Aging anxiety and epigenetic aging in a national sample of adult women in the United States

BACKGROUND: Aging anxiety is a multidimensional psychosocial stressor with potential implications for women's long-term health, yet its biological embedding remains poorly understood. This study examined whether domain-specific aging anxieties are associated with accelerated epigenetic aging, using second-generation methylation-based biomarkers. METHODS: Data were drawn from 726 women participating in the Midlife in the United States (MIDUS) study. Aging anxiety was assessed across three domains: declining attractiveness, declining health, and reproductive aging. Epigenetic aging was measured using two complementary second-generation clocks: GrimAge2, which estimates cumulative biological damage and predicts mortality risk, and DunedinPACE, which captures the current pace of biological aging. Multivariable linear regression models tested associations between aging anxiety and epigenetic age acceleration, adjusting sequentially for sociodemographic factors, chronic health conditions, and health behaviors. RESULTS: Greater declining health anxiety was significantly associated with higher DunedinPACE z-scores (0.07 SD increase, 95 % CI: 0.01, 0.13). This association attenuated to non-significance after adjusting for health behaviors (0.02 SD increase, 95 % CI: -0.04, 0.08), which could be potential mediators on the exposure-outcome association pathway. Higher cumulative aging anxiety was significantly associated with a 0.07 SD increase (95 % CI: 0.01, 0.14) in DunedinPACE, but this association attenuated to non-significance after adjusting for chronic health conditions (0.06 SD increase, 95 % CI: -0.01, 0.13) and health behaviors (0.03 SD increase, 95 % CI: -0.03, 0.08). CONCLUSION: Findings indicate that specific domains of aging anxiety, particularly fears about declining health, may manifest biologically and contribute to accelerated aging processes. These results support a biopsychosocial model in which subjective experiences of aging contribute to physiological decline. Future longitudinal studies are needed to clarify whether aging-related anxiety influences epigenetic aging trajectories among women.