Aging & Longevity

Health behaviours and telomere biology in severe mental disorders.

TL;DR

A healthier lifestyle is associated with longer telomere length in individuals with severe mental disorders, with healthy lifestyle individuals exhibiting a roughly 6-year lower biological age compared to those with unhealthy lifestyles.

Key Findings

Individuals with severe mental disorders who had an unhealthy lifestyle had significantly shorter telomere length compared to those with a healthy lifestyle.

  • Cohen's d = 0.58, F = 8.62, p = 0.004
  • The effect size (Cohen's d = 0.58) indicates a medium-to-large effect
  • Analysis was adjusted for age, sex, ethnicity, trauma exposure, medication daily defined dose (DDD), years of education, and diagnosis
  • Leukocyte telomere length was measured via blood using quantitative real-time PCR (qPCR)

There was a dose-response relationship between increasing number of unhealthy behaviours and shorter telomere length.

  • F = 2.69, p = 0.02
  • A health behaviour variable was created indicating the level of unhealthy behaviours across six lifestyle domains
  • The six lifestyle domains assessed were: diet, exercise, smoking, alcohol consumption, substance use, and coffee consumption
  • The analysis was adjusted for age, sex, ethnicity, trauma exposure, medication daily defined dose (DDD), years of education, and diagnosis

In terms of base-pair loss, individuals with healthy lifestyles exhibited a roughly 6-year lower biological age compared to individuals with unhealthy lifestyles.

  • This estimate was derived from telomere length differences expressed as base-pair loss
  • The finding was observed within a sample of individuals with severe mental disorders, not the general population
  • The sample consisted of 410 participants from the Norwegian Thematically Organised Psychosis (TOP) study

The study sample consisted of 410 participants with severe mental disorders drawn from the Norwegian Thematically Organised Psychosis (TOP) study.

  • Schizophrenia spectrum disorders: n = 225
  • Affective disorders: n = 185
  • Self-report data were collected across six lifestyle domains: diet, exercise, smoking, alcohol consumption, substance use, and coffee consumption
  • A global dichotomised (healthy vs. unhealthy) lifestyle variable was created in addition to a continuous health behaviour variable

Alterations in telomere length have been previously reported in individuals with severe mental disorders, and unhealthy lifestyles may exacerbate telomere attrition, but the impact of lifestyle on telomere length within SMD had remained unexplored prior to this study.

  • Telomere length is described as 'a marker of cellular ageing'
  • Epidemiological studies of the general population had previously highlighted that unhealthy lifestyles may exacerbate telomere attrition
  • The authors state the impact of lifestyle on telomere length 'within the context of SMD remains unexplored' prior to their study

What This Means

This research suggests that the way people with serious mental illnesses (such as schizophrenia and bipolar disorder) live their daily lives is linked to how quickly their cells age. The study measured telomere length — protective caps on chromosomes that shorten as we age — in 410 people with severe mental disorders in Norway. Participants who had healthier lifestyles across six areas (diet, exercise, smoking, alcohol, substance use, and coffee consumption) had significantly longer telomeres than those with unhealthier lifestyles. Furthermore, the more unhealthy behaviors a person engaged in, the shorter their telomeres tended to be, suggesting a cumulative effect. The difference in telomere length between the healthy and unhealthy lifestyle groups translated to approximately 6 years of biological age — meaning people with healthier habits had cells that appeared about 6 years younger at the cellular level. This effect was found even after accounting for factors like age, sex, medication use, education, and trauma history. The medium-to-large effect size (Cohen's d = 0.58) indicates this is a meaningful, not trivial, association. This research suggests that lifestyle factors are not only important for physical health in the general population, but may also play a meaningful role in how quickly cells age in people living with serious psychiatric conditions. Because people with severe mental disorders often face elevated rates of physical health problems and premature mortality, findings like these highlight that health behaviors could be important clinical targets. Supporting people with mental illness in adopting healthier habits may have measurable biological benefits, potentially slowing cellular aging.

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Citation

Mlakar V, Di Forti M, Halff E, Srivastava D, Akkouh I, Djurovic S, et al.. (2026). Health behaviours and telomere biology in severe mental disorders.. Translational psychiatry. https://doi.org/10.1038/s41398-026-04362-2