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Do good health and material circumstances protect older people from the increased risk of death after bereavement?

Shah SM, Carey IM, Harris T, DeWilde S, Victor CR, Cook DG - Am. J. Epidemiol. (2012)

Bottom Line: In a model adjusted for age, sex, comorbid conditions at baseline, material deprivation based on area of residence, season, and smoking status, the hazard ratio for mortality in the first year after bereavement was 1.25 (95% confidence interval: 1.18, 1.33).The association was strongest in individuals with no significant chronic comorbid conditions throughout follow up (hazard ratio = 1.50, 95% confidence interval: 1.28, 1.77) and in more affluent couples (P = 0.035).Good health and material circumstances do not protect individuals from increased mortality rates after bereavement.

View Article: PubMed Central - PubMed

Affiliation: Division of Population Health Sciences and Education, St. George's University of London, London, UK. sushah@sgul.ac.uk

ABSTRACT
An increased risk of death in persons who have suffered spousal bereavement has been described in many populations. The impact of modifying factors, such as chronic disease and material circumstances, is less well understood. The authors followed 171,720 [corrected] couples 60 years of age or older in a United Kingdom primary care database between 2005 and 2010 for an average of 4 years. A total of 26,646 (15.5%) couples experienced bereavement, with mean follow up after bereavement of 2 years. In a model adjusted for age, sex, comorbid conditions at baseline, material deprivation based on area of residence, season, and smoking status, the hazard ratio for mortality in the first year after bereavement was 1.25 (95% confidence interval: 1.18, 1.33). Further adjustment for changes in comorbid conditions throughout follow up did not alter the hazard ratio for bereavement (hazard ratio = 1.27, 95% confidence interval: 1.19, 1.35). The association was strongest in individuals with no significant chronic comorbid conditions throughout follow up (hazard ratio = 1.50, 95% confidence interval: 1.28, 1.77) and in more affluent couples (P = 0.035). In the first year after bereavement, the association between bereavement and death is not primarily mediated through worsening or new onset of chronic disease. Good health and material circumstances do not protect individuals from increased mortality rates after bereavement.

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Quarterly log scale hazard ratios for death after bereavement in older couples, United Kingdom, 2005–2010. Hazard ratios were adjusted for age, sex, and region. Bars, 95% confidence interval.
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KWS162F1: Quarterly log scale hazard ratios for death after bereavement in older couples, United Kingdom, 2005–2010. Hazard ratios were adjusted for age, sex, and region. Bars, 95% confidence interval.

Mentions: We based our approach to identification of cohabiting couples on an analysis of national survey data. This showed that among those who were 60 years of age or older, couples of the opposite sex with an age difference of less than 10 years who live together in a household are almost invariably married or cohabiting (12). We developed an algorithm (Appendix Figure 1) that identified households that contained a person who was 60 years of age or older living and with another adult 50 years of age or older of opposite sex. We required that included couples had an age difference of 10 years or less and that no younger adult in the household be within 15 years of either of the couple.Figure 1.


Do good health and material circumstances protect older people from the increased risk of death after bereavement?

Shah SM, Carey IM, Harris T, DeWilde S, Victor CR, Cook DG - Am. J. Epidemiol. (2012)

Quarterly log scale hazard ratios for death after bereavement in older couples, United Kingdom, 2005–2010. Hazard ratios were adjusted for age, sex, and region. Bars, 95% confidence interval.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472615&req=5

KWS162F1: Quarterly log scale hazard ratios for death after bereavement in older couples, United Kingdom, 2005–2010. Hazard ratios were adjusted for age, sex, and region. Bars, 95% confidence interval.
Mentions: We based our approach to identification of cohabiting couples on an analysis of national survey data. This showed that among those who were 60 years of age or older, couples of the opposite sex with an age difference of less than 10 years who live together in a household are almost invariably married or cohabiting (12). We developed an algorithm (Appendix Figure 1) that identified households that contained a person who was 60 years of age or older living and with another adult 50 years of age or older of opposite sex. We required that included couples had an age difference of 10 years or less and that no younger adult in the household be within 15 years of either of the couple.Figure 1.

Bottom Line: In a model adjusted for age, sex, comorbid conditions at baseline, material deprivation based on area of residence, season, and smoking status, the hazard ratio for mortality in the first year after bereavement was 1.25 (95% confidence interval: 1.18, 1.33).The association was strongest in individuals with no significant chronic comorbid conditions throughout follow up (hazard ratio = 1.50, 95% confidence interval: 1.28, 1.77) and in more affluent couples (P = 0.035).Good health and material circumstances do not protect individuals from increased mortality rates after bereavement.

View Article: PubMed Central - PubMed

Affiliation: Division of Population Health Sciences and Education, St. George's University of London, London, UK. sushah@sgul.ac.uk

ABSTRACT
An increased risk of death in persons who have suffered spousal bereavement has been described in many populations. The impact of modifying factors, such as chronic disease and material circumstances, is less well understood. The authors followed 171,720 [corrected] couples 60 years of age or older in a United Kingdom primary care database between 2005 and 2010 for an average of 4 years. A total of 26,646 (15.5%) couples experienced bereavement, with mean follow up after bereavement of 2 years. In a model adjusted for age, sex, comorbid conditions at baseline, material deprivation based on area of residence, season, and smoking status, the hazard ratio for mortality in the first year after bereavement was 1.25 (95% confidence interval: 1.18, 1.33). Further adjustment for changes in comorbid conditions throughout follow up did not alter the hazard ratio for bereavement (hazard ratio = 1.27, 95% confidence interval: 1.19, 1.35). The association was strongest in individuals with no significant chronic comorbid conditions throughout follow up (hazard ratio = 1.50, 95% confidence interval: 1.28, 1.77) and in more affluent couples (P = 0.035). In the first year after bereavement, the association between bereavement and death is not primarily mediated through worsening or new onset of chronic disease. Good health and material circumstances do not protect individuals from increased mortality rates after bereavement.

Show MeSH
Related in: MedlinePlus