title: An integrative review of factors associated with telomere length and implications for biobehavioral research.
abstract: BACKGROUND
  Although telomere shortening occurs as a natural part of aging, there is now a robust body of research that suggests that there is a relationship between psychosocial, environmental, and behavioral factors and changes in telomere length. These factors need to be considered when integrating telomere measurement in biobehavioral research studies.
  
  
  OBJECTIVE
  This article provides a brief summary of the known facts about telomere biology and an integrative review of current human research studies that assessed relationships between psychosocial, environmental, or behavioral factors and telomere length.
  
  
  METHODS
  An integrative review was conducted to examine human research studies that focused on psychosocial, environmental, and behavioral factors affecting telomere length and telomerase activity using the electronic databases PubMed/Medline and CINAHL from 2003 to the present. In addition to the known individual factors that are associated with telomere length, the results of the integrative review suggest that perceived stress, childhood adversities, major depressive disorder, educational attainment, physical activity, and sleep duration should also be measured.
  
  
  CONCLUSIONS
  Multiple factors have been shown to affect telomere length. To advance understanding of the role of telomere length in health and disease risk, it will be important to further elucidate the mechanisms that contribute to telomere shortening.
authors: Angela R. Starkweather, PhD, ACNP-BC, CNRN, is Associate Professor, School of Nursing, Virginia Commonwealth University, Richmond. Areej A. Alhaeeri, BS, is Graduate Student, School of Medicine, Virginia Commonwealth University, Richmond. Alison Montpetit, PhD, RN, is Assistant Professor, School of Nursing, Virginia Commonwealth University, Richmond. Jenni Brumelle, PhD, is Postdoctoral Fellow, School of Medicine, Virginia Commonwealth University, Richmond. Kristin Filler, RN, BS, is Doctoral Student Fellow; Marty Montpetit, PhD, is Assistant Professor; Lathika Mohanraj, PhD, is Postdoctoral Fellow; Debra E. Lyon, PhD, RN, FNP-BC, FNAP, FAAN, is Associate Dean for Research, School of Nursing, Virginia Commonwealth University, Richmond. Colleen K. Jackson-Cook, PhD, is Professor, School of Medicine, Virginia Commonwealth University, Richmond.
authors: Angela R
authors: AR
authors: Starkweather
authors: Areej A
authors: AA
authors: Alhaeeri
authors: Alison
authors: A
authors: Montpetit
authors: Jenni
authors: J
authors: Brumelle
authors: Kristin
authors: K
authors: Filler
authors: Marty
authors: M
authors: Montpetit
authors: Lathika
authors: L
authors: Mohanraj
authors: Debra E
authors: DE
authors: Lyon
authors: Colleen K
authors: CK
authors: Jackson-Cook
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000235:genetics* / Q000502:physiology*; D001519:Behavior / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000235:genetics*; D008875:Middle Aged; D013315:Stress, Psychological / Q000235:genetics*; D059505:Telomere Homeostasis; D059506:Telomere Shortening; D055815:Young Adult