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

The biological aging mechanisms by which loss exposure relates to mortality are not well-understood, particularly among communities of color. In this pre-registered, longitudinal study, we evaluated whether salivary telomeres mediate associations between loss burden-premature and cumulative exposure to family member deaths over the lifetime-and mortality. Leveraging a prospective sample of 4837 U.S. older adults from the Health and Retirement Study who recorded at least one kin death, we tested whether participants' loss burden related to their salivary telomeres 2 years later (linear regression models) and, in turn, predicted all-cause mortality 14 years later (Cox regression models). Models adjusted for covariates including family size, socioeconomic status, and baseline health including smoking. Telomeres did not mediate relationships between loss burden and mortality. Higher loss burden and shorter telomeres each predicted higher odds of mortality. Unexpectedly in race-stratified models, more childhood loss related to longer telomeres among Hispanic participants, and younger kin deaths related to longer telomeres among Black participants. Findings highlight the limitations of salivary telomeres in explaining racial health disparities and the need to identify biological aging mechanisms after loss among communities of color.