Mathur · Brain, behavior, and immunity 2016 · Systematic review and random-effects meta-analysis · n=23 studies (22 meta-analyzed, 8,948 participants)

Perceived stress and telomere length: A systematic review, meta-analysis, and methodologic considerations for advancing the field.

Cited 258 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational studies

PubMed 26853993 · doi:10.1016/j.bbi.2016.02.002 · record verified 2026-08-29

What was done

Systematic review and random-effects meta-analysis investigating the association between self-reported perceived psychological stress (PS) and telomere length (TL). The authors searched PubMed, PsycInfo, Scopus, and unpublished sources, and contacted authors to obtain correlation data. Study quality was evaluated using modified MINORS criteria. The primary outcome was the age-adjusted correlation between PS and TL, with post hoc subgroup analyses and meta-regression evaluating sex, life stress exposure, PS measure validation, and publication bias.

What was found

Across 22 meta-analyzed studies (total n = 8,948): - Increased PS was associated with a very small decrease in age-adjusted TL: r = -0.06 (95% CI: -0.10 to -0.008; p = 0.01; n = 8,724). - The association remained similar between sexes and in studies using validated PS instruments. - Samples recruited specifically for stress exposure showed a marginally stronger correlation: r = -0.13 (versus general samples: b = -0.11; 95% CI: -0.27 to 0.01; p = 0.05). - Publication bias was detected, and correcting for it attenuated the association.

Why it matters

This review clarifies that the general association between short-term perceived stress and telomere length is statistically significant but very small, comparable to that between obesity and telomeres, and may be inflated by publication bias.

Limits

All included studies relied on single, short-term measures of perceived stress (past month) rather than longitudinal assessments of chronic stress. Observational designs limit causal inference, and correcting for potential publication bias reduced the observed effect.

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