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Ludwikowska-Świeboda K, Sekowski M. The Quality of Interpersonal Relationships, Intrusive and Deliberate Rumination and Adjustment to the Death of a Spouse. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241265442. [PMID: 39030966 DOI: 10.1177/00302228241265442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
The aim of the presented study was to gain a better understanding of relationships between the pre-loss quality of marriage, global attachment style, rumination, the severity of complicated grief and the level of posttraumatic growth among widowed individuals. After the researchers obtained the consent of the ethics board to conduct the study, they examined widowed individuals (n = 152) using the Experiences in Close Relationships - Revised, the Dyadic Adjustment Scale, the Event Related Rumination Inventory, the Inventory of Complicated Grief, and the Posttraumatic Growth Inventory. Results show a positive relationship between attachment anxiety and complicated grief via intrusive rumination, as well as a positive relationship between attachment anxiety and posttraumatic growth via intrusive and deliberate rumination. Results also show that the greater the attachment avoidance the higher the severity of complicated grief, but only in the case of perceived low quality of the marriage. The presented research provides insight into the complex associations between the quality of interpersonal relationships, rumination and adjustment to loss among individuals who experienced the death of a spouse.
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Affiliation(s)
| | - Marcin Sekowski
- Department of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
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2
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Maura G, Blotière PO, Wastesson JW, Johnell K. Spousal bereavement and four-year trajectories of medication use: A nationwide register-based study in Swedish older adults. J Am Geriatr Soc 2024; 72:2048-2059. [PMID: 38720614 DOI: 10.1111/jgs.18950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 03/14/2024] [Accepted: 04/14/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Medication use around widowhood has been poorly described for most medication classes. Medication use patterns can reflect health consequences of spousal loss, as previously shown for psychotropic drugs. METHODS We used data from nationwide health registers (2008-2020) to describe the patterns of use of dispensed medications in all widowed Swedes aged ≥65 years followed between 2 years before and 2 years after spousal death. All prescription drugs used by at least 5% of the cohort were considered according to their therapeutic subgroups (Anatomical Therapeutic Chemical [ATC] classification system 2nd level). We used group-based trajectory models to cluster widowed individuals into up to 4 distinct longitudinal patterns of monthly medication use. We ranked the therapeutic subgroups with similar patterns according to their plausibility to reflect potential health effects of spousal loss, compared to those of psycholeptics (mainly anxiolytics, hypnotics) and psychoanaleptics (mainly antidepressants) as the references. RESULTS From 212,111 widowed adults included (68% female and 70% aged ≥75 years), we observed a significant increasing trend in medication use, especially after spousal death, for 21 out of the 39 different therapeutic subgroups that were used by at least 5% (most represented pharmacological groups: cardiovascular system, nervous system, and alimentary tract and metabolism). This increasing trend often concerned only a small proportion of individuals, with varying magnitude and speed of change in medication use across therapeutic subgroups. The patterns of use of antiepileptics, laxatives, skin emollients/protectives, analgesics, and drugs for anemia, constipation, or peptic ulcers, were the closest to those of references, displaying the largest changes in use, and were therefore ranked as the most likely to reflect health effects of spousal loss. CONCLUSION Our results confirmed the increase in psychotropic medications' use in widowed older adults and identified several potential physical health effects of spousal loss that warrant further research.
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Affiliation(s)
- Géric Maura
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pierre-Olivier Blotière
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonas W Wastesson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, Stockholm, Sweden
| | - Kristina Johnell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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3
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Cornwell B, Qu T. "I Love You to Death": Social Networks and the Widowhood Effect on Mortality. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024; 65:273-291. [PMID: 37378678 DOI: 10.1177/00221465231175685] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Research on "the widowhood effect" shows that mortality rates are greater among people who have recently lost a spouse. There are several medical and psychological explanations for this (e.g., "broken heart syndrome") and sociological explanations that focus on spouses' shared social-environmental exposures. We expand on sociological perspectives by arguing that couples' social connections to others play a role in this phenomenon. Using panel data on 1,169 older adults from the National Social Life, Health, and Aging Project, we find that mortality is associated with how well embedded one's spouse is in one's own social network. The widowhood effect is greater among those whose spouses were not well connected to one's other network members. We speculate that the loss of a less highly embedded spouse signals the loss of unique, valuable, nonredundant social resources from one's network. We discuss theoretical interpretations, alternative explanations, limitations, and directions for future research.
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4
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Hossain B, James KS. Widowhood status, morbidity, and mortality in India: evidence from a follow-up survey. J Biosoc Sci 2024; 56:574-589. [PMID: 37881942 DOI: 10.1017/s0021932023000226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
A known health effect of widowhood is an increased mortality risk among surviving spouses, with gender- and age-specific observations. While morbidity conditions with socio-economic factors may exacerbate the effect of widowhood on mortality, no research has attempted to predict mortality among the widowed over the married population with the presence of morbidity in India. Thus, the present study concurrently examines marital status and health in the Indian setting, bringing substantial empirical evidence to explore the link between marital status, morbidity, and mortality. The study used prospective data from India Human Development Survey (IHDS) wave 1 (2004-2005) and wave 2 (2011-2012). In total, 82,607 individuals aged 25 years and above were considered for the analysis. To present the preliminary findings, descriptive statistics and bivariate analysis were used. Using multivariable logistic regression, the interaction effect of marital status and morbidity status was estimated to predict the likelihood of mortality. Across all socio-economic groups, widowed individuals reporting any morbidity had a higher mortality proportion than married people. Young widowers with any morbidity are more susceptible to increased mortality. Asthma among young widowers and cardiovascular diseases among elderly widowers significantly elevate the probability of mortality. However, older widowed women with diabetes had a lower probability of mortality than older married women with diabetes. The widowers' disadvantage in mortality and morbidity may be attributable to less care-receiving and the greater incidence of unhealthy lifestyle practices during the post-widowhood period, indicating the need for more research.
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Affiliation(s)
- Babul Hossain
- International Institute for Population Sciences (IIPS), Mumbai, India
| | - K S James
- International Institute for Population Sciences (IIPS), Mumbai, India
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5
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Boerner K, Stokes J, Jansen T. Widowhood and bereavement in late life. Curr Opin Psychol 2024; 55:101748. [PMID: 38071788 DOI: 10.1016/j.copsyc.2023.101748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 01/28/2024]
Abstract
Bereavement is a common and often challenging experience in late life. Evidence shows that while many older adults manage to adjust well and demonstrate resilience in response to the death of a close person, bereavement puts a substantial minority at risk of adverse mental and physical health impacts including mortality. Current research further indicates that 1) this is the case across different countries and cultures across the globe; 2) that the COVID-19 pandemic posed unprecedented challenges for coping with late-life bereavement; 3) that loneliness and social isolation among bereaved older adults tend to be prevalent and harmful, particularly under pandemic but also in nonpandemic circumstances; and, recently, 4) that bereavement may be a risk factor for cognitive decline in this population.
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Affiliation(s)
- Kathrin Boerner
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Ammerländer Heerstraße 140, 26129 Oldenburg, Germany; Department of Gerontology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125, USA.
| | - Jeffrey Stokes
- Department of Gerontology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125, USA
| | - Taylor Jansen
- Department of Gerontology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125, USA
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6
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Wang W, Dearman A, Bao Y, Kumari M. Partnership status and positive DNA methylation age acceleration across the adult lifespan in the UK. SSM Popul Health 2023; 24:101551. [PMID: 38034479 PMCID: PMC10682041 DOI: 10.1016/j.ssmph.2023.101551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/24/2023] [Accepted: 10/29/2023] [Indexed: 12/02/2023] Open
Abstract
Although a significant body of research has shown that married people are healthier and live longer, empirical research on sex differences in the link between marital status and health suggests results are mixed. Moreover, the sex disparities in marital status and health relationships vary across adulthood. The literature on partnership status and measures of ageing is largely focused on older age groups and is limited in its view of early adulthood. Data from waves 2 and 3 (2010-2012) of Understanding Society: UKHLS were used to examine the association of current partnership status with epigenetic age acceleration (AA) assessed with DNA methylation (DNAm) algorithms 'Phenoage' and ' DunedinPACE ' in 3492 participants (aged 16-97). Regression models were estimated separately for men and women, and further stratified by age groups. Divorced/separated and widowed people showed positive age acceleration compared to the married/cohabiting people (reference group). Some sex differences were apparent, especially, among the single and divorced/separated groups. Age differences were also apparent, for example in men, being single was negatively associated with DNAmAA in the youngest group, but positively in the oldest group compared to partnered counterparts. These findings illustrate the importance of partnerships on the ageing process, in particular marital change through divorce and widowhood for positive age acceleration in adults. For single groups, observations were heterogenous by age and sex.
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Affiliation(s)
- Wen Wang
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Anna Dearman
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Yanchun Bao
- Department of Mathematics, University of Essex, Wivenhoe Park, Colchester, Essex, UK
| | - Meena Kumari
- Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
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7
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Nilaweera D, Gurvich C, Freak-Poli R, Woods RL, Owen A, McNeil J, Nelson M, Stocks N, Ryan J. The association between adverse events in later life and mortality in older individuals. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100210. [PMID: 37753199 PMCID: PMC10518669 DOI: 10.1016/j.cpnec.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Background Stress can have adverse impacts on health, particularly when it is chronic or resulting from major adverse events. Our study investigated whether relatively common adverse events in older individuals were associated with an increased risk of death, as well as cause-specific death and potential gender differences. Methods Participants were 12896 community-dwelling Australians aged ≥70 years at enrolment into the ASPREE (ASPirin in Reducing Events in the Elderly) study and without known life-limiting disease. A questionnaire administered in the year after enrolment, collected information on ten adverse events experienced in the past year. Mortality status was verified by multiple sources including health records and the National Death Index across a maximum of 10 years. Underlying causes of death were determined using clinical information by two adjudicators. Cox-proportional hazards regression models were used to estimate mortality risk. Results Two of the ten adverse events were associated with an increased risk of mortality in fully adjusted models. A 69% increased risk of mortality was observed in participants who reported their spouse/partner had recently died (95% CI: 1.19-2.39, P < 0.01). Cancer-related but not cardiovascular deaths also increased. Participants with a seriously ill spouse/partner also had a 23% increased risk of mortality (HR: 1.23, 95% CI: 1.02-1.48, P = 0.03). There was a tendency for these associations to be stronger among men than women. Limitations Perceived stress and cortisol were not measured, thus limiting our understanding of the psychological and physiological impacts of adverse events. Conclusions Experiencing adverse events in later-life, especially the death of a spouse/partner, may be a risk factor for earlier mortality. These findings may increase public health awareness and better inform initiatives for particular groups, including bereaved men.
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Affiliation(s)
- Dinuli Nilaweera
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Caroline Gurvich
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, University of Adelaide, South Australia, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Høeg BL, Guldin MB, Karlsen RV, Løppenthin KB, Kissane D, Dalton SO, Bidstrup PE. Cohort profile of FALCON: a prospective nationwide cohort of families with minor children who have lost a parent in Denmark in 2019-2021. DEATH STUDIES 2023; 48:228-237. [PMID: 37249101 DOI: 10.1080/07481187.2023.2214899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Difficulties in recruiting newly bereaved families and following them over time present a major barrier in grief research following the death of a spouse/parent. We established FALCON-the first prospective nationwide cohort of families with children below age 18 years whose parent died in Denmark between April 2019 and July 2021. Data from parents and children were collected within 2 months of death with ongoing follow-up assessments up to 18 months post-death. A total of 992 families were invited. The final cohort consisted of 250 families (250 widowed parents, 134 adolescents, 120 children aged 6-12 years and 63 children aged 0-5 years). In this paper, we describe the rationale for the cohort's creation, the challenges of researching grief in families, the methods used and future plans to utilize this unique family-level dataset.
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Affiliation(s)
- Beverley Lim Høeg
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Randi Valbjørn Karlsen
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
- Institute of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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9
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Vieveen MJM, Yildiz B, Korfage IJ, Witkamp FE, Becqué YN, van Lent LGG, Pasman HR, Zee MS, Onwuteaka-Philipsen BD, van der Heide A, Goossensen A. Meaning-making following loss among bereaved spouses during the COVID-19 pandemic (the CO-LIVE study). DEATH STUDIES 2023:1-9. [PMID: 36892091 DOI: 10.1080/07481187.2023.2186979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This study investigates how individuals construe, understand, and make sense of experiences during the first wave of the COVID-19 pandemic. Seventeen semi-structured interviews were conducted with bereaved spouses focusing on meaning attribution to the death of their partner. The interviewees were lacking adequate information, personalized care, and physical or emotional proximity; these challenges complicated their experience of a meaningful death of their partner. Concomitantly, many interviewees appreciated the exchange of experiences with others and any last moments together with their partner. Bereaved spouses actively sought valuable moments, during and after bereavement, that contributed to the perceived meaning.
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Affiliation(s)
- M J M Vieveen
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
- Master Vitality and Ageing, LUMC, Leiden University Medical Center, The Netherlands
| | - B Yildiz
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - I J Korfage
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - F E Witkamp
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
- Research Center Innovations in Care, University of Applied Sciences, Rotterdam, The Netherlands
| | - Y N Becqué
- Research Center Innovations in Care, University of Applied Sciences, Rotterdam, The Netherlands
| | - L G G van Lent
- Department of Internal Oncology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands
| | - H R Pasman
- Department of Public and Occupational Health, Amsterdam Public Health research institute and Expertise center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - M S Zee
- Department of Public and Occupational Health, Amsterdam Public Health research institute and Expertise center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - B D Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam Public Health research institute and Expertise center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - A van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands
| | - A Goossensen
- University of Humanistic Studies, Universiteit voor Humanistiek, Utrecht, The Netherlands
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10
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Lytje M, Dyregrov A. When young children grieve: Supporting daycare children following bereavement-A parent's perspective. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:980-1001. [PMID: 33626991 DOI: 10.1177/0030222821997702] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Thirteen parents who lost the mother or father to their child were interviewed, using semi-structured interviews. Participants reflect on their young children's (3-6) grief, support needs, and what they learned from this trying time. The event scarred all participants. While some moved on, others were still struggling years after. The study uncovers difficulties associated with informing a young child, with a limfited understanding of illness and loss, in a life-situation where parents themselves are clinging to hope. While support is available from daycare, it can be better organised and structured. Proactive support that assists the child through illness and death relieves the parental care burden.
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Affiliation(s)
- Martin Lytje
- Danish Cancer Society, Copenhagen, Denmark.,Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Atle Dyregrov
- Center for Crisis Psychology, University of Bergen, Bergen, Norway
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Tzeng HJ, Lee CB, Chen CT, Lee MC. Trajectories of Instrumental and Emotional Social Support and the Associated Risk of Mortality in Bereaved Older Adults in Taiwan. Res Aging 2022:1640275221144251. [DOI: 10.1177/01640275221144251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study identified the trajectories of instrumental and emotional perceived social support (PSS) from 1996 to 2003 and investigated the associated risk of mortality in bereaved older adults in Taiwan. The study analyzed 1,188 bereaved older adults who had experienced loss of a spouse, a child, or both before 1996 from the Taiwan Longitudinal Study on Aging. More favorable trajectories of PSS are associated with lower mortality risk in bereaved older adults. Compared with the spousal or dual bereavement, the parental bereavement benefited more from consistently high instrumental PSS. The present study revealed that consistently high emotional PSS had a stronger protective effect on mortality risk for a widow or widower than did consistently high instrumental support. The findings of this study can serve as an empirical reference to inform social policies and clinical practices for bereaved older adults in culturally similar societies.
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Affiliation(s)
- Huei-Jia Tzeng
- Department of Social Welfare, National Chung Cheng University, Chiayi, Taiwan
- Department of Preventive Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan
| | - Chiachi Bonnie Lee
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Cheng-Tsung Chen
- School of Information Engineering, Sanming University, Fujian, China
| | - Miaw-Chwen Lee
- Department of Social Welfare, National Chung Cheng University, Chiayi, Taiwan
- Center for Innovative Research on Aging Society, National Chung Cheng University, Chiayi, Taiwan
- Advanced Institute of Manufacturing with High-tech Innovations, National Chung Cheng University, Chiayi, Taiwan
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12
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Tey MQ, Lee GL. Understanding Bereavement Experiences and Coping Among Bereaved Family Caregivers in Singapore: Positive Meaning Reconstruction in the Dual Process Model. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221133584. [PMID: 36222021 DOI: 10.1177/00302228221133584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this retrospective qualitative study was to examine the bereavement experiences and coping of family caregivers, with the Dual Process Model (DPM) as the theoretical framework. A purposive sample of 15 bereaved family caregivers, who had lived with and/or cared for their dying spouse or parent, were recruited from a local hospice. Using the interpretative phenomenological analysis approach, all one-to-one interviews were audio-recorded, transcribed, and entered into NVivo 12 Plus software for analysis. The major themes in this study mirrored well-established components of the DPM, including the concept of overload from the revised model. The cognitive processes of meaning making, an integral component of the DPM, were also discovered and put forth as a fifth theme to illustrate reconstruction of positive meaning. This is posited as an adaptive outcome to successful oscillation between loss-oriented and restoration-oriented grieving processes and, hence, leading to implications for bereavement care and support.
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Affiliation(s)
- Mei Qi Tey
- Department of Social Work, National University of Singapore, Singapore
- Assisi Hospice, Singapore
| | - Geok Ling Lee
- Department of Social Work, National University of Singapore, Singapore
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13
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Kim JW, Byun MS, Lee JH, Yi D, Kim MJ, Jung G, Lee JY, Lee YS, Kim YK, Kang KM, Sohn CH, Lee DY. Spouse bereavement and brain pathologies: A propensity score matching study. Psychiatry Clin Neurosci 2022; 76:490-504. [PMID: 35751876 PMCID: PMC9796777 DOI: 10.1111/pcn.13439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/25/2022] [Accepted: 06/16/2022] [Indexed: 01/07/2023]
Abstract
AIM Spouse bereavement is one of life's greatest stresses and has been suggested to trigger or accelerate cognitive decline and dementia. However, little information is available about the potential brain pathologies underlying the association between spouse bereavement and cognitive decline. We aimed to investigate that lifetime spouse bereavement is associated with in vivo human brain pathologies underlying cognitive decline. METHODS A total of 319 ever-married older adults between the ages of 61 and 90 years underwent comprehensive clinical assessments and multimodal brain imaging including [11 C] Pittsburgh compound B-positron emission tomography (PET), AV-1451 PET, [18 F] fluorodeoxyglucose-PET, and magnetic resonance imaging. Participants were classified as experiencing no spouse bereavement or spouse bereavement, and comparisons using propensity score matching (59 cases and 59 controls) were performed. RESULTS Spouse bereavement was significantly associated with higher cerebral white matter hyperintensity (WMH) volume compared with no spouse bereavement. Interaction and subsequent subgroup analyses showed that spouse bereavement was significantly associated with higher WMH in the older (>75 years) subgroup and among those with no- or low-skill occupations. In addition, spouse bereavement at 60 years or older affects WMH volume compared with no spouse bereavement, whereas spouse bereavement at younger than 60 years did not. No group differences were observed in other brain pathologies between spouse bereavement categories. CONCLUSIONS The findings suggest that the spouse bereavement may contribute to dementia or cognitive decline by increasing cerebrovascular injury, particularly in older individuals and those with no- or low-skill occupations.
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Affiliation(s)
- Jee Wook Kim
- Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.,Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Min Soo Byun
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Geriatric Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Dahyun Yi
- Medical Research Center Seoul National University, Institute of Human Behavioral Medicine, Seoul, Republic of Korea
| | - Min Jung Kim
- Department of Psychiatry, Eulji University Nowon Eulji Medical Center, Seoul, Republic of Korea
| | - Gijung Jung
- Medical Research Center Seoul National University, Institute of Human Behavioral Medicine, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Yun-Sang Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Koung Mi Kang
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Medical Research Center Seoul National University, Institute of Human Behavioral Medicine, Seoul, Republic of Korea
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14
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Can the internet mitigate the negative effect of widowhood on Quality of Life? A gender analysis. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09373-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractWidowhood often reduces the Quality of Life of individuals of advanced ages by negatively affecting their social network ties. Yet conversely, the Internet has also created new opportunities for communication and interaction, thus contributing to improved Quality of Life. This research analyses the role of the Internet in the relationship between widowhood and Quality of Life from a gender perspective.This study focuses on 31,814 individuals aged 65 or over residing in 17 European countries who participated in Wave 6 of SHARE – the Survey of Health, Ageing and Retirement in Europe.The linear regression analyses highlighted that the role of the Internet in the relationship between widowhood and Quality of Life varies according to gender. More specifically, in Europe, the Quality of Life for widowed women aged 65+ using the Internet is .414 higher (CI=.006 to .0822) than widows who do not use the Internet and married women or women in a de facto relationship whether or not they use the Internet. The results have relevant implications for the development of social policies and suggest a need to develop digital inclusion projects targeting older people, particularly widows, to help promote their Quality of Life.
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Wang H, Smith-Greenaway E, Bauldry S, Margolis R, Verdery AM. Mourning in a Pandemic: The Differential Impact of COVID-19 Widowhood on Mental Health. J Gerontol B Psychol Sci Soc Sci 2022; 77:2306-2316. [PMID: 35753008 PMCID: PMC9278192 DOI: 10.1093/geronb/gbac085] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES The death of a spouse is an established predictor of mental health decline that foreshadows worsening physical health and elevated mortality. The millions widowed by COVID-19 worldwide may experience even worse health outcomes than comparable pre-pandemic widows given the particularities of dying, mourning, and grieving during a pandemic defined by protracted social isolation, economic precarity, and general uncertainty. If COVID-19 pandemic bereavement is more strongly associated with mental health challenges than pre-pandemic bereavement, the large new cohort of COVID-19 widow(er)s may be at substantial risk of downstream health problems long after the pandemic abates. METHODS We pooled population-based Survey of Health, Ageing and Retirement in Europe data from 27 countries for two distinct periods: (1) pre-pandemic (Wave 8, fielded October 2019-March 2020; N = 46,266) and (2) early pandemic (COVID Supplement, fielded June-August 2020; N = 55,796). The analysis used a difference-in-difference design to assess whether a spouse dying from COVID-19 presents unique mental health risks (self-reported depression, loneliness, and trouble sleeping), compared with pre-pandemic recent spousal deaths. RESULTS We find strong associations between recent spousal death and poor mental health before and during the pandemic. However, our difference-in-difference estimates indicate those whose spouses died of COVID-19 have higher risks of self-reported depression and loneliness, but not trouble sleeping, than expected based on pre-pandemic associations. DISCUSSION These results highlight that the millions of COVID-19 widow(er)s face extreme mental health risks, eclipsing those experienced by surviving spouses pre-pandemic, furthering concerns about the pandemic's lasting impacts on health.
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Affiliation(s)
- Haowei Wang
- Population Research Institute, Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Emily Smith-Greenaway
- Department of Sociology, University of Southern California, Los Angeles, California, USA
| | - Shawn Bauldry
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
| | - Rachel Margolis
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Ashton M Verdery
- Address correspondence to: Ashton M. Verdery, PhD, Population Research Institute, Department of Sociology and Criminology, The Pennsylvania State University, Oswald Tower, University Park, PA 16802, USA. E-mail:
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Gerber K, Brijnath B, Lock K, Bryant C, Hills D, Hjorth L. 'Unprepared for the depth of my feelings' - Capturing grief in older people through research poetry. Age Ageing 2022; 51:afac030. [PMID: 35284925 PMCID: PMC9171723 DOI: 10.1093/ageing/afac030] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Older people are more likely to experience bereavements than any other age group. However, in healthcare and society, their grief experiences and support needs receive limited attention. Through innovative, arts-based research poetry, this study aimed to capture older people's bereavement stories and the effects of grief on their physical and mental health. METHOD Semi-structured in-depth interviews with 18 bereaved older adults were analysed using thematic and poetic narrative analysis, following a five-step approach of immersion, creation, critical reflection, ethics and engagement. RESULTS Research poems were used to illustrate three themes of bereavement experiences among older adults: feeling unprepared, accumulation of losses and ripple effects of grief. While half of participants reported that the death of their family member was expected, many felt unprepared despite having experienced multiple bereavements throughout their life. Instead, the accumulation of losses had a compounding effect on their health and well-being. While these ripple effects of grief focussed on emotional and mental health consequences, many also reported physical health effects like the onset of a new condition or the worsening of an existing one. In its most extreme form, grief was connected with a perceived increased mortality risk. CONCLUSIONS By using poetry to draw attention to the intense and often long-lasting effects of grief on older people's health and well-being, this article offers emotional, engaging and immersive insights into their unique bereavement experiences and thereby challenges the notion that grief has an expiry date.
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Affiliation(s)
- Katrin Gerber
- Melbourne Ageing Research Collaboration, National Ageing Research Institute, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Bianca Brijnath
- Melbourne Ageing Research Collaboration, National Ageing Research Institute, Melbourne, Australia
- School of Allied Health, Curtin University, Perth, Australia
- School of Social Sciences, University of Western Australia, Perth, Australia
| | - Kayla Lock
- Melbourne Ageing Research Collaboration, National Ageing Research Institute, Melbourne, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Danny Hills
- School of Health, Federation University, Ballarat, Australia
| | - Larissa Hjorth
- School of Media and Communication, RMIT University, Melbourne, Australia
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Psychometric properties of a revised posttraumatic growth inventory and its short form in Chinese Shidu parents. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01717-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Harfmann EJ, McAuliffe TL, Larson ER, Claesges SA, Sauber G, Hillard CJ, Goveas JS. Circulating endocannabinoid concentrations in grieving adults. Psychoneuroendocrinology 2020; 120:104801. [PMID: 32682172 PMCID: PMC7348598 DOI: 10.1016/j.psyneuen.2020.104801] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/01/2020] [Accepted: 07/02/2020] [Indexed: 02/04/2023]
Abstract
Bereavement is one of the most intense, distressing, and traumatic events an elderly person will experience. The symptom responses to bereavement vary, particularly during the first year. However, the neurobiology underlying the symptom variance in grief is poorly understood. The endocannabinoid signaling (ECS) system is stress-responsive; mounting evidence implicates the central ECS in psychopathology. The current study aimed to investigate the hypothesis that the ECS is abnormal in grief, using circulating eCB concentrations as a biomarker of central ECS. A predominantly older sample of grief participants, within 13 months following the death of a loved one, and healthy comparison (HC) participants were studied. Associations of circulating eCBs with symptom variance in grievers were also examined. A total of 61 (grief: n = 44; HC: n = 17) adults completed cross-sectional clinical assessments and a fasting blood draw. Assessments included the Inventory of Complicated Grief scale; the 17-item Hamilton Depression Rating Scale; and the Hamilton Anxiety scale. Serum eCB concentrations (i.e., N-arachidonoylethanolamine [AEA] and 2-arachidonoylglycerol [2-AG]) were quantified using isotope dilution, liquid chromatography-mass spectrometry. Relative to HC participants, grievers had significantly elevated serum AEA but similar 2-AG concentrations. In grievers, serum AEA concentrations were positively associated with depressive and anxiety symptoms, but only in those with low grief symptoms. These novel findings indicate that elevated circulating eCB concentrations are found following bereavement. The eCB signaling response varies based on the degree of grief severity. Circulating eCB measures may have the potential to serve as biomarkers of prolonged grief disorder.
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Affiliation(s)
- Elisabeth J Harfmann
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA; Clement J. Zablocki Veterans Affairs Medical Center, 5000 W. National Ave, Milwaukee, Wisconsin, 53295, USA
| | - Timothy L McAuliffe
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA
| | - Eric R Larson
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA; Clement J. Zablocki Veterans Affairs Medical Center, 5000 W. National Ave, Milwaukee, Wisconsin, 53295, USA
| | - Stacy A Claesges
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA
| | - Garrett Sauber
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA; Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA; Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA
| | - Joseph S Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA; Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA; Institute for Health and Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wisconsin, 53226, USA.
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van Velsen L, Cabrita M, Op den Akker H, Brandl L, Isaac J, Suárez M, Gouveia A, Dinis de Sousa R, Rodrigues AM, Canhão H, Evans N, Blok M, Alcobia C, Brodbeck J. LEAVES (optimizing the mentaL health and resiliencE of older Adults that haVe lost thEir spouSe via blended, online therapy): Proposal for an Online Service Development and Evaluation. JMIR Res Protoc 2020; 9:e19344. [PMID: 32897238 PMCID: PMC7509633 DOI: 10.2196/19344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/17/2020] [Accepted: 06/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background Loss of a spouse is a frequent occurrence in later life. While most older adults successfully process this loss and will return to a normal life, about 10% of the individuals are unable to cope, and progress to prolonged grief (PG). PG, in turn, can result in mental and physical problems including poor sleep, cardiovascular problems, depression, and suicidal tendencies. Objective LEAVES (optimizing the mentaL health and resiliencE of older Adults that haVe lost thEir spouSe via blended, online therapy) is an online bereavement program that will support the prevention and treatment of PG, so that elderly mourners can continue to lead an active, meaningful, and dignified life. LEAVES will cater to secondary end users (eg, family, informal caregivers) by reducing stress. Methods LEAVES will help older adults to process the loss of a spouse in an online environment, which consists of (1) an existing online grief self-help program LIVIA, (2) the Before You Leave program that allows for storing personal memories, (3) a virtual agent platform, and (4) an accessible front-end design. LEAVES can detect persons at risk for complications, reveal negative trends in their emotional life, and act to counter such trends. The service relies on online support whenever possible but is blended with telephone or face-to-face counseling when necessary. Results The project will take place between February 2020 and January 2023 and includes a real-life evaluation in which 315 end users will use the service across 3 countries (the Netherlands, Portugal, and Switzerland). The evaluation of LEAVES will focus on clinical effect, its business case, and technology acceptance. The results will pave the way for smooth integration into existing care paths and reimbursement schemes. Conclusions The LEAVES service aims to soften the mourning process, prevents depression or social isolation, strengthens widow(er)s resilience and well-being, and quickens one’s return to societal participation. International Registered Report Identifier (IRRID) DERR1-10.2196/19344
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Affiliation(s)
- Lex van Velsen
- eHealth group, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
| | - Miriam Cabrita
- eHealth group, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
| | - Harm Op den Akker
- eHealth group, Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems Group, University of Twente, Enschede, Netherlands
| | - Lena Brandl
- eHealth group, Roessingh Research and Development, Enschede, Netherlands
| | - Joana Isaac
- Unidade Local de Saúde do Baixo Alentejo, Beja, Portugal.,Comprehensive Health Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - María Suárez
- Unidade Local de Saúde do Baixo Alentejo, Beja, Portugal
| | - Afonso Gouveia
- Unidade Local de Saúde do Baixo Alentejo, Beja, Portugal
| | - Rute Dinis de Sousa
- Comprehensive Health Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana Maria Rodrigues
- Comprehensive Health Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Helena Canhão
- Comprehensive Health Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | | | | | - Marije Blok
- National Foundation for the Elderly, Amersfoort, Netherlands.,Department of Sociology, Vrije Universiteit, Amsterdam, Netherlands
| | | | - Jeannette Brodbeck
- School of Social Work, FHNW University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland.,Department for Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
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Abstract
AIMS Widowed people have increased mortality compared to married people of the same age. Although most widowed people are of older age, few studies include the oldest old. As life expectancy is increasing, knowledge of widowhood into older age is needed. This study aimed to examine mortality and widowhood in older age by comparing mortality in widowed and married people by sex, age, time since spousal loss and cause of death. METHODS A Danish register-based matched cohort study of 10% of widowed persons ⩾65 years in the years 2000-2009. For each randomly drawn widowed person, five married persons were matched on sex and age. Mortality rate ratios (MRR) were calculated using Poisson regression, and stratified according to sex and 5-year age intervals. MRRs were furthermore calculated by time since spousal loss and by specific cause of death. RESULTS The study included 82 130 persons contributing with 642 914.8 person-years. The overall MRR between widowed and married persons with up to 16 years of follow-up was 1.25 (95% CI 1.23-1.28). At age ⩾95 years for men, and ⩾90 years for women, no differences in mortality rates were seen between widowed and married persons. Mortality in widowed persons was increased for most specific causes of death, with the highest MRR from external causes (MRR 1.53 [1.35-1.74]) and endocrine diseases (MRR 1.51 [1.34-1.70]). CONCLUSIONS Widowhood was associated with increased mortality in older age for both men and women until age ⩾95 and ⩾90 years, respectively. Increased mortality was observed for almost all causes of death.
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Wright L, Steptoe A, Fancourt D. Are we all in this together? Longitudinal assessment of cumulative adversities by socioeconomic position in the first 3 weeks of lockdown in the UK. J Epidemiol Community Health 2020; 74:683-688. [PMID: 32503892 PMCID: PMC7298206 DOI: 10.1136/jech-2020-214475] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 11/18/2022]
Abstract
Background Despite media claims that coronavirus disease 2019 (COVID-19) is uniting societies and countries in shared experience, there has been concern that the pandemic is in fact exposing and widening existing inequalities within societies. Data have shown these differences for cases and fatalities, but data on other types of adversities are lacking. Therefore, this study explored the changing patterns of adversity relating to the COVID-19 pandemic by socioeconomic position (SEP) during the early weeks of lockdown in the UK. Methods Data were from 12 527 UK adults in the University College London COVID-19 Social Study (a panel study that involves online weekly data collection from participants during the COVID-19 pandemic). We analysed data collected from 25 March to 14 April 2020. The sample was well-stratified and weighted to population proportions of gender, age, ethnicity, education and country of living. We used Poisson and logit models to assess 10 different types of adverse experiences depending on an index of SEP over time. Results There was a clear gradient across the number of adverse events experienced each week by SEP. This was most clearly seen for adversities relating to finances (including loss of employment and cut in income) and basic needs (including access to food and medications) but less for experiences directly relating to the virus. Inequalities were maintained with no reductions in discrepancies between socioeconomic groups over time. Conclusions There were clear inequalities in adverse experiences during the COVID-19 pandemic in the early weeks of lockdown in the UK. Results suggest that measures taken to try to reduce such adverse events did not go far enough in tackling inequality.
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Affiliation(s)
- Liam Wright
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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