Associations of Telomere Length and Change With Cognitive Decline Were Modified by Sex and Race: The REGARDS Study.

INTRODUCTION:We examined the associations of baseline telomere length (TL) and TL change with cognitive function over time in older US adults, as well as differences by sex and race. METHODS:A total of 1820 cognitively healthy individuals (median baseline age: 63 years) were included. Telomere length was measured using qPCR-based method at baseline and among 614 participants in the follow-up examination 10 years later. Cognitive function was assessed by a four-test battery every 2 years. RESULTS:In multivariable-adjusted linear mixed models, longer baseline TL and smaller attrition/lengthening of TL over time were associated with better Animal Fluency Test score. Longer baseline TL was also linearly associated with better Letter Fluency Test score. The observed associations were consistently more pronounced in women than men and in Black compared to White participants. DISCUSSION:Telomere length may be a biomarker that predicts long-term verbal fluency and executive function, particularly in women and Black Americans.