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Uchino BN, Rook KS. Emotions, relationships, health and illness into old age. Maturitas 2020; 139:42-48. [PMID: 32747039 PMCID: PMC7403529 DOI: 10.1016/j.maturitas.2020.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023]
Abstract
There is strong evidence linking relationships and emotions to physical health outcomes. What is critically missing is a more comprehensive understanding of how these important psychosocial factors influence disease over the lifespan. In this narrative review, existing lifespan models of social support and emotion regulation are reviewed and integrated into a general conceptual framework in the health domain. This integrated model takes into account bidirectional links between relationships and emotions, as well as health behaviors, biological pathways, and health. Evidence is consistent with the utility of an integrative model attempting to understand its links to health-relevant pathways and outcomes in older adults. Future work that examines multiple pathways using prospective designs will be necessary for this work to reach its full potential, including intervention and policy opportunities.
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Affiliation(s)
- Bert N Uchino
- Department of Psychology and Health Psychology Program, University of Utah, United States.
| | - Karen S Rook
- Department of Psychological Science, University of California, Irvine, United States
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52
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Wörn J, Comijs H, Aartsen M. Spousal Loss and Change in Cognitive Functioning: An Examination of Temporal Patterns and Gender Differences. J Gerontol B Psychol Sci Soc Sci 2020; 75:195-206. [PMID: 30219919 DOI: 10.1093/geronb/gby104] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The study investigates whether the disadvantaged position of men in the adverse consequences of widowhood for health and mortality also exists for changes in cognitive health. METHODS We used data of up to 1,269 men and women aged 65 years and older who participated in the Longitudinal Aging Study Amsterdam in 3-yearly assessments between 1992 and 2012 (5,123 person-observations). All were married and without cognitive impairment (Mini-Mental State Examination ≥ 24) at baseline and up to 419 lost their spouse. In fixed effects regression models, the effect of spousal loss on change in four domains of cognitive functioning was estimated independently of age-related cognitive change. RESULTS For women, a robust temporary decrease was found in the second year after spousal loss in the reasoning domain, but not in global cognitive functioning, processing speed, or memory. No robust effects were found for men. DISCUSSION Considering that only one cognitive domain was affected and effects were temporary, cognitive functioning seems rather robust to the experience of spousal loss. Despite men having often been reported to be in a disadvantaged position in other health domains, our analyses indicate no such pattern for cognitive functioning.
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Affiliation(s)
- Jonathan Wörn
- Research Training Group SOCLIFE, Albertus-Magnus-Platz, Cologne, Germany.,Institute of Sociology and Social Psychology, University of Cologne, Albertus-Magnus-Platz, Cologne, Germany
| | - Hannie Comijs
- GGZinGeest/Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - Marja Aartsen
- NOVA, Norwegian Social Research, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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53
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Chen C, Chow AYM, Tang S. Trajectories of depression symptoms in Chinese elderly during widowhood: a secondary analysis. Aging Ment Health 2020; 24:1254-1262. [PMID: 30983380 DOI: 10.1080/13607863.2019.1603285] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: This study aims to identify heterogeneous depressive symptom trajectories among the widowed elderly in China, to explore predictive variables of latent class membership, and to detect between-classes differences in life satisfaction across time.Method: Data of 198 individuals widowed between 2011 and 2013 were drawn from The China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. Latent class growth analysis was employed to identify depressive symptom trajectories across 2011, 2013, and 2015, and a three-step auxiliary approach was applied to detect predictive variables of latent class membership. Mixed Analysis of Variances was followed to make between-class comparisons on life satisfaction across time.Results: Four grieving trajectories were identified: resilient (54.6%), chronic grief (23.7%), depressed-improved (11.6%), and chronic depression (10.1%). Older age, living exclusively with spouse before widowhood, and agricultural Hukou were significant predictors of depressed-improved, chronic grief, and chronic depression patterns, respectively. Life satisfaction in all groups except for the resilient one remained stable across time, and that of the chronic depression group was significantly lower than those of all the remaining groups.Conclusion: Consistent depressive symptom trajectories during late-life widowhood exist across nations while the specific culture, values, and resources in the Chinese context may have contributed to a particularly high proportion of the chronic grief trajectory. More efforts should be made to identify patterns with predictors before support are provided, and interventions need to be tailored to target specific needs in each subgroup of the elderly during their transitions to widowhood.
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Affiliation(s)
- Chuqian Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Suqin Tang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China.,Shenzhen University, Shenzhen, China
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54
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Trevisan C, Grande G, Vetrano DL, Maggi S, Sergi G, Welmer AK, Rizzuto D. Gender Differences in the Relationship Between Marital Status and the Development of Frailty: A Swedish Longitudinal Population-Based Study. J Womens Health (Larchmt) 2020; 29:927-936. [DOI: 10.1089/jwh.2019.8095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Giulia Grande
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Davide Liborio Vetrano
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Centro Medicina dell'Invecchiamento, IRCCS Fondazione Policlinico “A. Gemelli” and Catholic University of Rome, Rome, Italy
| | - Stefania Maggi
- National Research Council, Neuroscience Institute - Aging Branch, Padova, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, Italy
| | - Anna-Karin Welmer
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Allied Health Professionals, Function Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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55
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Höltge J, Samper-Ternent R, García-Peña C, Gutiérrez-Robledo LM. A Longitudinal Study on Multidimensional Resilience to Physical and Psychosocial Stress in Elderly Mexicans. J Aging Health 2020; 32:1450-1463. [PMID: 32602776 DOI: 10.1177/0898264320932777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To identify trajectories of depression and daily disability in the context of serious falls and widowhood and to predict those trajectories before the events occurred. Methods: Longitudinal data were used from the Mexican Health and Aging Study. Trajectories were estimated using latent class growth analysis. Internal and socio-ecological resources were analyzed as predictors of the trajectories. Results: Unfavorable (worsening of symptoms and chronic high symptoms) and favorable (improvement of symptoms and stable low symptoms (resistance)) trajectories were identified. Favorable trajectories were more likely for daily disability. Persons who showed resistance in depression also tended to show resistance in daily disability. Net worth, cognition, and subjective well-being were early predictors for most trajectories. Discussion: Besides resistance, individuals rather show different co-occurring trajectories in the studied outcomes. While some factors could be identified that lead to favorable trajectories in both stressful contexts, the study also shows the necessity for context-specific research and praxis.
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Affiliation(s)
- Jan Höltge
- University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland.,Resilience Research Centre, Dalhousie University, Halifax, Canada
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Al-Kandari YY. Older Men With Living Spouses Versus Men Without Spouses: An Example From the Arab World-Kuwait. Am J Mens Health 2020; 14:1557988320937213. [PMID: 32627707 PMCID: PMC7492863 DOI: 10.1177/1557988320937213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/23/2020] [Accepted: 05/29/2020] [Indexed: 01/20/2023] Open
Abstract
This research is concentrated on elderly Kuwait men and the effect that losing wife, a major determinant of social support, has on their general health. A sample of 472 older male adults aged 60 years and older have been included in this study. A questionnaire was the major tool of the study. The questionnaire included sociocultural information and social support scales (Degree of Religiosity, Social Support Scale, Frequency of Contact, and Strength of Relation scales). Health measurements also were used: two, one-item self-reported health scales in the current year and last year and a Somatic Symptoms Inventory (SSI) were used. Systolic and diastolic blood pressure and glucose levels were taken. Statistical Package for Social Sciences (SPSS, version 21) was used for data entry and analysis. t-test and regression were the major statistical procedures. Data show that there are differences between elderly men with a living wife compared to those without a living wife. Having a living wife was positively associated with better social support and health in Kuwaiti elderly men. Data show that a living wife is an important factor of men's health and well-being in general and that a wife is one of the major social support elements of elderly men.
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Affiliation(s)
- Yagoub Yousif Al-Kandari
- Department of Sociology and Social Work
and Anthropology Department, Kuwait University, Kifan, Kuwait
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57
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Xu J, Wu Z, Schimmele CM, Li S. Widowhood and depression: a longitudinal study of older persons in rural China. Aging Ment Health 2020; 24:914-922. [PMID: 30739494 DOI: 10.1080/13607863.2019.1571016] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Using six waves of longitudinal data (2001-2015) collected in Anhui, China (N = 2,131) and generalized estimating equations (GEE) models, this study fulfilled several objectives. First, the study compared the widowed to the married to examine if the transition to and duration of widowhood contributes to changes in depression. Second, the study examined if the bereavement-depression relationship is a process that precedes widowhood or is an abrupt change following the death of a spouse. Third, the study examined if social resources influence the bereavement-depression relationship. The study found that there is pre-widowhood effect on depression and that the widowhood event also contributes to increases in depression. Levels of post-widowhood depressive symptoms peak during the first six months bereavement and taper off within 25 months. Controlling for social support, contact with children, and living arrangements does not change the bereavement-depression relationship. The findings support Attachment Theory, which suggests that the loss of a spouse leads to emotional isolation that cannot be overcome with kin-based social support and social integration.
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Affiliation(s)
- Jie Xu
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. China
| | - Zheng Wu
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | | | - Shuzhuo Li
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. China
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58
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Domingue BW, Duncan L, Harrati A, Belsky DW. Short-Term Mental Health Sequelae of Bereavement Predict Long-Term Physical Health Decline in Older Adults: U.S. Health and Retirement Study Analysis. J Gerontol B Psychol Sci Soc Sci 2020; 76:1231-1240. [PMID: 32246152 DOI: 10.1093/geronb/gbaa044] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Spousal death is a common late-life event with health-related sequelae. Evidence linking poor mental health to disease suggests the hypothesis that poor mental health following death of a spouse could be a harbinger of physical health decline. Thus, identification of bereavement-related mental health symptoms could provide an opportunity for prevention. METHODS We analyzed data from N = 39,162 individuals followed from 1994 to 2016 in the U.S. Health and Retirement Study; N = 5,061 were widowed during follow-up. We tested change in mental and physical health from prebereavement through the 5 years following spousal death. RESULTS Bereaved spouses experienced an increase in depressive symptoms following their spouses' deaths but the depressive shock attenuated within 1 year. Bereaved spouses experienced increases in disability, chronic-disease morbidity, and hospitalization, which grew in magnitude over time, especially among older respondents. Bereaved spouses were at increased risk of death compared to nonbereaved respondents. The magnitude of depressive symptoms in the immediate aftermath of spousal death predicted physical-health decline and mortality risk over 5 years of follow-up. DISCUSSION Bereavement-related depressive symptoms indicate a risk for physical health decline and death in older adults. Screening for depressive symptoms in bereaved older adults may represent an opportunity for intervention to preserve healthy life span.
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Affiliation(s)
- Benjamin W Domingue
- Stanford Graduate School of Education and Stanford Population Health Sciences, California
| | - Laramie Duncan
- Stanford Department of Psychiatry and Behavioral Sciences, California
| | - Amal Harrati
- Primary Care and Population Health, Stanford School of Medicine, California
| | - Daniel W Belsky
- Department of Epidemiology and Robert N Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, New York
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59
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Carr D, Utz RL. Families in Later Life: A Decade in Review. JOURNAL OF MARRIAGE AND THE FAMILY 2020; 82:346-363. [PMID: 33633412 PMCID: PMC7904069 DOI: 10.1111/jomf.12609] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 08/13/2019] [Indexed: 05/06/2023]
Abstract
Later-life families encompass the legal, biological, romantic, and kin-like relationships of persons ages 65 and older. Research on older families has flourished over the past decade, as population aging has intensified concerns regarding the capacities of families to care for older adults and the adequacy of public pension systems to provide an acceptable standard of living. Shifting patterns of family formation over the past half-century have created a context in which contemporary older adults' family lives differ markedly from earlier generations. Decreasing numbers of adults are growing old with their first and only spouse, with rising numbers divorcing, remarrying, forming non-marital romantic partnerships, or living single by choice. Remarriage and the formation of stepfamilies pose challenges and opportunities as older adults negotiate complex decisions such as inheritance and caregiving. Family relationships are consequential for older adults' well-being, operating through both biological and psychosocial mechanisms. We synthesize research from the past decade, revealing how innovations in data and methods have refined our understanding of late-life families against a backdrop of demographic change. We show how contemporary research refines classic theoretical frameworks and tests emerging conceptual models. We organize the article around two main types of family relationships: (1) marriage and romantic partnerships and (2) intergenerational relationships. We discuss how family caregiving occurs within these relationships, and offer three promising avenues for future research: ethnic minority and immigrant families; older adults without close kin ("elder orphans"); and the potentials of rapidly evolving technologies for intergenerational relationships and caregiving.
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Affiliation(s)
- Deborah Carr
- Department of Sociology, Boston University, 100 Cummington Mall, Boston, MA 02215
| | - Rebecca L Utz
- Department of Sociology, University of Utah, Social & Behavior Sciences Building, Salt Lake City, UT 84112-0250
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60
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Yu J, Kahana E, Kahana B, Han C. Depressive symptoms among elderly men and women who transition to widowhood: comparisons with long term married and long term widowed over a 10-year period. J Women Aging 2019; 33:231-246. [DOI: 10.1080/08952841.2019.1685855] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jiao Yu
- Sociology Department, Case Western Reserve University, Cleveland, Ohio, USA
| | - Eva Kahana
- Sociology Department, Case Western Reserve University, Cleveland, Ohio, USA
| | - Boaz Kahana
- Psychology Department, Cleveland State University, Cleveland, Ohio, USA
| | - Chengming Han
- Sociology Department, Case Western Reserve University, Cleveland, Ohio, USA
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61
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West CL, Dreeben SJ, Busing K. The Development of the Widowhood Resilience Scale. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:958-975. [PMID: 31510858 DOI: 10.1177/0030222819873489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Widowhood researchers have been increasingly interested in the construct of resilience and identifying factors which contribute to adaptive responses to conjugal loss. Available measures of general resilience were validated on nonwidowed samples and broadly lack face validity for use with widowed people. This article reports the development and validation of a resilience scale specific to widowhood, the Widowhood Resilience Scale. Initially, qualitative responses from 744 widowed people were analyzed and cross-referenced with existing literature on resilience to develop 49 items. The 49 items were tested on a sample of 1,188 widowed people, resulting in a 6-factor, 25-item scale.
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62
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Förster F, Pabst A, Stein J, Röhr S, Löbner M, Heser K, Miebach L, Stark A, Hajek A, Wiese B, Maier W, Angermeyer MC, Scherer M, Wagner M, König HH, Riedel-Heller SG. Are older men more vulnerable to depression than women after losing their spouse? Evidence from three German old-age cohorts (AgeDifferent.de platform). J Affect Disord 2019; 256:650-657. [PMID: 31301630 DOI: 10.1016/j.jad.2019.06.047] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/24/2019] [Accepted: 06/30/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Old age is accompanied by a higher risk of losing a spouse. This study aims to longitudinally investigate the effect of widowhood on depression severity with a special focus on sex differences. We examine depression before and after widowhood in men and women separately to investigate which sex is at greater risk after losing a spouse. METHODS Data came from the AgeDifferent.de platform, which includes three pooled old age cohort studies. In order to examine factors associated with depression over time, we applied a linear hybrid mixed-effects regression model for the overall sample and analysed additional separate models for men and women. RESULTS Of 2470 respondents (mean age at baseline 79.2 (SD 3.64) years), 1256 were men. In total, 209 men and 332 women experienced spousal bereavement after baseline. In general, both sexes showed higher depression severity after widowhood. However, there were significant sex differences. Widowed men were more prone to subsequent depression than widowed women. In terms of depression severity, widowed men differed significantly compared to non-widowed men; however, this was not the case for women. LIMITATION We harmonized three cohort studies which used different measurement scales for depression and different recruitment procedures. CONCLUSION Our study showed that although both genders suffer from losing a spouse, men are more prone to subsequently develop depressive symptoms. Raising the awareness among practitioners for sex-specific differences as well as developing tailored interventions for both widowed men and women should be considered.
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Affiliation(s)
- Franziska Förster
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany
| | - Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Lisa Miebach
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany; DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Anne Stark
- Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany; DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Matthias C Angermeyer
- Center for Public Mental Health, Gösing am Wagram, Austria; Dipartimento di Sanità Pubblica, Università degli Studi di Cagliari, Italy
| | - Martin Scherer
- Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany; DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany
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Brown SL, Lin IF, Hammersmith AM, Wright MR. Later Life Marital Dissolution and Repartnership Status: A National Portrait. J Gerontol B Psychol Sci Soc Sci 2019; 73:1032-1042. [PMID: 27131167 DOI: 10.1093/geronb/gbw051] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 04/15/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives Our study compares two types of later life marital dissolution that occur after age 50-divorce and widowhood-and their associations with repartnership status (i.e., remarried, cohabiting, or unpartnered). Method We used data from the Health and Retirement Study to provide a portrait of later life divorce and widowhood for women and men. Next, we tested whether marital dissolution type is related to women's and men's repartnered status, distinguishing among remarrieds, cohabitors, and unpartnereds, net of key sociodemographic indicators. Results Divorcees are more often repartnered through either remarriage or cohabitation than are widoweds. This gap persists among women net of an array of sociodemographic factors. For men, the differential is reduced to nonsignificance with the inclusion of these factors. Discussion Later life marital dissolution increasingly occurs through divorce rather than widowhood, and divorce is more often followed by repartnership. The results from this study suggest that gerontological research should not solely focus on widowhood but also should pay attention to divorce and repartnering during later life.
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Affiliation(s)
- Susan L Brown
- Department of Sociology, Bowling Green State University, Ohio
| | - I-Fen Lin
- Department of Sociology, Bowling Green State University, Ohio
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64
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Jadhav A, Weir D. Widowhood and Depression in a Cross-National Perspective: Evidence from the United States, Europe, Korea, and China. J Gerontol B Psychol Sci Soc Sci 2019; 73:e143-e153. [PMID: 28329854 DOI: 10.1093/geronb/gbx021] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 02/15/2017] [Indexed: 11/14/2022] Open
Abstract
Objectives We explore marital and depression trajectories over time for men and women, and distinguish between mood and somatic depression across contexts. Method We use longitudinal data from 2002 to 2013 from the United States, England, Europe, Korea, and China to explore depression among individuals married at baseline and follow their trajectories into widowhood with married as the reference group. We use random effects models to estimate these trajectories using the Center for Epidemiologic Studies Depression Scale (CES-D) or EURO-D scales for men and women. Results Depression peaks within the first year of widowhood for men and women, but women recover to levels comparable to married counterparts in all countries. Men sustain high levels of depression even 6-10 years post-widowhood everywhere except Europe. Widowed women have higher somatic depression compared to men, who have higher mood depression. Family plays differential roles in mediating depression across countries. Discussion Our research shows the complex global relationship between widowhood and depression. Studies that do not compare depression trajectories over time may make incorrect inferences about the persistence of depression by gender and country. Interventions should target different components of depression: mood-related symptoms for men and somatic-related symptoms for women for most effective recovery.
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Affiliation(s)
- Apoorva Jadhav
- Population Studies Center and Health and Retirement Study and Health and Retirement Study, University of Michigan, Ann Arbor
| | - David Weir
- Population Studies Center and Health and Retirement Study and Health and Retirement Study, University of Michigan, Ann Arbor
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65
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Perone AK, Dunkle RE, Feld S, Shen HW, Kim MH, Pace GT. Depressive Symptoms among Former Spousal Caregivers: Comparing Stressors, Resources, and Circumstances of Caregiving Cessation among Older Husbands and Wives. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2019; 62:682-700. [PMID: 31352869 DOI: 10.1080/01634372.2019.1647906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 07/10/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
Little research focuses on the mental health of caregivers (CGs) who stop providing care to their community-dwelling spouse. We examine depressive symptoms of former primary CG spouses who stopped caregiving over a two-year follow-up period when the care recipient (CR): (1) no longer has functional problems; (2) continues having functional problems; or (3) dies. Using data from the Health and Retirement Study (2000-2014), we located 2,370 couples who were both 50+ at baseline and where one partner provided help with ADL and/or IADL limitations but did not do so two years later. OLS regressions stratified by gender indicated that both male and female former spousal CGs whose CR died had significantly more depressive symptoms than those who ceased caregiving when their spouse did or did not still have functional problems. Former wife CGs who were older and whose husbands had more baseline ADLs had fewer follow-up depressive symptoms; wife CGs whose husbands had a nursing home stay had more depressive symptoms. Former husband CGs who had provided longer monthly hours of care had fewer follow-up symptoms. Findings underscore the importance of targeting mental and physical health services to both former caregiving husbands and wives, especially after spousal death.
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Affiliation(s)
- Angela K Perone
- School of Social Work, University of Michigan , Ann Arbor , Michigan , USA
| | - Ruth E Dunkle
- School of Social Work, University of Michigan , Ann Arbor , Michigan , USA
| | - Sheila Feld
- School of Social Work, University of Michigan , Ann Arbor , Michigan , USA
| | - Huei-Wern Shen
- Graduate Institute of Social Work, National Taiwan Normal University , Taipei , Taiwan
| | - Min Hee Kim
- School of Social Work, University of Michigan , Ann Arbor , Michigan , USA
| | - Garrett T Pace
- School of Social Work, University of Michigan , Ann Arbor , Michigan , USA
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The association of time since spousal loss and depression in widowhood: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2019; 54:781-792. [PMID: 30887075 DOI: 10.1007/s00127-019-01680-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 02/25/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To conduct a systematic review and meta-analysis examining the association of the prevalence of depression and time since spousal loss in widowed people. METHODS The databases MEDLINE, Embase and PsycInfo were searched (May 2017) for papers reporting on time since spousal loss in widowed people and the prevalence of common mental disorders. A systematic review was conducted according to MOOSE guidelines. Random effects meta-analyses of the prevalence of depression were conducted by intervals of time since spousal loss. RESULTS The literature search identified 12,982 studies of which 22 were eligible for inclusion in the systematic review. Of these, 14 were furthermore eligible for inclusion in the meta-analysis. The summary estimates found in the meta-analysis for the prevalence of depression in the intervals of time since spousal loss were: ≤ 1 month: 38.2% (21.9-55.8%); > 1 month to 3 months: 25.0% (17.3-33.5%); > 3 months to 6 months: 23.1% (18.0-28.7%); > 6 months to 12 months: 19.4% (15.2-24.0%); > 12 months to 18 months: 11.1% (5.3-18.7%); > 18 months to 24 months: 15.2% (12.3-18.2%); > 24 months to 60 months: 10.5% (4.3-18.5%). CONCLUSION Widowhood is associated with a high prevalence of depression and the study identifies a population group needing special attention in daily clinical practice. The prevalence is highest in the first month of widowhood, however, continues to be high at least 5 years into widowhood.
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67
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Li YP, Lin HS. Widowhood and health in late life: does health change before or after widowhood in older Taiwanese men and women? J Women Aging 2019; 32:684-699. [DOI: 10.1080/08952841.2019.1618128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Yueh-Ping Li
- Department of Nursing, National Tainan Junior College of Nursing, Tainan City, Taiwan, ROC
| | - Huey-Shyan Lin
- Department of Health-Business Administration, Dean, Office of Student Affairs, Fooyin University, Kaohsiung city, Taiwan, ROC
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Lin IF, Brown SL, Wright MR, Hammersmith AM. Depressive Symptoms Following Later-life Marital Dissolution and Subsequent Repartnering. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2019; 60:153-168. [PMID: 30957562 PMCID: PMC6565490 DOI: 10.1177/0022146519839683] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The doubling of the divorce rate among individuals over age 50 during the past 20 years underscores the urgency of studying the consequences of gray divorce and subsequent repartnering for adult well-being. We filled this gap by using the 1998-to-2014 Health and Retirement Study to evaluate how the levels of depressive symptoms changed following gray divorce versus widowhood. Individuals who divorced or became widowed already had experienced higher levels of depressive symptoms before dissolution relative to those who remained married. Compared with those who became widowed, those who transitioned to divorce experienced a lower elevation and a shorter time to recovery in depressive symptoms. When repartnering, both groups experienced similar magnitudes of initial reduction and subsequent rates of increase. Both the negative consequences of marital dissolution and the beneficial effects of repartnership for mental health persisted for several years, although ultimately they reverted to their predissolution levels of depressive symptoms.
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Affiliation(s)
- I-Fen Lin
- 1 Bowling Green State University, Bowling Green, OH, USA
| | - Susan L Brown
- 1 Bowling Green State University, Bowling Green, OH, USA
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Szabó Á, Kok AAL, Beekman ATF, Huisman M. Longitudinal Examination of Emotional Functioning in Older Adults After Spousal Bereavement. J Gerontol B Psychol Sci Soc Sci 2019; 75:1668-1678. [DOI: 10.1093/geronb/gbz039] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
This study examined trajectories of emotional functioning in three domains (depressive symptoms, emotional, and social loneliness) for individuals who experienced spousal bereavement and investigated cross-domain adaptation. We hypothesized that emotional difficulties after bereavement would be more detectable in emotional loneliness than depressive symptoms or social loneliness.
Methods
Using latent class growth analysis, we modeled changes in depressive symptoms, emotional loneliness, and social loneliness from 12 years pre- to 12 years post-bereavement on data from 686 older adults to identify trajectories indicating adaptive and maladaptive functioning in each domain.
Results
Most participants reported depressive symptoms below the clinically relevant threshold by showing a resilient (15.5%) or a slightly elevated (53.5%) trajectory post-bereavement. One third (31%) reported clinically relevant depressive symptoms. More than half of the sample reported emotional loneliness post-bereavement, varying form prolonged (17%), increasing and prolonged (28.3%), and chronically high (8.9%) levels. Remaining participants displayed resilience (13.5%) or recovery (32.3%). Social loneliness showed four trajectories: very low and resilient (43.3%), low and resilient (27.5%), increasing (20.2%), and chronically high (9%) levels. One third of participants maintained adaptive, whereas 12% displayed maladaptive, functioning across all domains post-bereavement.
Discussion
An increase in emotional loneliness was the most commonly observed change after spousal bereavement. This highlights the central role of emotional loneliness in depression after bereavement.
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Affiliation(s)
- Ágnes Szabó
- School of Health Sciences, Massey University, Wellington, New Zealand
| | - Almar A L Kok
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, Amsterdam, The Netherlands
- Vrije Universiteit, Amsterdam, Department of Sociology, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Martijn Huisman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, Amsterdam, The Netherlands
- Vrije Universiteit, Amsterdam, Department of Sociology, Amsterdam, The Netherlands
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Zhang Z, Li LW, Xu H, Liu J. Does widowhood affect cognitive function among Chinese older adults? SSM Popul Health 2019; 7:100329. [PMID: 30581964 PMCID: PMC6293047 DOI: 10.1016/j.ssmph.2018.100329] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/17/2018] [Accepted: 11/19/2018] [Indexed: 01/26/2023] Open
Abstract
There is growing evidence from Western countries that widowhood may affect cognitive health in later life. However, little is known about whether widowhood is associated with cognitive health in Eastern Asian countries such as China and what factors may explain the association between widowhood and cognitive health. We add to this line of research by investigating the effect of widowhood on 2-year change in cognitive function among Chinese adults ages 55 and older from 2011 to 2013, using data from the China Health and Retirement Longitudinal Study. Cognitive function was measured by episodic memory and mental intactness (i.e., attention and time orientation). Our results showed that Chinese older adults who were continually widowed at both waves had significantly lower episodic memory scores at Wave 2 than their continually married counterparts, controlling for episodic memory at Wave 1, age, gender, education, and other sociodemographic variables. This suggests that the continually widowed experienced greater decline in episodic memory than the continually married over the 2-year period. After further controlling for economic resources, health, and social engagement, the difference in memory decline between the continually widowed and the continually married barely changed. The effect of widowhood on memory decline was similar for men and women. However, the continually widowed were not significantly different from the continually married in the decline of mental intactness. In addition, newly widowed adults were not significantly different from the continually married in the change of episodic memory and mental intactness. We conclude that staying widowed for 2 years or more may be an independent risk factor for episodic memory decline in China. More research is needed to investigate the mediating and moderating mechanisms underlying the association between widowhood and memory decline.
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Affiliation(s)
- Zhenmei Zhang
- Department of Sociology, Michigan State University, East Lansing, MI 48824, USA
| | - Lydia W. Li
- School of Social Work, University of Michigan, USA
| | - Hongwei Xu
- Department of Sociology, Queens College - CUNY, USA
| | - Jinyu Liu
- School of Social Work, Columbia University, USA
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71
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Pei Y, Cong Z, Wu B. Risk and Resiliency in the Relationship Between Widowhood and Depressive Symptoms Among Older Mexican Americans. J Cross Cult Gerontol 2019; 34:149-170. [PMID: 30903551 DOI: 10.1007/s10823-019-09367-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined the association between widowhood and depressive symptoms and the extent to which the association is contingent upon risk and resiliency, including immigration status, functional limitations, financial strains, and intergenerational support, among older Mexican Americans. The sample included 344 parent-child pairs reported by 83 respondents. Clustered regression analysis showed that widowhood elevated risks for depressive symptoms. We found that having some functional limitations, having more children and living in the same city with children exacerbated the adverse effects of widowhood on depressive symptoms. We also found that living in the same city with children increased the detrimental effects of widowhood on the depressive symptoms in men, whereas we did not find this pattern in women. The findings highlight the heterogeneity within the widowed Mexican American older adults. Implications for future research and practice are discussed.
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Affiliation(s)
- Yaolin Pei
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, USA.
| | - Zhen Cong
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY, 10010, USA
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72
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Blanner Kristiansen C, Kjær JN, Hjorth P, Andersen K, Prina AM. Prevalence of common mental disorders in widowhood: A systematic review and meta-analysis. J Affect Disord 2019; 245:1016-1023. [PMID: 30699843 DOI: 10.1016/j.jad.2018.11.088] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/27/2018] [Accepted: 11/12/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Widowed people have a high risk of common mental disorders, however no summary estimates of the prevalences exist. The aim of this study was to conduct a systematic review and meta-analysis of the prevalence of common mental disorders in widowed people in the community. METHODS MEDLINE, Embase and PsycInfo were searched for papers reporting on prevalence of common mental disorders and widowhood. Eligible studies were included in random effects meta-analyses of the prevalence of depression and anxiety disorders. Subgroup analyses were performed on method of assessment of depression and age and sex. RESULTS The literature search identified 13,781 titles of which 42 were eligible for meta-analysis. The pooled prevalence of depression in studies using a screening scale was 40.6% (33.6%-47.6%) (n = 30). For studies using full diagnostic criteria the pooled prevalence of depression was 19.2% (13.4%-25.0%) (n = 12). Subgroup analyses of age (≥ or < 65) and sex did not show any differences regarding depression. Five studies reported the prevalence of anxiety disorders. The pooled prevalence estimate was 26.9% (8.1%-45.7%). LIMITATIONS The prevalence estimates in this study are summary estimates of prevalences from existing literature. Although the reporting bias assessment showed no evidence, there could be some reporting bias, as studies might only present results if there is a high prevalence. CONCLUSIONS Widowed people have a high prevalence of depression and anxiety disorders. The high prevalence of depression was independent of age and sex. The study identifies a population group at high risk needing special attention in clinical practice.
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Affiliation(s)
- Christina Blanner Kristiansen
- Department of Psychiatry - Odense. Mental Health Services in the Region of Southern Denmark, Denmark; Institute of Psychiatry, Psychology & Neuroscience at King's College London, Department of Health Service and Population Research, Social Epidemiology Research Group, London, UK; Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Jesper Nørgaard Kjær
- Psychiatric Research Academy, Department of Affective Disorders, Aarhus University Hospital, Risskov, Denmark
| | - Peter Hjorth
- Institute for Regional Health, Region of Southern Denmark, Odense, Denmark; Centre for Psychiatric Nursing and Health Care Research, Region of Southern Denmark, Denmark
| | - Kjeld Andersen
- Department of Psychiatry - Odense. Mental Health Services in the Region of Southern Denmark, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark
| | - A Matthew Prina
- Institute of Psychiatry, Psychology & Neuroscience at King's College London, Department of Health Service and Population Research, Social Epidemiology Research Group, London, UK
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73
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Das A. Loneliness does (not) have cardiometabolic effects: A longitudinal study of older adults in two countries. Soc Sci Med 2019; 223:104-112. [DOI: 10.1016/j.socscimed.2018.10.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/01/2018] [Accepted: 10/23/2018] [Indexed: 12/31/2022]
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74
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Bennett KM, Chao Q, Roper L, Lowers V. "The deceased has left; the alive has to move on": Experiences of Chinese Widows in the UK. DEATH STUDIES 2018; 42:498-507. [PMID: 29173041 DOI: 10.1080/07481187.2017.1387617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Relatively little is known about the experiences of Chinese widows, especially those living outside China. This qualitative study examines the experiences of eight Chinese or Hong Kong-born widows living in the UK. Using a semistructured approach to interviewing, participants were asked about their lives before, during, and after their spousal bereavement. Five major themes emerged: (1) complexity of marital lives; (2) experiences around the time of the death including fate; (3) loneliness and isolation; (4) the challenges of practical tasks; and finally, (5) current life. The implications of the findings for social policy and practice are briefly discussed.
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Affiliation(s)
| | - Qiuling Chao
- b Department of International Cooperation and Exchange , Xi'an Jiaotong University , Xi'an , China
| | - Louise Roper
- a School of Psychology , University of Liverpool , Liverpool , UK
| | - Victoria Lowers
- a School of Psychology , University of Liverpool , Liverpool , UK
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75
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Kaufman JE, Lee Y, Vaughon W, Unuigbe A, Gallo WT. Depression Associated With Transitions Into and Out of Spousal Caregiving. Int J Aging Hum Dev 2018; 88:127-149. [PMID: 29382211 DOI: 10.1177/0091415018754310] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigates depressive symptoms among spousal caregivers in three groups: those who become caregivers, those who continue care, and those who exit caregiving, compared with those who remain non-caregivers. We also examine depressive symptoms among widowed caregivers by length of bereavement. We use four waves of the U.S. Health and Retirement Study (2006, 2008, 2010, and 2012), for a total of 43,262 observations. Findings show elevated levels of depressive symptoms for new caregivers, continuing caregivers, and exit caregivers. Among exit caregivers, symptoms were elevated when measured in the first 15 months after the spouse’s death but declined thereafter. These findings add to the evidence that spousal caregiving carries a risk for depression, and symptoms are likely to peak near the end of the caregiving episode. These results underscore the need to provide support to newly widowed individuals.
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Affiliation(s)
- Jennifer E Kaufman
- Graduate School of Public Health and Health Policy, City University of New York, NY, USA
| | - Yeonjung Lee
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Wendy Vaughon
- Graduate School of Public Health and Health Policy, City University of New York, NY, USA
| | - Aig Unuigbe
- Graduate Center, City University of New York, NY, USA
| | - William T Gallo
- Graduate School of Public Health and Health Policy, City University of New York, NY, USA
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76
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Monserud MA. Marital Status and Trajectories of Depressive Symptoms Among Older Adults of Mexican Descent. Int J Aging Hum Dev 2018; 88:22-45. [PMID: 29350050 DOI: 10.1177/0091415017752940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Little is known about the implications of marital status for the age patterning of depressive symptoms in later life. Drawing on seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly, this research uses growth curve models to examine age trajectories of depressive symptoms among continuously married and recently and continuously widowed older adults of Mexican descent (aged 65 years and older; N = 1,452). The findings demonstrate that despite having a higher mean level of depressive symptoms, the recently widowed experienced a similar rate of increase in distress with age to that of their married counterparts. Compared with the married, the continuously widowed had a steeper rise in depressive symptoms with age, although they had fewer symptoms at younger ages in later life. Physical health, financial strain, social support, and church attendance might account to a certain extent for marital status differences in depressive symptoms across later life.
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77
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Ongeri L, McCulloch C, Neylan T, Bukusi E, Macfarlane S, Othieno C, Ngugi A, Meffert S. Suicidality and associated risk factors in outpatients attending a general medical facility in rural Kenya. J Affect Disord 2018; 225:413-421. [PMID: 28850856 PMCID: PMC5663198 DOI: 10.1016/j.jad.2017.08.059] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/10/2017] [Accepted: 08/20/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Low-and-Middle-Income-Countries (LMICs) account for 75% of global suicides. While primary care populations in high-income countries (HIC) typically have higher prevalence of suicidal behavior relative to general populations, few studies have explored suicidal behavior among general medical outpatients in LMICs. This study addresses the research gap by characterizing potential risk factors for suicidal ideation in a large general medical outpatient setting in rural Kenya. METHODS A cross-sectional study of adult general medical outpatients attending a rural sub-county hospital in Kaloleni, Kenya. Primary outcomes included major depressive disorder (MDD), posttraumatic stress disorder (PTSD) and suicidal behavior measured by the Mini International Neuropsychiatric Interview (MINI 5.0). We use binary logistic regression to model suicidality, mental disorders, intimate partner violence, and lifetime abuse. RESULTS 394 outpatients completed the assessment. The prevalence of SI over the past month was 20%. 18% of those with suicidal ideation over the past month also attempted suicide in the past month. Participants who met criteria for MDD (suicidality item removed) were 19 times [CI: 4.56, 79.05] more likely to report suicidal ideation compared to those without MDD (adjusted odds ratio 12.15 [CI: 2.66, 55.49]). LIMITATIONS This was a cross sectional study design with convenience sampling and hence vulnerable to selection and recall bias. CONCLUSION The prevalence of SI and its strong association with actual suicide attempt in this population, make an urgent public health case for intervention. These data identify MDD as a highly significant correlate of SI.
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Affiliation(s)
- L. Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya,Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Corresponding author at: Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya. (L. Ongeri)
| | - C.E. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA,Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - T.C. Neylan
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
| | - E. Bukusi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Global Health Sciences, University of California San Francisco, California, USA
| | - S.B. Macfarlane
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of Nairobi, Kenya
| | - C. Othieno
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Centre for Population Health Sciences, Faculty of Health Sciences-East Africa, Aga Khan University, Nairobi, Kenya
| | - A.K. Ngugi
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
| | - S.M. Meffert
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya,Department of Psychiatry, University of California San Francisco (UCSF), San Francisco, USA
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78
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Pagliai G, Sofi F, Vannetti F, Caiani S, Pasquini G, Molino Lova R, Cecchi F, Sorbi S, Macchi C. Mediterranean Diet, Food Consumption and Risk of Late-Life Depression: The Mugello Study. J Nutr Health Aging 2018; 22:569-574. [PMID: 29717755 DOI: 10.1007/s12603-018-1019-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To investigate eating habits and adherence to Mediterranean Diet (MD) in relation to the risk of depression in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues, including those related to nutritional status. DESIGN Cross-sectional study. SETTING Homes and nursing homes in the Mugello area, Florence, Italy. PARTICIPANTS Subjects aged 90-99 years [N=388 (271F; 117M) mean age: 92.7±3.1]. MEASUREMENTS All subjects were evaluated through questionnaires and instrumental examinations. Adherence to MD was assessed through the Mediterranean Diet Score. A shorter version of the Geriatric Depression Scale (GDS) was used to detect the possible presence of depressive symptoms. In addition, cognitive and functional status was assessed using the Mini-Mental State Examination, the Clock Drawing Test, as well as the Basic and Instrumental Activities of Daily Living test. RESULTS Depressed subjects (DS) (GDS score≥5, 43.8%) were older, females and widows, than non-depressed subjects (NDS). DS reported a slightly but not statistically significant lower MD score than NDS (33.9±3.9 vs. 34.6±3.3, p=0.149). Subjects who reported to consume a greater amount of olive oil and fruit were associated with a lower risk of depression (OR=0.35, 95%CI=0.20-0.59, p<0.001 and OR=0.46, 95%CI=0.26-0.84, p=0.011, respectively) after adjustment for many possible confounders. Similar results were obtained for women, while no statistically significant differences emerged for men. CONCLUSION Our results support the hypothesis that a diet rich in olive oil and fruit, characteristics of MD, may protect against the development of depressive symptoms in older age.
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Affiliation(s)
- G Pagliai
- Giuditta Pagliai, Department of Experimental and Clinical Medicine, University of Florence, Italy, Largo Brambilla 3, 50134, Florence, Italy, Phone: 0557947510,
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79
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Girgus JS, Yang K, Ferri CV. The Gender Difference in Depression: Are Elderly Women at Greater Risk for Depression Than Elderly Men? Geriatrics (Basel) 2017; 2:geriatrics2040035. [PMID: 31011045 PMCID: PMC6371140 DOI: 10.3390/geriatrics2040035] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/31/2017] [Accepted: 11/02/2017] [Indexed: 12/20/2022] Open
Abstract
Numerous epidemiological reports have found that adolescent, young adult, and middle-aged adult girls and women are more likely to be diagnosed with unipolar depression and report greater symptoms of depression when compared to boys and men of similar ages. What is less well-known is whether this gender difference persists into late life. This literature review examines whether the well-known gender difference in unipolar depression continues into old age, and, if it does, whether the variables that are known to contribute to the gender difference in unipolar depression from adolescence through adulthood continue to contribute to the gender difference in the elderly, and/or whether there are new variables that arise in old age and contribute to the gender difference in the elderly. In this review of 85 empirical studies from every continent except for Antarctica, we find substantial support for the gender difference in depression in individuals who are 60 and older. More research is necessary to determine which factors are the strongest predictors of the gender difference in depression in late life, and particularly whether the factors that seem to be responsible for the gender difference in depression in earlier life stages continue to predict the gender difference in the elderly, and/or whether new factors come into play in late life. Longitudinal research, meta-analyses, and model-based investigations of predictors of the gender difference in depression are needed to provide insights into how and why the gender difference in depression persists in older age.
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Affiliation(s)
- Joan S Girgus
- Department of Psychology, Princeton University, Princeton, NJ 08540, USA.
| | - Kaite Yang
- School of Social and Behavioral Sciences, Stockton University, 101 Vera King Farris Drive, Galloway, NJ 08205, USA.
| | - Christine V Ferri
- School of Social and Behavioral Sciences, Stockton University, 101 Vera King Farris Drive, Galloway, NJ 08205, USA.
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80
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Hu YH, Chiu CJ, Wong JD, Lin DC, Wray LA. The Role of Leisure Activities in the Relationship Between Marital Transition in Later Midlife and Psychological Well-Being Trajectories. Int J Aging Hum Dev 2017; 86:327-346. [DOI: 10.1177/0091415017729683] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the levels and rates of changes in psychological well-being for middle-aged adults of different statuses or marital transitions. The moderating effects of different leisure activities were also tested. Longitudinal data on 1,270 persons aged 50 to 65 years at baseline from the Taiwan longitudinal study on aging were analyzed. Adults who were stably unmarried or unpartnered reported worse mental health at baseline, but their psychological well-being improved over time. The trajectory of depressive symptoms fluctuated markedly in adults who became widowed during our observation period. Engagement in physical, cognitive, or social activities was significantly associated with participants’ psychological well-being. Participation in religious activities was significantly associated with life satisfaction and decreased depressive symptoms for those undergoing bereavement. Findings from this study suggest that social and physical activities, among the four selected leisure activities, have the greatest association between decreasing depressive symptoms and increasing life satisfaction, respectively. Religious activities, in particular, may improve psychological well-being in bereaved middle-aged and older adults.
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Affiliation(s)
- Yi-Han Hu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Jen D. Wong
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Dai-Chan Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Linda A. Wray
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
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81
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Karantzas GC, Gillath O. Stress and wellbeing during chronic illness and partner death in later-life: the role of social support. Curr Opin Psychol 2017; 13:75-80. [PMID: 28813299 DOI: 10.1016/j.copsyc.2016.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 04/29/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
Abstract
Chronic illness and the death of a romantic partner are two of the most significant stressors reported by older adults, resulting in various physical and mental health consequences. Evidence suggests that social support is a key factor in understanding the association between chronic illness and widowhood and the wellbeing of older adults. Nevertheless, research into social support is often approached in an atheoretical manner when investigating these stressors in older adulthood. We attempt to address this theoretical chasm by proposing an integrative model to explain social support processes in older couples which draws on models of social support and attachment theory. Our model provides an important framework for understanding existing research findings as well as guiding future research.
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Affiliation(s)
- Gery C Karantzas
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
| | - Omri Gillath
- Department of Psychology, University of Kansas, 1415 Jayhawk Boulevard, Lawrence, KS 66045, USA
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82
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Myroniuk TW. Marital Dissolutions and the Health of Older Individuals in a Rural African Context. J Gerontol B Psychol Sci Soc Sci 2017; 72:656-664. [PMID: 27382043 PMCID: PMC5927165 DOI: 10.1093/geronb/gbw077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 06/13/2016] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Research from high-income countries has often found a negative relationship between marital dissolutions and health. This paper assesses that relationship among older sub-Saharan Africans, on a now-aging continent. Such individuals are likely to be at risk of a dissolution, or have already experienced one, due to high rates of marriage. METHODS Data from over 1,200 rural Malawians, age 45+, are employed from the 2008 and 2010 waves of the Malawi Longitudinal Study of Families and Health. Cross-sectional and lagged dependent variable regressions examine the relationship between marital dissolutions and 4 measures of self-reported health: retrospective health, relative health (compared with others in one's village), and age-standardized SF-12 mental and physical health scales. RESULTS Worse relative, mental, and physical health are associated with being currently divorced/widowed compared with being married. However, worse retrospective health is linked to becoming divorced/widowed between 2008 and 2010. Those divorced/widowed prior to 2008, and who remained so through 2010, are in worse relative and physical health. DISCUSSION The findings question the relative hardship of marital dissolutions for those who have managed to survive into old age, and call for the collection of more detailed longitudinal data on older Africans on this topic.
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Affiliation(s)
- Tyler W Myroniuk
- Department of Sociology and Anthropology, George Mason University, Fairfax, Virginia
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83
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Monserud MA, Markides KS. Changes in depressive symptoms during widowhood among older Mexican Americans: the role of financial strain, social support, and church attendance. Aging Ment Health 2017; 21:586-594. [PMID: 26739834 PMCID: PMC5516892 DOI: 10.1080/13607863.2015.1132676] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study examines how depressive symptoms change during the widowhood process among older adults of Mexican descent. This research also investigates whether financial strain, social support, and church attendance moderate changes in depressive symptoms in the context of widowhood. METHOD This study uses seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly collected at approximately two-year intervals. This research applies multiphase growth models to examine changes in depressive symptomatology before, during, and after the transition to widowhood (the measurement wave at which spousal bereavement was first reported) among 385 older adults of Mexican descent who experienced the death of a spouse during the survey. RESULTS This study demonstrates that older adults of Mexican descent experienced a significant increase in depressive symptoms pre-widowhood and in particular, during the transition to widowhood. The levels and rates of changes in depressive symptoms post-widowhood did not differ from the pre-widowhood ones. Greater social support was related to more depressive symptoms during the transition to widowhood. More frequent church attendance was a protective factor against increases in depressive symptoms pre-widowhood. CONCLUSION This study highlights the multiphase pattern in the effects of the widowhood process on depressive symptomatology among older adults of Mexican descent. The findings also suggest that social support and church attendance can have implications for the interplay between widowhood and depressive symptoms.
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Affiliation(s)
- Maria A. Monserud
- University of Houston, Department of Sociology, 489 Philip G. Hoffman Hall, Houston, TX 77204-3012
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84
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Kravdal Ø, Grundy E. Health effects of parental deaths among adults in Norway: Purchases of prescription medicine before and after bereavement. SSM Popul Health 2017; 2:868-875. [PMID: 28470035 PMCID: PMC5404113 DOI: 10.1016/j.ssmph.2016.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 10/20/2016] [Accepted: 10/21/2016] [Indexed: 01/23/2023] Open
Abstract
We analyse effects of parental deaths on the health of women and men aged 18–59 in 2004–2008, indicated by purchases of prescription medicines. Register data covering the entire Norwegian population were used, and fixed-effects models were estimated to control for unobserved time-invariant individual factors. A parent's death seemed to have immediate adverse consequences in both main age groups considered (18–39, 40–59), although effects were lower in the older group. Some results suggested that this health disadvantage widened with increasing time since the parent's death. However, effects were weak: the annual number of different medicines purchased was only increased by 1–7% as a result of losing a parent. Death of a parent was associated with an immediate increase in purchases of medication for mental diseases, and there were indications of a physical response as well. As time since the parental death increased, there was a decline in the purchase of medication for mental diseases, but an opposite trend with respect to medication for other diseases. On the whole, maternal and paternal deaths had the same impact, and effects on daughters and sons were of the same magnitude. A parent’s death seemed to have immediate weakly adverse health consequences. Some results suggested that this health disadvantage widened with time since death. The effects on physical and mental health seemed to be different. Purchases of prescription medicine were used as indicators of health. Unobserved time-invariant individual factors were controlled for.
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Affiliation(s)
- Øystein Kravdal
- Department of Economics, University of Oslo, Norway.,Norwegian Institute of Public Health, Norway
| | - Emily Grundy
- Department of Social Policy, London School of Economics and Political Science, London, UK
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85
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Perceived emotional social support in bereaved spouses mediates the relationship between anxiety and depression. J Affect Disord 2017; 211:83-91. [PMID: 28103522 PMCID: PMC5304338 DOI: 10.1016/j.jad.2017.01.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 12/03/2016] [Accepted: 01/03/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Prior research has shown that anxiety symptoms predict later depression symptoms following bereavement. Nevertheless, no research has investigated mechanisms of the temporal relationship between anxiety and later depressive symptoms or examined the impact of depressive symptoms on later anxiety symptoms following bereavement. METHODS The current study examined perceived emotional social support as a possible mediator between anxiety and depressive symptoms in a bereaved sample of older adults (N =250). Anxiety and depressive symptoms were measured at Wave 1 (immediately after bereavement), social support was measured at Wave 2 (18 months after bereavement), and anxiety and depressive symptoms were also measured at Wave 3 (48 months after bereavement). RESULTS Using Bayesian structural equation models, when controlling for baseline depression, anxiety symptoms significantly positively predicted depressive symptoms 48 months later, Further, perceived emotional social support significantly mediated the relationship between anxiety symptoms and later depressive symptoms, such that anxiety symptoms significantly negatively predicted later emotional social support, and emotional social support significantly negatively predicted later depressive symptoms. Also, when controlling for baseline anxiety, depressive symptoms positively predicted anxiety symptoms 48 months later. However, low emotional social support failed to mediate this relationship. CONCLUSIONS Low perceived emotional social support may be a mechanism by which anxiety symptoms predict depressive symptoms 48 months later for bereaved individuals.
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86
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Vignes B. Crisis or Chronic Strain?: Gender and Age Differences in Sickness Absence following Early Spousal Loss. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2017; 58:54-69. [PMID: 28661767 DOI: 10.1177/0022146516688243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This population-based study ( N = 908,468) examines the effects of spousal loss on being absent from work due to illness or injury (sickness absence) among employed individuals in Norway. Fixed-effects models capturing antecedent and short- and long-term effects of spousal loss over a 15-year period were estimated to explore gender and age differences in the impact of widowhood. The crisis model, the social-role model, and the life course perspective are discussed. Furthermore, the study calls into question whether parenthood explains the gendered age gradient of the widowhood effect. The results show that the theoretical relevance of the crisis and social-role models is best understood in dialogue with a gendered life course approach. The results show that the crisis response is especially high among young widowers, whereas the recovery period is markedly prolonged among young widows. Parenthood at the time of widowhood explains much of the age difference among widowers and widows.
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Affiliation(s)
- Bo Vignes
- 1 University of Bergen, Bergen, Norway
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87
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Kuo SC, Sun JL, Tang ST. Trajectories of depressive symptoms for bereaved family members of chronically ill patients: a systematic review. J Clin Nurs 2017; 26:3784-3799. [DOI: 10.1111/jocn.13720] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Su Ching Kuo
- Graduate Institute of Clinical Medical Sciences; Chang Gung University; Taoyuan Taiwan
- Department of Nursing; Yuanpei University of Medical Technology; Hsinchu Taiwan
| | - Jia Ling Sun
- Department of Nursing; National Taichung University of Science and Technology; Taichung Taiwan
| | - Siew Tzuh Tang
- School of Nursing; Chang Gung University; Taoyuan Taiwan
- Department of Nursing; Chang Gung Memorial Hospital at Kaohsiung; Kaohsiung Taiwan
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou; Taoyuan Taiwan
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88
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Ornstein KA, Aldridge MD, Garrido MM, Gorges R, Bollens-Lund E, Siu AL, Langa KM, Kelley AS. The Use of Life-Sustaining Procedures in the Last Month of Life Is Associated With More Depressive Symptoms in Surviving Spouses. J Pain Symptom Manage 2017; 53:178-187.e1. [PMID: 27864126 PMCID: PMC5253251 DOI: 10.1016/j.jpainsymman.2016.08.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/11/2016] [Accepted: 08/26/2016] [Indexed: 11/15/2022]
Abstract
CONTEXT Family caregivers of individuals with serious illness who undergo intensive life-sustaining medical procedures at the end of life may be at risk of negative consequences including depression. OBJECTIVES The objective of this study was to determine the association between patients' use of life-sustaining procedures at the end of life and depressive symptoms in their surviving spouses. METHODS We used data from the Health and Retirement Study, a longitudinal survey of U.S. residents, linked to Medicare claims data. We included married Medicare beneficiaries aged 65 years and older who died between 2000 and 2011 (n = 1258) and their surviving spouses. The use of life-sustaining procedures (i.e., intubation/mechanical ventilation, tracheostomy, gastrostomy tube insertion, enteral/parenteral nutrition, and cardiopulmonary resuscitation) in the last month of life was measured via claims data. Using propensity score matching, we compared change in depressive symptoms of surviving spouses. RESULTS Eighteen percent of decedents underwent one or more life-sustaining procedures in the last month of life. Those whose spouses underwent life-sustaining procedures had a 0.32-point increase in depressive symptoms after death (scale range = 0-8) and a greater likelihood of clinically significant depression (odds ratio = 1.51) compared with a matched sample of spouses of those who did not have procedures (P < 0.05). CONCLUSION Surviving spouses of those who undergo intensive life-sustaining procedures at the end of life experience a greater magnitude of increase in depressive symptoms than those whose spouses do not undergo such procedures. Further study of the circumstances and decision making surrounding these procedures is needed to understand their relationship with survivors' negative mental health consequences and how best to provide appropriate support.
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Affiliation(s)
- Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Melissa D Aldridge
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; James J. Peters Veterans Affairs Medical Center, Bronx, New York
| | - Melissa M Garrido
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; James J. Peters Veterans Affairs Medical Center, Bronx, New York
| | - Rebecca Gorges
- Harris School of Public Policy, University of Chicago, Chicago, Illinois
| | - Evan Bollens-Lund
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Albert L Siu
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; James J. Peters Veterans Affairs Medical Center, Bronx, New York
| | - Kenneth M Langa
- Department of Internal Medicine, Veterans Affairs Center for Clinical Management Research, Institute for Social Research, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Amy S Kelley
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; James J. Peters Veterans Affairs Medical Center, Bronx, New York
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89
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Patlamazoglou L, Simmonds JG, Snell TL. Same-Sex Partner Bereavement: Non-HIV-Related Loss and New Research Directions. OMEGA-JOURNAL OF DEATH AND DYING 2017; 78:178-196. [PMID: 28120628 DOI: 10.1177/0030222817690160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The experience of same-sex-attracted people who have lost a partner is neglected in the existing literature on bereavement. Previous research on lesbian, gay, bisexual, transgender, intersex, queer and questioning (LGBTIQ) populations tends to focus on the loss of a partner to HIV-related causes, and there is scant research concerning non-HIV-related bereavement. The purpose of this article is to investigate the non-HIV-related bereavement experiences of same-sex partners and to address the potential complications of disenfranchised grief. Coping with the loss of a same-sex partner and the impact of bereavement on subsequent relationships are also discussed. Implications for counseling of bereaved same-sex-attracted individuals are drawn, and recommendations for future psychological research on the experience of bereavement are made.
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Affiliation(s)
| | - Janette G Simmonds
- 1 Psychology Programs, Faculty of Education, Monash University, Victoria, Australia
| | - Tristan L Snell
- 1 Psychology Programs, Faculty of Education, Monash University, Victoria, Australia
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90
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Perkins JM, Lee HY, James KS, Oh J, Krishna A, Heo J, Lee JK, Subramanian SV. Marital status, widowhood duration, gender and health outcomes: a cross-sectional study among older adults in India. BMC Public Health 2016; 16:1032. [PMID: 27716203 PMCID: PMC5045657 DOI: 10.1186/s12889-016-3682-9] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 09/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research has demonstrated health benefits of marriage and the potential for worse outcomes during widowhood in some populations. However, few studies have assessed the relevance of widowhood and widowhood duration to a variety of health-related outcomes and chronic diseases among older adults in India, and even fewer have examined these relationships stratified by gender. METHODS Using a cross-sectional representative sample of 9,615 adults aged 60 years or older from 7 states in diverse regions of India, we examine the relationship between widowhood and self-rated health, psychological distress, cognitive ability, and four chronic diseases before and after adjusting for demographic characteristics, socioeconomic status, living with children, and rural-urban location for men and women, separately. We then assess these associations when widowhood accounts for duration. RESULTS Being widowed as opposed to married was associated with worse health outcomes for women after adjusting for other explanatory factors. Widowhood in general was not associated with any outcomes for men except for cognitive ability, though men who were widowed within 0-4 years were at greater risk for diabetes compared to married men. Moreover, recently widowed women and women who were widowed long-term were more likely to experience psychological distress, worse self-rated health, and hypertension, even after adjusting for other explanatory variables, whereas women widowed 5-9 years were not, compared to married women. CONCLUSIONS Gender, the duration of widowhood, and type of outcome are each relevant pieces of information when assessing the potential for widowhood to negatively impact health. Future research should explore how the mechanisms linking widowhood to health vary over the course of widowhood. Incorporating information about marital relationships into the design of intervention programs may help better target potential beneficiaries among older adults in India.
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Affiliation(s)
- Jessica M Perkins
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Massachusetts Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Hwa-Young Lee
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, 71 Ihwajang-gil, Jongno-gu, Seoul, 110-810, Korea
| | - K S James
- Jawaharlal Nehru University, New Delhi, India
| | - Juhwan Oh
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, 71 Ihwajang-gil, Jongno-gu, Seoul, 110-810, Korea
| | - Aditi Krishna
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jongho Heo
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, 71 Ihwajang-gil, Jongno-gu, Seoul, 110-810, Korea.,Public Health Joint Doctoral Program, San Diego State University & University of California, San Diego, CA, USA
| | - Jong-Koo Lee
- JW LEE Center for Global Medicine, Seoul National University College of Medicine, 71 Ihwajang-gil, Jongno-gu, Seoul, 110-810, Korea. .,Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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91
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Abstract
OBJECTIVE This study examines the link between marital disruption and biological risk, and asks whether the association of this precarious life event with health is contingent on marital loss duration and history. METHOD Data are drawn from the National Social Life, Health, and Aging Project ( N = 1,414), and Poisson regressions are presented for allostatic load and logistic regressions for individual biomarkers. RESULTS The currently unmarried with more distant marital disruptions exhibit higher levels of allostatic load than the currently married, which is primarily driven by dysregulation of cardiovascular and metabolic indicators. Results also reveal the differing ways marital disruption "gets under the skin" with widowhood associated with compromised inflammatory, metabolic, and cardiovascular functioning, and divorce with cardiovascular and neuroendocrine markers. DISCUSSION Findings lend support for both the crisis and chronic strain models, and likely reflect normative expectations of the timing of life events, decrements in marital resources, and selection processes.
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92
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Reczek C, Pudrovska T, Carr D, Thomeer MB, Umberson D. Marital Histories and Heavy Alcohol Use among Older Adults. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:77-96. [PMID: 26957135 PMCID: PMC4785832 DOI: 10.1177/0022146515628028] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We develop a gendered marital biography approach-which emphasizes the accumulating gendered experiences of singlehood, marriage, marital dissolution, and remarriage-to examine the relationship between marital statuses and transitions and heavy alcohol use. We test this approach using individual-level (n = 10,457) and couple-level (n = 2,170) longitudinal data from the Health and Retirement Study, and individual-level (n = 46) and couple-level (n = 42) in-depth interview data. Quantitative results show that marriage, including remarriage, reduces men's but increases women's drinking relative to being never married and previously married, whereas divorce increases men's but decrease women's drinking, with some variation by age. Our qualitative findings reveal that social control and convergence processes underlie quantitative results. We call attention to how men's and women's heavy drinking trajectories stop, start, and change direction as individuals move through their distinctive marital biography.
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93
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DePasquale N, Davis KD, Zarit SH, Moen P, Hammer LB, Almeida DM. Combining Formal and Informal Caregiving Roles: The Psychosocial Implications of Double- and Triple-Duty Care. J Gerontol B Psychol Sci Soc Sci 2016; 71:201-11. [PMID: 25271309 PMCID: PMC4757948 DOI: 10.1093/geronb/gbu139] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 08/25/2014] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Women who combine formal and informal caregiving roles represent a unique, understudied population. In the literature, healthcare employees who simultaneously provide unpaid elder care at home have been referred to as double-duty caregivers. The present study broadens this perspective by examining the psychosocial implications of double-duty child care (child care only), double-duty elder care (elder care only), and triple-duty care (both child care and elder care or "sandwiched" care). METHOD Drawing from the Work, Family, and Health Study, we focus on a large sample of women working in nursing homes in the United States (n = 1,399). We use multiple regression analysis and analysis of covariance tests to examine a range of psychosocial implications associated with double- and triple-duty care. RESULTS Compared with nonfamily caregivers, double-duty child caregivers indicated greater family-to-work conflict and poorer partner relationship quality. Double-duty elder caregivers reported more family-to-work conflict, perceived stress, and psychological distress, whereas triple-duty caregivers indicated poorer psychosocial functioning overall. DISCUSSION Relative to their counterparts without family caregiving roles, women with combined caregiving roles reported poorer psychosocial well-being. Additional research on women with combined caregiving roles, especially triple-duty caregivers, should be a priority amidst an aging population, older workforce, and growing number of working caregivers.
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Affiliation(s)
- Nicole DePasquale
- Department of Human Development & Family Studies, The Pennsylvania State University, University Park.
| | - Kelly D Davis
- Department of Human Development & Family Studies, The Pennsylvania State University, University Park
| | - Steven H Zarit
- Department of Human Development & Family Studies, The Pennsylvania State University, University Park
| | - Phyllis Moen
- Department of Sociology, University of Minnesota, Minneapolis
| | | | - David M Almeida
- Department of Human Development & Family Studies, The Pennsylvania State University, University Park
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94
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Lee HJ, Lee SG, Chun SY, Park EC. Sex differences in depressive effects of experiencing spousal bereavement. Geriatr Gerontol Int 2016; 17:322-329. [DOI: 10.1111/ggi.12712] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Hyo Jung Lee
- Department of Public Health; Graduate School; Yonsei University; Seoul Korea
- Institute of Health Services Research; Yonsei University; Seoul Korea
| | - Sang Gyu Lee
- Institute of Health Services Research; Yonsei University; Seoul Korea
- Department of Hospital Management; Graduate School of Public Health; Yonsei University; Seoul Korea
| | - Sung-Youn Chun
- Department of Public Health; Graduate School; Yonsei University; Seoul Korea
- Institute of Health Services Research; Yonsei University; Seoul Korea
| | - Eun-Cheol Park
- Institute of Health Services Research; Yonsei University; Seoul Korea
- Department of Preventive Medicine; College of Medicine; Yonsei University; Seoul Korea
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95
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Bourassa KJ, Knowles LM, Sbarra DA, O'Connor MF. Absent but Not Gone: Interdependence in Couples' Quality of Life Persists After a Partner's Death. Psychol Sci 2015; 27:270-81. [PMID: 26710822 DOI: 10.1177/0956797615618968] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 11/02/2015] [Indexed: 11/16/2022] Open
Abstract
Spouses influence each other's psychological functioning and quality of life. To explore whether this interdependence continues after a person becomes widowed, we tested whether deceased spouses' characteristics were associated with their widowed partners' later quality of life using couples drawn from a multinational sample of aging adults. Independent subsamples (ns = 221 and 325) were assessed before and after a spouse's death. Regressions revealed that deceased partners' quality of life prior to their death positively predicted their spouses' quality of life after the partners' death, even when we controlled for spouses' prior quality of life to account for environmental factors shared within couples. Further, widowed participants' quality of life was lower than nonwidowed couples' 2 years before and after their partners' death, but was equivalent 4 years prior. Finally, the strength of the association between partners' earlier quality of life and participants' later quality of life did not differ between widowed and nonwidowed participants. These findings suggest that interdependence in quality of life continues after one's partner has passed away.
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96
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Examining the 16-year trajectories of mental health and wellbeing through the transition into widowhood. Int Psychogeriatr 2015; 27:1979-86. [PMID: 25851736 DOI: 10.1017/s1041610215000472] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Becoming widowed is a significant event. There is considerable evidence that surviving partners report substantial changes in their wellbeing and mental health. Changes can occur prior to partner's death as an anticipatory effect and consequently during the period after partner's death. For most, declines in wellbeing and mental health dissipate over time. However, there is a limited long-term evidence to compare age-normative trajectories in mental health and wellbeing with the trajectories of those who transition into widowhood. METHODS Participants (n = 652) were older adults (aged 65-94 years at baseline) from the 16-year Melbourne Longitudinal Studies on Healthy Ageing project who were either married or de facto (n = 577), or recently widowed (n = 75). Generalized Estimating Equations (GEE) examined the immediate and long-term impact of widowhood. GEE piecewise regression analyses examined the trajectories of wellbeing and mental health in those who transitioned into widowed with time centered at time of partner's death. Analyses were stratified by gender. RESULTS For both men and women, becoming widowed was strongly related to a strong decline in positive affect post partner's death. Otherwise, no long-term impact of widowhood on negative affect or depressive symptomology was reported. CONCLUSIONS The impact of widowhood reports differential impacts on different indicators of wellbeing and mental health, which were inconsistent between men and women.
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97
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Tiedt AD, Saito Y, Crimmins EM. Depressive Symptoms, Transitions to Widowhood, and Informal Support From Adult Children Among Older Women and Men in Japan. Res Aging 2015; 38:619-42. [PMID: 26243334 DOI: 10.1177/0164027515595442] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines the relationships among depressive symptoms, transitions to widowhood, worsening health, and family support in Japan over 10 years. The analyses focus on availability and receipt as the two primary dimensions of intergenerational support relationships. We used growth curve models to analyze data from the Nihon University Japanese Longitudinal Study of Aging, finding that (1) becoming widowed correlated with increased depressive symptoms and this relationship was weaker among women than men, (2) continuous widowhood was associated with fewer depressive symptoms over time, (3) transitions to coresidence with sons and daughters among the widowed was correlated with reduced depressive symptoms, (4) self-reported health and difficulty with activities of daily living were predictors of depressive symptoms over time. The findings suggest the importance of new research on household transitions, availability and proximity of family caregivers, and social embeddedness as protections against depressive symptoms.
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Affiliation(s)
- Andrew D Tiedt
- Bureau of Justice Statistics, U.S. Department of Justice, Washington, DC, USA
| | - Yasuhiko Saito
- University Research Center, Nihon University, Tokyo, Japan
| | - Eileen M Crimmins
- Andrus Gerontology Center, University of Southern California, Los Angeles, CA, USA
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98
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Perrig-Chiello P, Spahni S, Höpflinger F, Carr D. Cohort and Gender Differences in Psychosocial Adjustment to Later-Life Widowhood. J Gerontol B Psychol Sci Soc Sci 2015; 71:765-74. [DOI: 10.1093/geronb/gbv004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 01/02/2015] [Indexed: 11/14/2022] Open
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99
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Monserud MA, Wong R. Depressive Symptoms Among Older Mexicans: The Role of Widowhood, Gender, and Social Integration. Res Aging 2015; 37:856-86. [PMID: 25651596 DOI: 10.1177/0164027514568104] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Widowhood is often associated with decreased mental health. In developing countries with low institutional support, such as Mexico, social integration can be particularly consequential for widowed older adults' psychological well-being. This study investigates the interplay among depressive symptoms, widowhood, gender, and social integration in a nationally representative sample of older Mexicans. Drawing on Waves 1 (2001) and 2 (2003) of the Mexican Health and Aging Study, we estimated the ordinary least squares regressions to examine the implications of widowhood, gender, social support, social network, and social engagement for changes in depressive symptoms between the waves among Mexicans aged 50 and older (N = 8,708). The findings indicate that social integration can mitigate as well as exacerbate depressive symptomatology among older Mexicans. Certain aspects of social integration can moderate marital status-gender differences in depressive symptoms among older Mexicans.
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Affiliation(s)
- Maria A Monserud
- Department of Sociology, University of Houston, Houston, TX, USA
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
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100
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Sher L, Rihmer Z, Didia-Attas J, de Leon J, Lin SK, Roncero C, Szerman N, Rice T. Future Research and Clinical Directions in the Field of Men's Mental Health: The Madrid Declaration. Front Public Health 2014; 2:242. [PMID: 25478555 PMCID: PMC4237033 DOI: 10.3389/fpubh.2014.00242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 11/03/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Leo Sher
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters Veterans’ Administration Medical Center, Bronx, NY, USA
| | | | | | | | - Shih-Ku Lin
- Taipei Medical University, Taipei, Taiwan
- Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Carlos Roncero
- University Hospital Vall Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | - Timothy Rice
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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