Telomere Length and All-Cause Mortality: A Meta-analysis

Ageing Res Rev. 2018 Dec:48:11-20. doi: 10.1016/j.arr.2018.09.002. Epub 2018 Sep 22.


Telomere attrition is associated with increased morbidity and mortality of various age-related diseases. Reports of association between telomere length (TL) and all-cause mortality remain inconsistent. In the present study, a meta-analysis was performed using published cohort studies and un-published data from the Swedish Twin Registry (STR). Twenty-five studies were included: four STR cohorts (12,083 individuals with 2517 deaths) and 21 published studies. In the STR studies, one standard deviation (SD) decrement of leukocyte TL corresponded to 13% increased all-cause mortality risk (95% confidence interval [CI]: 7%-19%); individuals in the shortest TL quarter had 44% higher hazard (95% CI: 27%-63%) than those in the longest quarter. Meta-analysis of all eligible studies (121,749 individuals with 21,763 deaths) revealed one SD TL decrement-associated hazard ratio of 1.09 (95% CI: 1.06-1.13); those in the shortest TL quarter had 26% higher hazard (95% CI: 15%-38%) compared to the longest quarter, although between-study heterogeneity was observed. Analyses stratified by age indicated that the hazard ratio was smaller in individuals over 80 years old. In summary, short telomeres are associated with increased all-cause mortality risk in the general population. However, TL measurement techniques and age at measurement contribute to the heterogeneity of effect estimation.

Keywords: all-cause mortality; epidemiology; meta-analysis; telomere length.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Aged, 80 and over
  • Cause of Death / trends*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Mortality
  • Registries
  • Sweden / epidemiology
  • Telomere / immunology
  • Telomere / metabolism*
  • Telomere / pathology
  • Telomere Homeostasis / physiology*
  • Telomere Shortening / physiology*