Family member bereavement, salivary telomere length, and all-cause mortality in older adults: Findings from the Health and Retirement Study.

Salivary telomere length did not mediate the association between loss burden and all-cause mortality.

• The study used a prospective sample of 4837 U.S. older adults from the Health and Retirement Study who recorded at least one kin death.
• Mediation was tested with salivary telomeres measured 2 years after loss burden assessment and mortality assessed 14 years later.
• Cox regression models were used for mortality outcomes and linear regression models for telomere outcomes.
• Models adjusted for covariates including family size, socioeconomic status, baseline health, and smoking.

Higher loss burden predicted higher odds of all-cause mortality.

• Loss burden was defined as premature and cumulative exposure to family member deaths over the lifetime.
• The association with mortality was independent of salivary telomere length.
• The study followed participants for up to 14 years for mortality outcomes.
• Models adjusted for socioeconomic status, family size, and baseline health including smoking.

Shorter salivary telomere length independently predicted higher odds of all-cause mortality.

• The association between shorter telomeres and mortality was independent of loss burden.
• Telomere length was measured from salivary samples.
• This finding held after adjustment for covariates including socioeconomic status and baseline health.
• Telomeres were assessed approximately 2 years after loss burden measurement.

In race-stratified models, more childhood loss was unexpectedly associated with longer telomeres among Hispanic participants.

• This finding was described as 'unexpected' by the authors.
• The direction of the association was opposite to that hypothesized, with more loss relating to longer rather than shorter telomeres.
• The authors noted this highlights 'the limitations of salivary telomeres in explaining racial health disparities.'
• Race-stratified models were conducted to examine differential associations by racial/ethnic group.

In race-stratified models, younger kin deaths were unexpectedly associated with longer telomeres among Black participants.

• This finding was also described as 'unexpected' by the authors.
• Younger kin deaths (i.e., more premature loss) related to longer rather than shorter telomeres among Black participants.
• The authors indicated a need 'to identify biological aging mechanisms after loss among communities of color.'
• This pattern suggests that salivary telomere length may not adequately capture biological aging processes related to bereavement in communities of color.

The study was pre-registered and longitudinal, leveraging the Health and Retirement Study sample of older U.S. adults.

• The sample consisted of 4837 U.S. older adults who had recorded at least one kin death.
• The design was prospective with loss burden assessed at baseline, telomeres measured 2 years later, and mortality tracked for 14 years.
• The study was pre-registered, indicating hypothesis and analysis plans were specified in advance.
• The Health and Retirement Study is a nationally representative longitudinal survey of Americans over age 50.