no correlation with Horvath, Hannum and PhenoAge; a multi-omics study found mild correlations between epigenetic and transcriptomic age gaps and between proteomic and metabolomic age gaps, but no correlation between epigenetic and proteomic/metabolomic age gaps.

Methods

  • Design: critical narrative review of ageing clocks built from omics data; no new experimental data, cohort, or primary statistical analysis.
  • Data: published studies using epigenomic, transcriptomic, proteomic, metabolomic and other omics layers, plus selected multi-omic and longitudinal studies.
  • Analysis: qualitative synthesis and comparison of clock construction, accuracy, age-gap associations with ageing phenotypes, and limitations; the review explicitly focuses on what biological ageing phenotypes age gaps measure rather than chronological-age prediction accuracy.

Limitations

  • Stated in the paper: current clocks are correlative statistical models, not causal; most are trained on cross-sectional data and do not directly predict future ageing rates; first-generation methylation clocks have weak/variable mortality associations and can overfit chronological-age noise; blood-based clocks may not capture ageing of other tissues because tissues age at different rates.
  • Stated in the paper: omics-specific limitations include transcriptomic noise/small samples and older microarray technology; proteomic confounding by kidney function and less validation than methylation clocks; metabolomic orphan compounds, sensitivity issues, and lower age-prediction accuracy despite large samples.
  • Evident from the text: as a review, it reports no new validation or head-to-head benchmark; comparisons across clocks are constrained by few meta-analyses and low concordance, so relative utility remains unresolved.

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Integrity signals

Registry

Crossref · 10.1038/s41576-022-00511-7

Cites

201 of 201 references verified0 citation errors · 0 not checkable

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Claims the paper makes

111 Not checked yet · 23 Own interpretation · 5 Partly supported · 4 Supported · 3 No basis given · 1 Supported so far · 1 Mixed support · accuracy not yet measured

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  • The paper relies on this without support.

    Current ageing clocks are all correlative statistical models.

    “Ultimately, current ageing clocks are all correlative statistical models.”
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Citations

Cites

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Research works printed but not linked: 3

  1. Elsevier. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics-6th Edition https://www.elsevier.com/books/tietz-textbook-of-clinical-chemistry-and-molecular-diagnostics/rifai/978-0-323-35921-4 (2017).
  2. Platt, J. Probabilistic outputs for support vector machines and comparisons to regularized likelihood methods. Adv. Large Margin Classif. 10, 61–74 (1999).
  3. Shrikumar, A., Greenside, P. & Kundaje, A. In Proceedings of the 34th International Conference on Machine Learning 3145–3153 (PMLR, 2017).

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Metadata

Authors
Rutledge, J., Oh, H., & Wyss-Coray, T.
Affiliations
Stanford Medicine (US)
Venue
Nature Reviews Genetics
Published
2022-06-17
Volume
23
Issue
12
Pages
715-727
ISSN
  • 1471-0056 (ISSN-L)
  • 1471-0064
OpenAlex
W4283016888
Cited by
570
References
201
Citations by year
2026: 145 · 2025: 178 · 2024: 148 · 2023: 82 · 2022: 16
FWCI
9.05
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Genetics (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Science Foundation
  • National Institute on Aging (P50AG047366, R01AG072255, P30AG066515)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Aging › Genetics, Aging, and Longevity in Model Organisms
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Telomeres, Telomerase, and Senescence
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
Keywords
biological age, biological aging, age-related diseases, healthspan, epigenomics, transcriptomics, proteomics, metabolomics, aging biomarkers, machine learning
MeSH terms
Aged, Aging, Humans, Biomarkers, Proteomics, Metabolomics, Epigenomics

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