Abstract
Aging increases the global burden of disease, yet its molecular basis remains incompletely understood. Recent studies indicate that reversible epigenetic drift-spanning DNA methylation clocks, histone codes, three-dimensional chromatin, and noncoding RNA networks-constitutes a central regulator of organismal decline and age-related diseases. How these epigenetic layers interact across different tissues-and how best to translate them into therapeutic strategies-are still open questions. This review outlines the specific mechanisms by which epigenetic changes influence aging, highlighting their impact on genomic instability, stem-cell exhaustion, and mitochondrial dysfunction. We critically evaluate emerging rejuvenation strategies-partial OSKM reprogramming, CRISPR-dCas9 epigenome editing, NAD⁺/sirtuin boosters, HDAC inhibitors, microbiota transfer, and precision lifestyle interventions-detailing their efficacy in resetting epigenetic age and restoring tissue homeostasis. Integrating single-cell multiomics and second-generation epigenetic clocks, we propose a roadmap for translating these insights into safe, personalized antiaging medicine.