Gender differential impact of bereavement on health outcomes: evidence from the China Health and Retirement Longitudinal Study, 2011-2015

Bereavement and Grief Among Employees in an Arab University Setting: A Cross-Sectional Study

BACKGROUND

Several mental health outcomes develop following bereavement. Little research has examined bereavement in the workplace and the associated risk factors, particularly in Arab populations.

OBJECTIVES

The objectives of this cross-sectional study were to determine the sociodemographic characteristics of bereaved employees, measure the prevalence of their dysfunction, establish the type of closeness and conflict in their relationship with the deceased, determine the available resources to the bereaved, and determine the proportion of bereaved employees who needed help.

METHODS

A study was conducted on Arabian Gulf University employees (91) in Bahrain. The revised Two Track Bereavement Questionnaire (TTBQ3-CG11) was utilized to assess bereavement outcomes.

RESULTS

The response rate of the study was 28%. The composition of the study population was as follows: 51.6% males, 37.4% in the age range of 40-49 years, 86.8% married, 39.6% Bahraini, and 51.6% academicians. Over half of the participants had biopsychosocial dysfunction, 35.2% had active relational grief and trauma (ARGT), 36.3% had a conflict with the deceased, and half were close to the deceased. Total TTBQ3-CG11 scores showed that 28.6% of the bereaved had a low score (14-22), 61.5% medium (23-28), and 9.9% high (29 or more), with more females than males in the high category. The majority reported receiving adequate support from the administration and colleagues following their loss.

CONCLUSION

There is a need to establish bereavement policies and procedures at tertiary educational institutes. This study may inform future policies to advance bereavement services in the educational institutions of the region.

Types of bereavement and depressive symptoms among older adults: Does race/ethnicity matter?

AIM

To explore racial/ethnic differences in relation between types of bereavement and depressive symptoms among older adults in the USA.

METHODS

The sample limited to racially/ethnically diverse adults aged ≥55 (n = 879) was drawn from the third wave of the National Social Life, Health, and Aging Project (NSHAP). The NSHAP provides self-identified racial/ethnic categories (non-Hispanic Whites, Blacks, and Hispanics) of respondents who were categorized into three groups by experience of bereavement: non-loss, spousal loss, and parental loss. Using the weights, a two-way analysis of covariance with Bonferroni post-test was conducted to explore the main effect of types of loss and race/ethnicity and their interaction effects on depressive symptoms.

RESULTS

Spousal loss reported higher levels of depressive symptoms than non-loss or parental loss. Based on the interaction between types of loss and race/ethnicity; however, distinctive patterns were observed. Blacks and Hispanics who lose a parent reported significantly higher levels of depressive symptoms than non-Hispanic Whites did.

CONCLUSIONS

An increase in depressive symptoms after bereavement manifested distinctively based on racial/ethnic background and the relationship with the deceased. This implies that it is necessary to develop coping strategies concerning race/ethnicity and whom they lose. Geriatr Gerontol Int 2024; 24: 266-272.

Relationship of depression and loneliness with quality of life in rural widowed elderly women living alone

OBJECTIVES

Rural widowed elderly women living alone may face higher risks of depression and loneliness than general elderly people, which will have an impact on their quality of life. This study aims to explore the correlation of depression and loneliness with quality of life among rural widowed elderly women living alone.

METHODS

A two-stage cluster sampling method was used to select 234 rural widowed older women living alone in Longshan county, Xiangxi autonomous prefecture, Hunan Province, and a questionnaire survey was conducted with the General Situation Questionnaire, the Geriatric Depression Scale-15 (GDS-15), the University of California, Los Angeles (UCLA) Loneliness Scale-8 (ULS-8), and the 36 Items Short Form Health Survey (SF-36).

RESULTS

The ages of 234 rural widowed older women living alone were (73.29±7.36) years. Among them, 103 (44.0%) women were detected as depressed, 114 (48.7%) were not lonely or mildly lonely, 111 (47.4%) were moderately lonely, and 9 (3.9%) were severely lonely. The total quality of life scores were 63.39±19.70. Depression and loneliness were negatively correlated with quality of life (all P<0.001). After adjusting for confounding factors, multiple linear regression analysis showed that age, number of acute and chronic diseases, personal monthly income, depression, and loneliness independently impacted the quality of life among rural widowed older women (all P<0.05).

CONCLUSIONS

Depression and loneliness can affect the quality of life of rural widowed older women living alone. In healthy aging efforts, the quality of life of these rural widowed older women can be improved by strengthening the management of underlying illnesses, increasing income, and alleviating depression and loneliness.

Development and validation of a multimorbidity risk prediction nomogram among Chinese middle-aged and older adults: a retrospective cohort study

OBJECTIVES

The aim of this study is to establish a self-simple-to-use nomogram to predict the risk of multimorbidity among middle-aged and older adults.

DESIGN

A retrospective cohort study.

PARTICIPANTS

We used data from the Chinese Longitudinal Healthy Longevity Survey, including 7735 samples.

MAIN OUTCOME MEASURES

Samples' demographic characteristics, modifiable lifestyles and depression were collected. Cox proportional hazard models and nomogram model were used to estimate the risk factors of multimorbidity.

RESULTS

A total of 3576 (46.2%) participants have multimorbidity. The result showed that age, female (HR 0.80, 95% CI 0.72 to 0.89), chronic disease (HR 2.59, 95% CI 2.38 to 2.82), sleep time (HR 0.78, 95% CI 0.72 to 0.85), regular physical activity (HR 0.88, 95% CI 0.81 to 0.95), drinking (HR 1.27 95% CI 1.16 to 1.39), smoking (HR 1.40, 95% CI 1.26 to 1.53), body mass index (HR 1.04, 95% CI 1.03 to 1.05) and depression (HR 1.02, 95% CI 1.01 to 1.03) were associated with multimorbidity. The C-index of nomogram models for derivation and validation sets were 0.70 (95% CI 0.69 to 0.71, p=0.006) and 0.71 (95% CI 0.70 to 0.73, p=0.008), respectively.

CONCLUSIONS

We have crafted a user-friendly nomogram model for predicting multimorbidity risk among middle-aged and older adults. This model integrates readily available and routinely assessed risk factors, enabling the early identification of high-risk individuals and offering tailored preventive and intervention strategies.

Grief, Social Support, Spirituality, and Depressive Symptoms Among Older Adults in Assisted Living in Kansas

PURPOSE

The purpose of this study was to explore the roles of grief, social support, as well as spirituality on the depressive symptoms of older adults in assisted living in Kansas. This study tested three hypotheses: a high level of grief will be related to a high level of depressive symptoms; high levels of social support (family, friends, and significant persons) will be associated with a low level of depressive symptoms; and high levels of spiritual experience and coping will be associated with a low level of depressive symptoms.

METHODS

This study recruited 316 older adult residents aged 65 or over from seven assisted living facilities in Kansas. This cross-sectional survey was done by face-to-face interviews using the purposive sampling method. Hierarchical multiple regression was used to test the three sets of variables in relation to depressive symptoms: socio-demographics, social support factors, and spiritual factors.

RESULTS

Participants' mean age was 82.6 years, ranging from 65 to 102; 70.9% were female. Married participants consisted of 18.7%, and over 64% were widowed. Hierarchical multivariate regression results indicated that a high level of grief was significantly related to a high level of depressive symptoms. On the other hand, high levels of social support from friends and spiritual coping were significantly associated with a low level of depressive symptoms.

DISCUSSION AND CONCLUSION

Assisted living facilities may consider developing appropriate bereavement, social support, and spiritual intervention programs, which will alleviate the depression issues of older adult residents after the COVID-19 pandemic.

The longitudinal contribution of prolonged grief to depression and suicide risk in the aftermath of suicide loss: The moderating role of self-criticism

BACKGROUND

Suicide-loss survivors (SLSs)-individuals who lost family member to suicide, have been recognized as at risk for several mental health complications, including depression and suicide. Recent studies have emphasized the contribution of prolonged grief (PG) symptoms and suicide-related shame as facilitators of depression and suicide risk in the aftermath of suicide loss. In this six-year longitudinal design study, we examined self-criticism as a moderator of the link between PG and depression and suicide risk, with suicide-related shame mediating these links.

METHOD

Participants were 152 SLSs (130 females) aged 18-70 who completed questionnaires assessing prolonged grief, depression, and suicide risk as well as trauma-related shame and self-criticism.

RESULTS

A moderated mediation model shows that high self-criticism intensified the relations between PG and shame and between shame and depression and suicide risk, above and beyond the contribution of the longitudinal PG trajectory. Importantly, the indirect effects of PG on both depression and suicide risk via shame levels were found only among SLSs with high levels of self-criticism.

CONCLUSION

The findings highlight the critical longitudinal role of self-criticism in facilitating depression and suicide risk among SLSs with higher levels of PG. Theoretical implications relating to healing processes and focused clinical recommendations are discussed, including interventions for addressing self-criticism and suicide-related shame in the aftermath of suicide loss.

Home Alone: Widows' Well-Being and Time

Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE, 2004-17) and time diaries from Poland (2013), the U.S. (2006-16), the U.K. (2014-15) and France (2009-10), we examine differences between widowed and partnered older women in well-being and its development in widowhood. Most importantly, our analysis accounts for time use, an aspect which has not been studied previously. We trace the evolution of well-being of women who become widowed by comparing them with their matched non-widowed 'statistical twins' and examine the role of an exceptionally broad set of potential moderators of widowhood's impact on well-being. We confirm a dramatic decrease in mental health and life satisfaction after the loss of partner, followed by a slow partial recovery over a 5-year period. An extensive set of controls recorded prior to widowhood, including detailed family ties and social networks, provides little help in explaining the deterioration in well-being. Unique data from time-diaries kept by older women in several European countries and the U.S. tell us why: the key factor behind widows' reduced well-being is increased time spent alone.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10902-023-00622-w.

Can the internet mitigate the negative effect of widowhood on Quality of Life? A gender analysis

Widowhood 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.

Adverse childhood experiences in depression and the mediating role of multimorbidity in mid-late life: A nationwide longitudinal study

BACKGROUNDS

Adverse childhood experiences are co-occurring factors of multimorbidity and depression in mid-late life, but the combined effect of ACEs and multimorbidity on depression over life has not been fully studied.

METHODS

We used data from the China Health and Retirement Longitudinal Study which includes 4,440 middle-aged and older adults. Different types of ACEs experienced up to the age of 17 were assessed based on self-reports. We used parallel process Latent Growth Curve modelling to evaluate the longitudinal mediation role of ACEs, multimorbidity and depression.

RESULTS

People who had more ACEs were found to have a higher level of multimorbidity (intercept: 0.057, 95% CI: 0.031 to 0.079) and depression (intercept: 0.047, 95% CI: 0.013 to 0.076) at the baseline and a faster increase in multimorbidity (slope: 0.107, 95%CI: 0.078 to 0.136) and depression (slope: 0.074, 95%CI: 0.035 to 0.153). The mediation analysis indicated that there was a positive indirect association of ACEs via the multimorbidity intercept with the intercept of depression (0.028, 95%CI: 0.012 to 0.043), and a small negative association with the slope of depression (-0.002, 95%CI: -0.003 to -0.001). We also found a positive indirect association of ACEs via the multimorbidity slope with the intercept (0.035, 95%CI: 0.021 to 0.049) and slope (0.008, 95%CI: 0.004 to 0.011) of depression.

CONCLUSIONS

ACEs were related to higher depression partly via elevated multimorbidity. Public health services and behavioural interventions to prevent and reduce the occurrence of ACEs might help to lower the risk of multimorbidity and depression in later life.

Prevalence of grief disorders in bereaved families of cancer patients: A meta-analysis

BACKGROUND

Cancer caregiving is a distressing experience and loss of a loved one can lead to intense grief and other adverse effects. However, the prevalence of grief disorders among families associated with cancer-related deaths remains unknown.

AIM

This study aimed to determine the prevalence of grief disorders among families of patients with cancer to better inform clinicians, researchers, and policymakers.

DESIGN

Meta-analysis, PROSPERO number CRD42020209392.

DATA SOURCES

The databases of CINAHL, Embase, MEDLINE, PubMed, Scopus, PsycINFO, and Web of Science were comprehensively searched with no language restrictions. The quality of included studies was assessed with Hoy's criteria.

RESULTS

Among the 3046 records screened, 19 studies were eligible for meta-analysis, with a total of 14,971 participants. The pooled prevalence rate of grief disorders was estimated at 14.2% (95% CI, 11.7%-16.7%), ranging from 7% to 39%. The prevalence was higher in females (10%; 95% CI, 8.2%-12.1%), those who are religious (9.55%; 95% CI, 8.97%-10.16%), spouses of the deceased (7.78%; 95% CI, 6.08%-9.69%), and families of patients with neurological cancers (6.4%; 95% CI, 0.10%-19.9%). Educational levels, study locations, diagnosis tools, time post-after loss, and study methods seemed not to affect the prevalence of grief disorders in families of patients with cancer.

CONCLUSIONS

As the prevalence of grief disorders in cancer-related bereavement is substantial, therefore, support including palliative care is important to reduce the burden of caregiving. In addition, future studies are needed to identify and explore effective strategies that can help reduce the burden caused by grief disorders after the death of the patient.

Microglia react to partner loss in a sex- and brain site-specific manner in prairie voles

Positive social relationships are paramount for the survival of mammals and beneficial for mental and physical health, buffer against stressors, and even promote appropriate immune system functioning. By contrast, impaired social relationships, social isolation, or the loss of a bonded partner lead to aggravated physical and mental health. For example, in humans partner loss is detrimental for the functioning of the immune system and heightens the susceptibility for the development of post-traumatic stress disorders, anxiety disorders, and major depressive disorders. To understand potential underlying mechanisms, the monogamous prairie vole can provide important insights. In the present study, we separated pair bonded male and female prairie voles after five days of co-housing, subjected them to the forced swim test on the fourth day following separation, and studied their microglia morphology and activation in specific brain regions. Partner loss increased passive stress-coping in male, but not female, prairie voles. Moreover, partner loss was associated with microglial priming within the parvocellular region of the paraventricular nucleus of the hypothalamus (PVN) in male prairie voles, whereas in female prairie voles the morphological activation within the whole PVN and the prelimbic cortex (PrL) was decreased, marked by a shift towards ramified microglial morphology. Expression of the immediate early protein c-Fos following partner loss was changed within the PrL of male, but not female, prairie voles. However, the loss of a partner did not affect the investigated aspects of the peripheral immune response. These data suggest a potential sex-dependent mechanism for the regulation of microglial activity following the loss of a partner, which might contribute to the observed differences in passive stress-coping. This study furthers our understanding of the effects of partner loss and its short-term impact on the CNS as well as the CNS immune system and the peripheral innate immune system in both male and female prairie voles.