Purpose This study aimed to synthesize evidence for the association of psychological stress with Telomere Length (TL)-a potential biomarker of cellular aging. Methods: A systematic literature search was conducted to identify eligible studies in the Cochrane Library, PubMed, Embase, and CINHAL. In this review, we included all papers published since the initiative's inception and summarized results as of March 2022. Studies that investigated subjective stress using questionnaires and objective stress using biomarkers of adults (aged≥18 years) were included. Ultimately, 20 studies met our selection criteria. The risk of bias was assessed using the Newcastle-Ottawa Scale. Results: Fifteen of the twenty studies (75.0%) reported that individuals with higher psychological stress levels had shorter TL. Eleven of sixteen studies (68.8%) measuring subjective stress and five of eight studies (62.5%) measuring objective stress showed significant associations of psychological stress with TL. However, five studies reported no association between psychological stress and TL shortening. Although the heterogeneous studies limited the ability to draw clear conclusions, it is suggested that psychological stress might accelerate the erosion of telomere ends. Conclusion Our findings indicate that TL could be a useful emerging biomarker for measuring stress-related health outcomes in nursing. Further large-scale longitudinal studies using TL as a genetic biomarker with multidimensional stress measurements are needed to investigate the association between psychological stress and cellular senescence.
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