title: Systematic review of the association between chronic social stress and telomere length: A life course perspective.
abstract: Our aim was to examine whether chronic social stress is associated with telomere length throughout the life course, following our protocol published in 2014. Structured searches were conducted in MEDLINE (PubMed interface), EMBASE (OVID interface), Cochrane Central (OVID interface) and grey from their start date onwards. Reference lists of retrieved citations were hand searched for relevant studies. Eighteen studies published until May 1, 2015 investigating the association between chronic social stress (as defined by poverty, exposure to violence, or family caregiving) and telomere length in healthy or diseased adults and children were independently selected by 2 reviewers. Sixteen of those studies were cross-sectional and two had a longitudinal design. Studies differed in type of stress exposure, method to measure telomere length and cell type. As meta-analysis could not be conducted, the data were synthesized as a narrative review. Based on this comprehensive review, chronic social stress accompanies telomere shortening in both early and adult exposures, with most eligible studies showing a significant relationship. We discuss the significance of chronic stress of social origin and the potential for social interventions through public policies and we recommend methodological improvements that would allow for future meta-analysis.
authors.affiliation: Department of Physiotherapy, Federal University of Rio Grande do Norte, Av Sen. Salgado Filho, 3000, Campus Universitário, Natal 59078-970, RN, Brazil. Electronic address: brunasioliveira@gmail.com.
authors.forename: Bruna Silva
authors.initials: BS
authors.lastname: Oliveira
authors.affiliation: Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), 7101 Avenue du Parc, Montréal, Québec H3N 1X 9, Canada. Electronic address: maria.victoria.zunzunegui@umontreal.ca.
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Zunzunegui
authors.affiliation: Genetics Institute, University of Florida, Gainesville, FL, Mulligan Lab. 2033 Mowry Rd., P.O. Box 103610, United States; Department of Anthropology, University of Florida, Gainesville, FL, United States. Electronic address: jacki.quinlan@gmail.com.
authors.forename: Jacklyn
authors.initials: J
authors.lastname: Quinlan
authors.affiliation: Department of Medicine, University of Montreal Hospital Research Centre (CRCHUM), 900, rue Saint-Denis, Montreal, Quebec, Canada. Electronic address: h.fahmi@umontreal.ca.
authors.forename: Hassan
authors.initials: H
authors.lastname: Fahmi
authors.affiliation: Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), 7101 Avenue du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3 J7, Canada. Electronic address: mai.thanh.tu@umontreal.ca.
authors.forename: Mai Thanh
authors.initials: MT
authors.lastname: Tu
authors.affiliation: Department of Physiotherapy, Federal University of Rio Grande do Norte, Av Sen. Salgado Filho, 3000, Campus Universitário, Natal 59078-970, RN, Brazil. Electronic address: roguerra@ufrnet.br.
authors.forename: Ricardo Oliveira
authors.initials: RO
authors.lastname: Guerra
mesh_terms: D000328:Adult; D002648:Child; D005192:Family Health; D006801:Humans; D011203:Poverty / Q000523:psychology*; D012931:Social Environment; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology; D059505:Telomere Homeostasis / Q000502:physiology; D059506:Telomere Shortening; D014754:Violence / Q000523:psychology*
keywords: Caregiving; Chronic stress; Life course epidemiology; Poverty; Telomere length; Violence