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Cited by 150Telomeres, Telomerase, and SenescenceGenetics, Aging, and Longevity in Model OrganismsHealth disparities and outcomes

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

Open access
Puterman, E, Lin, J, Krauss, J, Blackburn, E H, Epel, E S·2015·Molecular Psychiatry
DOI 10.1038/mp.2014.70PMC PMC4310821
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Abstract

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 35 bp (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 (1 s.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.

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Written from the paper’s full text.

TL;DR

In 239 healthy post-menopausal non-smoking women followed for one year, accumulating major life stressors predicted greater leukocyte telomere shortening, and higher cumulative health behaviors buffered this association. This is reported as the first study to identify predictors of telomere length change over a one-year period.

Key findings

  • Major life stressors during the year significantly predicted accelerated telomere shortening: B = −.18, p = .01; each additional stressor was associated with a 34.7 base pair greater decline over the year (SE = 14.04, 95% CI = −62.3, −6.9).
  • Cumulative health behaviors moderated the stress–telomere attrition relationship: interaction B = 0.19, p = .041. At one SD below the mean of cumulative health behaviors, each stressor was associated with 76.5 base pairs of shortening (95% CI = −123.1, −30.0; B = −.29, p = .001); at average health behaviors, 39.6 base pairs (95% CI = −76.4, −2.7; B = −.15, p = .04); at one SD above the mean, stressors were unrelated to shortening (b = −2.6, 95% CI = −58.0, 52.7; B = −0.01, p > .50).
  • Individual health behaviors did not significantly moderate the association (all interaction p’s > .10), though the pattern was similar to cumulative health behaviors.
  • Baseline mean leukocyte telomere length was 5548 base pairs (SD = 328.9) and follow-up mean was 5584 base pairs (SD = 354.9); baseline and follow-up telomere length were correlated r(229) = .74, p < .001, and average percent change was 0.65% (SD = 4.86%), with 68% not changing more than approximately 5%.

Methods

  • Prospective observational study of 263 healthy midlife women aged 50–65 recruited from the San Francisco Bay Area in 2010; 239 returned for one-year follow-up blood draw, and 231 had complete main study variable data. Exclusion criteria included cancer within the previous 10 years, autoimmune disease, and current smoking.
  • Leukocyte telomere length was measured by qPCR in Blackburn’s laboratory at UCSF at baseline and one-year follow-up; inter-assay coefficient of variation was 4.3%. Major life stressors over the previous year were self-reported at follow-up using a 13-item checklist.
  • Health behaviors were self-reported at baseline, 4 months, 8 months, and one-year follow-up: leisure-time physical activity (Stanford Brief Activity Scale), typical dietary practices (MESA-based food frequency questions), and sleep quality (one Pittsburgh Sleep Quality Index item). Cumulative health behaviors were the sum of the three standardized scores.
  • Analyses regressed telomere length change on major life stressors with covariates including baseline telomere length, sociodemographics, medication use, BMI, and health behaviors; then tested interactions between stressors and each health behavior alone and cumulative health behaviors, followed by simple slope analyses at one SD above and below the mean.

Limitations

  • The paper states findings may be limited to postmenopausal, non-smoking women; participants were primarily Caucasian, highly educated, healthy with lower BMI and low medication use, and had lower stress levels than national averages.
  • The paper states behavioral measures were self-reported and subject to reporting bias; future studies should use objective monitoring devices such as accelerometers and daily food diaries.
  • The paper notes that reversibility may depend on stressor duration, and that lifespan studies combining early-life and adulthood experiences with health behaviors are needed; the text also makes evident that this is observational, so causal direction and intervention effects cannot be established from these data.

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Integrity signals

Registry

Crossref · 10.1038/mp.2014.70

Cites

92 of 92 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 57 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    For women at one standard deviation below the mean of cumulative health behaviors, every additional major life stressor was related to accelerated telomere shortening over the year by an additional mean 76.5 base pairs (95% CI −123.1 to −30.0, B = −.29, p = .001).

    “For women who engaged in lower levels of health behaviors (one standard deviation below the average sample mean of cumulative health behaviors), every additional stressor was related to accelerated telomere shortening over the year by an additional mean 76.5 base pairs (95%C.I. = −123.1, −30.0 base pairs, B = -.29, p = .001) compared to women with no adverse stressors.”
    Quote in the paperSubstantial claim
  • Findingown data

    In separate moderation analyses, the interaction between major life stressors and each individual health behavior (physical activity, sleep quality, or diet) was not statistically significant (all interaction p's > .10).

    “However, the interaction effects for the three moderation analyses were not statistically significant (all interaction p’s > .10).”
    Quote in the paperSubstantial claim
  • Findingown data

    At average levels of cumulative health behaviors, accelerated telomere shortening over the year occurred by an additional 39.6 base pairs for every major life stressor (95% CI −76.4 to −2.7, B = −.15, p = .04).

    “At average levels of health behaviors, accelerated telomere shortening over the year occurred by an additional 39.6 base pairs for every major life stressor that occurred, on average (95% C.I. = −76.4, −2.7 base pairs, B = -.15, p = .04).”
    Quote in the paperSubstantial claim
  • Findingown data

    For women at one standard deviation above the mean of cumulative health behaviors, adverse events were unrelated to telomere shortening (b = −2.6, 95% CI −58.0 to 52.7, B = −0.01, p > .50).

    “For those women at higher levels of healthy behaviors (one standard deviation above the average sample mean of health behaviors), adverse events were unrelated to telomere shortening (unstandardized b = −2.6, 95% C.I. = −58.0, 52.7 base pairs, B = −0.01, p > .50).”
    Quote in the paperSubstantial claim
  • Findingown data

    For every major life stressor that occurred during the year, there was a significantly greater decline in telomere length over the year of 34.7 base pairs (SE = 14.04, 95% CI −62.3 to −6.9).

    “for every major life stressor that occurred during the year, there was a significantly greater decline in telomere length over the year of 35 base pairs (p < .05).”
    • Also stated in: § Multivariate analyses main results · plain
      “for every one event, there was a significantly greater decline in telomere length over the year of 34.7 base pairs (SE = 14.04, 95%C.I. = −62.3, −6.9).”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 18
  • May combine two claims. 19

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Healthy behaviors were not significantly related to number of life events, though a marginal trend emerged for leisure activity, such that those who had more events during the year were less likely to be active (r(229) = −.12, p = .08).

    “Healthy behaviors were not significantly related to number of life events, though a marginal trend emerged for leisure activity, such that those who had more events during the year were less likely to be active (r (229) = −.12, p = .08).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Cumulative leisure time physical activity over the year was significantly related to typical foods eaten over the year (r(229) = .34, p < .001) and to sleep quality during the year (r(229) = 0.14, p = .04).

    “Cumulative leisure time physical activity over the year was significantly related to typical foods eaten over the year (r (229) = .34, p < .001) and to sleep quality during the year (r (229) = 0.14, p = .04).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Typical foods and sleep quality were not significantly related to each other (r(229) = .10, p = .11).

    “Typical foods and sleep quality were not significantly related to each other (r (229) = .10, p = .11) but the trend was in a positive direction.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    At baseline, mean leukocyte telomere length was 5548 base pairs (SD = 328.9), and at 12-month follow-up it was 5584 base pairs (SD = 354.9).

    “At baseline, mean leukocyte telomere length was 5548 base pairs (SD = 328.9) and mean 12-month follow-up leukocyte telomere length was similar, 5584 base pairs (SD = 354.9).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Longer telomeres at baseline were more likely to shorten over time (B = −.31, p < .001); for every 100 base pairs above the sample average at baseline, telomeres shortened by an average 24 base pairs over the year (SE = 0.5, 95% CI −33.9 to −12.8).

    “longer telomeres at baseline were more likely to shorten over time (B = −.31, p < .001), such that for every 100 base pairs above the average of the sample at baseline, telomeres were likely to significantly shorten by an average 24 (SE = 0.5, 95% C.I. = −33.9, −12.8) base pairs over the year.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Baseline and follow-up leukocyte telomere length were significantly related (r(229) = .74, p < .001), indicating considerable stability over one year.

    “Baseline and follow-up telomere length were significantly related (r (229) = .74, p < .001), indicating considerable stability over time”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In separate analyses for each individual health behavior, at one standard deviation below the mean and at the mean of each behavior, major life stressors significantly predicted telomere shortening, while at one standard deviation above the mean of each health behavior, life stressors were unrelated to telomere shortening.

    “As seen in Table 2, results indicated that at one standard deviation below the mean and at the mean of each behavior separately, major life stressors significantly predicted telomere shortening. At one standard deviation above the mean of each health behavior, life stressors were unrelated to telomere shortening.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The average percent change in telomere length over one year was minimal (0.65%), with a standard deviation of 4.86%.

    “the average percent change was minimal (0.65%) with a standard deviation for percent change in telomere length of 4.86%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Telomere length was stable over a short period (r = .74) but far from fixed, and many people showed changes.

    “The stability of telomere length (r = .74) suggests that telomere length tends to be stable over a short period, but is far from fixed, and many people showed changes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    The women in the study were primarily Caucasian, highly educated, healthy (lower BMI, low medication use), and had lower stress than national averages.

    “The women in the current study were also primarily Caucasian, highly educated, healthy (lower BMI, low medication use) and had lower levels of stress than national averages (89).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [89]

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The qPCR method used to measure mean leukocyte telomere length was validated and shown to be significantly associated with the Southern blot method.

    “This method was validated for mean telomere length measurement and shown to be significantly associated with the Southern blot method (51).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Aviv A, Hunt SC, Lin J, Cao X, Kimura M, Blackburn E . Impartial comparative analysis of measurement of leukocyte telomere length/DNA content by Southern blots and qPCR. Nucleic Acids Res 2011; 39: e134. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The inter-assay coefficient of variation for telomere length measurement in this study was 4.3%.

    “The inter-assay coefficient of variation for telomere length measurement was 4.3% for this study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    This is the first study to identify predictors of telomere length change over the short period of a year.

    “This is the first study to identify predictors of telomere length change over the short period of a year.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: No studies have prospectively examined whether the emergence of new life stressors is related to shortening of telomeres over time.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Ninety-one percent (N=239) of the women returned for follow-up blood draw.

    “Ninety-one percent (N=239) of the women returned for follow-up blood draw.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Health behaviors naturally cluster, and a combination of healthy behaviors seems to be a stronger predictor of telomere length than each individual behavior alone.

    “Health behaviors, however, naturally cluster (45,46) and a combination of healthy behaviors seem to be a stronger predictor of telomere length than each individual behavior alone (47).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [45] Poortinga W . The prevalence and clustering of four major lifestyle risk factors in an English adult population. Prev Med 2007; 44: 124–128. source

      Not checked in the free run.

    • cites [46] Sun Q, Shi L, Prescott J, Chiuve SE, Hu FB, De Vivo I et al. Healthy lifestyle and leukocyte telomere length in US women. PLoS One 2012; 7: e38374. source

      Not checked in the free run.

    • cites [47] Puterman E, Epel ES . An intricate dance: life experience, multisystem resiliency, and rate of telomere decline throughout the lifespan. Soc Personal Psychol Compass 2012; 6: 807–825. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Recent reviews identify strong relationships between psychological stress and physical activity, stress and eating, and stress and sleep.

    “Recent reviews in the literature identify strong relationships between psychological stress and physical activity (65), stress and eating (66), and stress and sleep (67,68).”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [65] Kahn M, Sheppes G, Sadeh A . Sleep and emotions: bidirectional links and underlying mechanisms. Int J Psychophysiol 2013; 89: 218–228. source

      Not checked in the free run.

    • cites [66] Vandekerckhove M, Cluydts R . The emotional brain and sleep: an intimate relationship. Sleep Med Rev 2010; 14: 219–226. source

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  • Classified as probably not a substantial claim.

    Study design and conductown data

    Analyses adjusted for baseline LTL, sociodemographic factors (age, income, education, ethnicity), medication use at baseline (hypertension reducing medication, cholesterol reducing medication, hormone replacement therapy, antidepressants), BMI at baseline, and health behaviors over the previous year.

    “Covariates included baseline LTL, sociodemographic factors [age, income, education (less than Bachelor’s degree/Bachelor’s or higher), ethnicity (Caucasian/other)], medication use at baseline [hypertension reducing medication (Yes/No), cholesterol reducing medication (Yes/No), hormone replacement therapy (Yes/No), antidepressants (Yes/No)], BMI at baseline, and health behaviors over the previous”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    The study prospectively measured lifestyle throughout the year at 3 time points and was able to examine short-term changes in telomere length over one year.

    “Strengths of the study are the prospective measurement of lifestyle throughout the year, at 3 time points, and the ability to examine at short-term changes in telomere length over one year.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Physical activity bolsters mediating immune proteins and gene expression and more distal biological aging endpoints, such as mitochondrial health and telomerase levels, which are related to telomere maintenance.

    “Physical activity also bolsters mediating immune proteins and gene expression (74,75) and more distal biological aging endpoints, such as mitochondrial health and telomerase levels (76–79), which are intimately related to telomere maintenance (20,80,81).”
    Quote in the paperNot a substantial claim0 of 9 sources checked
    • cites [74] Navarro A, Gomez C, López-Cepero JM, Boveris A . Beneficial effects of moderate exercise on mice aging: survival, behavior, oxidative stress, and mitochondrial electron transfer. Am J Physiol Regul Integr Comp Physiol 2004; 286: R505–R511. source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Short telomeres have been linked to numerous diseases of aging and, in many but not all cases, to all-cause and disease-specific mortality.

    “Short telomeres have been linked to numerous diseases of aging and in many but not all cases, to all-cause and disease-specific mortality (12–17).”
    Quote in the paperNot a substantial claim0 of 6 sources checked
    • cites [12] Armanios M, Blackburn EH . The telomere syndromes. Nat Rev Genet 2012; 13: 693–704. source

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      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The Stanford Brief Activity Scale (SBAS) and its revised L-CAT are well-validated and reliable, as shown by studies demonstrating matching results to the Seven Day Physical Activity Recall and to Centers for Disease Control and Prevention recommendations for physical activity.

    “The SBAS and its revised L-CAT are well-validated and reliable, as seen in studies demonstrating matching results to the Seven Day Physical Activity Recall and to Centers for Disease Control and Prevention recommendations for physical activity (55,56)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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  • Classified as probably not a substantial claim.

    Premisecitation

    Chronic psychological stress has been associated with shorter telomeres during childhood and adulthood, though not consistently.

    “Chronic psychological stress has been associated with shorter telomeres during childhood and adulthood, though not consistently.”
    Quote in the paperSubstantial claim0 of 8 sources checked
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      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A composite of health behaviors is a stronger cross-sectional predictor of telomere length than each individual behavior alone.

    “A composite of health behaviors has previously been evidenced to be a stronger cross-sectional predictor of telomere length than each individual behavior alone (47).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [47] Puterman E, Epel ES . An intricate dance: life experience, multisystem resiliency, and rate of telomere decline throughout the lifespan. Soc Personal Psychol Compass 2012; 6: 807–825. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Healthy lifestyle factors, alone or in combination, might mitigate the impact of chronic psychological stress on telomere length, and this effect has been documented cross-sectionally in chronically stressed adults and in depressed adults.

    “We recently proposed that healthy lifestyle factors, alone or in combination, might mitigate the impact of chronic psychological stress on telomere length (48,49), and documented this effect cross-sectionally in chronically stressed adults and in depressed adults (31,50).”
    Quote in the paperSubstantial claim0 of 4 sources checked
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      Not checked in the free run.

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    • cites [31] Humphreys J, Epel ES, Cooper BA, Lin J, Blackburn EH, Lee KA . Telomere shortening in formerly abused and never abused women. Biol Res Nurs 2011; 14: 115–123. source

      Not checked in the free run.

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Fit younger and older adults have quicker biological stress recoveries than unfit adults.

    “Previous studies have shown that fit younger and older adults have quicker biological stress recoveries than unfit adults (71–73).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
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  • May combine two claims.

    Premisecitation

    Each of physical activity, dietary intake, and sleep quality has been associated with telomere length cross-sectionally.

    “Each behavior has been associated with telomere length cross-sectionally (36–40).”
    Quote in the paperSubstantial claim0 of 5 sources checked
    • cites [36] Krauss J, Farzaneh-Far R, Puterman E, Na B, Lin J, Epel ES et al. Physical fitness and telomere length in patients with coronary heart disease: findings from the Heart and Soul Study. PLoS One 2011; 6: e26983. source

      Not checked in the free run.

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    • cites [38] Paul L . Diet, nutrition and telomere length. J Nutr Biochem 2011; 22: 895–901. source

      Not checked in the free run.

    • cites [39] Shiels PG, McGlynn LM, MacIntyre A, Johnson PCD, Batty GD, Burns H et al. Accelerated telomere attrition is associated with relative household income, diet and inflammation in the pSoBid cohort. PLoS One 2011; 6: e22521. source

      Not checked in the free run.

    • cites [40] Yoo S-S, Gujar N, Hu P, Jolesz FA, Walker MP . The human emotional brain without sleep—a prefrontal amygdala disconnect. Curr Biol 2007; 17: R877–R878. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Complete data with main study variables were available for 231 women.

    “Complete data with main study variables were available for 231 women.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Physical activity promotes neurogenesis, cognitive flexibility, and memory formation in humans and other animals.

    “Physical activity promotes neurogenesis, cognitive flexibility and memory formation in both humans and other animals alike (70)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [70] Rimmele U, Zellweger BC, Marti B, Seiler R, Mohiyeddini C, Ehlert U et al. Trained men show lower cortisol, heart rate and psychological responses to psychosocial stress compared with untrained men. Psychoneuroendocrinology 2007; 32: 627–635. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Years of providing care significantly predicts shorter telomeres.

    “For example, years of providing care significantly predicts shorter telomeres (29)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] O’Donovan A, Tomiyama AJ, Lin J, Puterman E, Adler NE, Kemeny M et al. Stress appraisals and cellular aging: a key role for anticipatory threat in the relationship between psychological stress and telomere length. Brain Behav Immun 2012; 26: 573–579. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Behavioral measures were self-reported, allowing for reporting bias to influence results.

    “Finally, our behavioral measures were self-reported, allowing for reporting bias to influence our results.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The extent to which the effects of stress on telomere biology are reversible may depend on how long the stressor remains.

    “The extent to which the effects of stress on telomere biology are reversible may depend on how long the stressor remains.”
    Quote in the paperNot a substantial claim
31 of 31

  • The authors state this as an assumption.

    No studies have prospectively examined whether the emergence of new life stressors is related to shortening of telomeres over time.

    “To date, no studies have prospectively examined whether the emergence of new life stressors is related to shortening of telomeres over time.”

  • The authors state this as an assumption.

    Whether each behavior alone or in combination can attenuate the biological burden of stress over time remains unexamined.

    “Whether each behavior alone or in combination can attenuate the biological burden of stress over time remains unexamined.”

  • The authors state this as an assumption.

    It is unknown whether a combination of life stressors is potent enough to lead to greater telomere shortening in a short period of time.

    “It is unknown whether a combination of life stressors is potent enough to lead to greater telomere shortening in a short period of time.”

  • The paper relies on this without support.

    Whether telomere length can change over as short a period as one year was an open question.

    “It has been an open question about whether telomere length might change in as short of a period as one year.”

  • The paper relies on this without support.

    This is the first observational study to examine short-term changes in telomere length.

    “This is the first observational study to examine short-term changes in telomere length.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentr(229) = 0.74reported p < .001 · recomputed p < .001

    “r (229) = .74, p < .001”

  • Consistentr(229) = 0.34reported p < .001 · recomputed p < .001

    “r (229) = .34, p < .001”

  • Consistentr(229) = 0.14reported p = .04 · recomputed p = .033

    “r (229) = 0.14, p = .04”

  • Consistentr(229) = 0.1reported p = .11 · recomputed p = .130

    “r (229) = .10, p = .11”

  • Consistentr(229) = -0.12reported p = .08 · recomputed p = .069

    “r (229) = −.12, p = .08”

5 of 5

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Least-active activity score is given as both 1 and 0

    Minor

    The activity scale assigns the least-active scenario a score of 1, but later defines 0 as the score for the least-active, mostly sedentary category.

1 of 1

Cites

1 retracted

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Puterman, E., Lin, J., Krauss, J., Blackburn, E. H., & Epel, E. S.
Affiliations
  • University of California, San Francisco (US)
  • Stanford Medicine (US)
Corresponding author
  • Puterman, E
  • Epel, E S
ORCID
Venue
Molecular Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2014-07-29
Volume
20
Issue
4
Pages
529-535
ISSN
  • 1359-4184 (ISSN-L)
  • 1476-5578
DOI
10.1038/mp.2014.70
PMC
PMC4310821
OpenAlex
W2083194770
Cited by
150
References
92
Citations by year
2026: 8 · 2025: 7 · 2024: 2 · 2023: 8 · 2022: 11 · 2021: 11 · 2020: 14 · 2019: 19 · 2018: 16 · 2017: 19 · 2016: 16 · 2015: 17 · 2014: 2
FWCI
12.00
Type
journal article
Language
en
Open access
Licence
Locations
  • Molecular Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (R00HL109247)
Topics
  • Health Sciences › Medicine › Physiology › Telomeres, Telomerase, and Senescence
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Aging › Genetics, Aging, and Longevity in Model Organisms
  • Social Sciences › Health › Health disparities and outcomes
Keywords
telomere length, telomere shortening, life events, chronic stress, health behavior, postmenopausal women, older women, physical activity, diet, sleep
MeSH terms
Aged, Female, Follow-Up Studies, Humans, Life Change Events, Middle Aged, Predictive Value of Tests, Stress, Psychological, Health Behavior, Multivariate Analysis, Telomere, Telomere Shortening

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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