The accelerated aging phenotype: The role of race and social determinants of health on aging

Abstract

The pursuit to discover the fundamental biology and mechanisms of aging within the context of the physical and social environment is critical to designing interventions to prevent and treat its complex phenotypes. Aging research is critically linked to understanding health disparities because these inequities shape minority aging, which may proceed on a different trajectory than the overall population. Health disparities are characteristically seen in commonly occurring age-associated diseases such as cardiovascular and cerebrovascular disease as well as diabetes mellitus and cancer. The early appearance and increased severity of age-associated disease among African American and low socioeconomic status (SES) individuals suggests that the factors contributing to the emergence of health disparities may also induce a phenotype of 'premature aging' or 'accelerated aging' or 'weathering'. In marginalized and low SES populations with high rates of early onset age-associated disease the interaction of biologic, psychosocial, socioeconomic and environmental factors may result in a phenotype of accelerated aging biologically similar to premature aging syndromes with increased susceptibility to oxidative stress, premature accumulation of oxidative DNA damage, defects in DNA repair and higher levels of biomarkers of oxidative stress and inflammation. Health disparities, therefore, may be the end product of this complex interaction in populations at high risk. This review will examine the factors that drive both health disparities and the accelerated aging phenotype that ultimately contributes to premature mortality.

Keywords: African Americans; Age; Epigenetics; Genetics; Health disparities; Hispanics; Inflammation; Minority aging.

Fig. 1.

Upstream and downstream determinants of health influence outcomes over the lifespan.

Fig. 2.

Social determinants of health biologic transducers that lead to the accelerated aging phenotype and health disparities in aging and age-related disease.

Fig. 3.

Factors leading to epigenetic age acceleration in minority populations. Psychosocial, lifestyle factors as well as demographics contribute to changes in DNA methylation that have been categorized as accelerated epigenetic aging. These epigenetic alterations may result in the observed gene expression changes in minority populations in response to the social determinants of health.

Fig. 4.

Discrimination lays the roots for health disparities in health outcomes.