Original Article

Molecular Psychiatry (2015) 20, 529–535; doi:10.1038/mp.2014.70; published online 29 July 2014

Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter

E Puterman1, J Lin2, J Krauss3, E H Blackburn2 and E S Epel1

  1. 1Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
  2. 2Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
  3. 3Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Stanford University, Stanford, CA, USA

Correspondence: Professor E Puterman or Professor ES Epel, Department of Psychiatry, School of Medicine, University of California, San Francisco, 3333 California Street Suite 465, San Francisco, CA 94143-0848, USA. E-mail: eli.puterman@ucsf.edu or eepel@lppi.ucsf.edu

Received 27 January 2014; Revised 13 May 2014; Accepted 6 June 2014
Advance online publication 29 July 2014



Telomere length, a reliable predictor of disease pathogenesis, can be affected by genetics, chronic stress and health behaviors. Cross-sectionally, highly stressed postmenopausal women have shorter telomeres, but only if they are inactive. However, no studies have prospectively examined telomere length change over a short period, and if rate of attrition is affected by naturalistic factors such as stress and engagement in healthy behaviors, including diet, exercise, and sleep. Here we followed healthy women over 1 year to test if major stressors that occurred over the year predicted telomere shortening, and whether engaging in healthy behaviors during this period mitigates this effect. In 239 postmenopausal, non-smoking, disease-free women, accumulation of major life stressors across a 1-year period predicted telomere attrition over the same period—for every major life stressor that occurred during the year, there was a significantly greater decline in telomere length over the year of 35bp (P<0.05). Yet, these effects were moderated by health behaviors (interaction B=0.19, P=0.04). Women who maintained relatively higher levels of health behaviors (1s.d. above the mean) appeared to be protected when exposed to stress. This finding has implications for understanding malleability of telomere length, as well as expectations for possible intervention effects. This is the first study to identify predictors of telomere length change over the short period of a year.