Prospective study of early bereavement on psychological and behavioural cardiac risk factors

Buckley, Thomas; Bartrop, Roger; McKinley, S.; Ward, Christopher; Bramwell, Margaret; Roche, Diane; Mihailidou, Anastasia S.; Morel-Kopp, Marie-Christine; Spinaze, MM; Hocking, Belinda; Goldston, Kerrie; Tennant, Christopher; Tofler, Geoffrey H.

doi:10.1111/j.1445-5994.2008.01879.x

Cited by 57 publications

(55 citation statements)

References 59 publications

(110 reference statements)

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“…Previous research has shown that related emotional stressors, such as anger, 16, 17 anxiety 16 and depression 18 may trigger cardiovascular events in the following hour(s). 19, 20 For instance, in our study population, 16 39 of the 1623 (2.4%) patients recruited by 1995 reported an episode of anger in the 2 hours prior to MI onset, resulting in a 2.3-fold (95%CI 1.7 to 3.2) increased risk of MI; there was a 1.6-fold (95% CI 1.1 to 2.2) elevated risk of MI in the 2 hours following episodes of marked anxiety. In a study of 295 patients interviewed immediately following an acute coronary event, 18 46 (18.2%) reported a time-limited episode of depression in the 2 hours before symptom onset.…”

Section: Discussionmentioning

confidence: 99%

“…21, 22 Acute bereavement is associated with psychological, behavioral and physiologic sequelae. 20–22 In particular, bereavement is associated with higher levels of negative affect, including symptoms of depression, anxiety and anger. 20 Acute bereavement is also associated with reduced sleep time, reduced appetite, lower total cholesterol and low density lipoprotein and higher cortisol levels.…”

Section: Discussionmentioning

confidence: 99%

“…20–22 In particular, bereavement is associated with higher levels of negative affect, including symptoms of depression, anxiety and anger. 20 Acute bereavement is also associated with reduced sleep time, reduced appetite, lower total cholesterol and low density lipoprotein and higher cortisol levels. These changes may contribute to the increased cardiovascular risk.…”

Section: Discussionmentioning

confidence: 99%

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Risk of Acute Myocardial Infarction After the Death of a Significant Person in One's Life

et al. 2012

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Background Acute psychological stress is associated with an abrupt increase in the risk of cardiovascular events. Intense grief in the days following the death of a significant person may trigger the onset of acute myocardial infarction (MI), but this relationship has not been systematically studied. Methods and Results We conducted a case-crossover analysis of 1985 participants from the multicenter Determinants of MI Onset Study interviewed during index hospitalization for an acute MI between 1989 and 1994. We compared the observed number of deaths in the days preceding MI symptom onset to its expected frequency based on each patient's control information, defined as the occurrence of deaths in the period from 1 to 6 months prior to infarction. Among the 1985 subjects, 270 (13.6%) experienced the loss of a significant person in the prior six months, including 19 within 1 day of their MI. The incidence rate of acute MI onset was elevated 21.1 fold (95%CI 13.1 to 34.1) within 24 hours of the death of a significant person, and declined steadily on each subsequent day. The absolute risk of MI within 1 week of the death of a significant person is 1 excess MI per 1394 exposed individuals at low (5%) 10-year MI risk and 1 per 320 among individuals at high (20%) 10-year risk. Conclusions Grief over the death of a significant person was associated with an acutely increased risk of MI in the subsequent days. The impact may be greatest among individuals at high cardiovascular risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk of Acute Myocardial Infarction After the Death of a Significant Person in One's Life

et al. 2012

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“…In addition to affecting well-being (Buckley et al, 2009), this stressor has also been linked to risk for dementia. For instance, studies have found parental death during childhood (Persson and Skoog, 1996) and maternal death during adolescence (Norton et al, 2011) to be associated with six-fold and two-fold increased risk for dementia and AD, respectively.…”

Section: Introductionmentioning

confidence: 99%

Family member deaths across adulthood predict Alzheimer's disease risk: The Cache County Study

Norton

Fauth

Clark

et al. 2015

Int J Geriat Psychiatry

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Objectives Parental death during childhood, and offspring and spouse death during adulthood have individually been associated with faster cognitive decline and higher Alzheimer’s disease (AD) risk in late-life. However, the cumulative effect of childhood and adulthood family deaths on AD risk among different age cohorts has not been studied. Methods To examine these associations, this prospective cohort study uses a population-based sample of 4,545 initially non-demented participants (56.7% female; age M=75.0/SD=6.9 years) observed at four triennial waves, linked with objective Utah Population Database data on cumulative mother, father, sibling, spouse and offspring death experienced during childhood and adulthood. Cox regression modeled survival time from baseline interview to AD onset, as a function of family deaths during childhood or adulthood, among different age groups, along with gender and presence of ε4 allele at apolipoprotein E (APOE) polymorphic genetic locus. Results Age group significantly moderated the relationship between family death and AD; among persons aged 65–69 years at baseline (children of the Great Depression), those exposed to 3–4 deaths and 5+ deaths during adulthood exhibited a doubling of AD risk (adjusted Hazard Ratio, aHR=2.25, p=.038 and aHR=2.72, p=.029), while among persons aged 80 years and older, those exposed to 3–4 deaths during adulthood exhibited lower AD risk (HR=0.539, p=0.014). In a combined model of childhood and adulthood deaths, these findings persisted. Conclusions Results suggest a cohort effect in the link between family member deaths during adulthood and AD risk later in life.

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“…(3,4) Even though the mortality of bereavement has been described in several populations, the role of modifying factors after bereavement such as incident cardiovascular disease (CVD) and depressive symptoms are not well understood. (3) Bereavement increases the risk for cardiovascular events (5) and depressive symptoms (6). Each of these factors—bereavement, (1–4) CVD, (7) and depression (7) – have been independently linked to mortality, but they have not been examined together in a single study.…”

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confidence: 99%

Mortality After Bereavement: The Role of Cardiovascular Disease and Depression

et al. 2016

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Objectives Late-life bereavement is associated with an increased risk of mortality. This study assesses the associations among bereavement, cardiovascular disease (CVD), and depressive symptoms on mortality in older men and women. Methods We examined data from the Cardiovascular Health Study, a prospective population-based cohort study of older adults. We compared mortality in those who became bereaved from 1989–1999 (n=593) to an age- and sex-matched sample of individuals who remained married (n=593). Cox regression was used to examine the association between bereavement and 3-year all-cause mortality and whether or not the association differed by sex, presence of CVD or post-bereavement depressive symptoms. Results One hundred ninety-nine (16.8%) individuals died. There was no association of bereavement with mortality, HR= 0.98 (0.74, 1.30). However, there were significant interaction effects of bereavement with participant sex (p<.001) and CVD (p=.010). Bereavement decreased the risk of mortality in women (HR=0.67 (0.46, 0.97)) and increased the risk of mortality in men (HR=1.77 (1.14, 2.75)). Within sex, the association of bereavement with mortality differed according to CVD status. The reduced risk of mortality associated with bereavement in women was only observed in women with CVD and the increased risk in men was only observed in men without CVD. High levels of depressive symptoms attenuated the relation between bereavement and mortality in men without CVD. Conclusions The relation between bereavement and mortality was different in men and women and varied by CVD status. Bereavement decreased mortality in women with CVD and increased mortality in men without CVD.

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Prospective study of early bereavement on psychological and behavioural cardiac risk factors

Abstract: These results offer insight into the psychological, behavioural and physical changes that may contribute to cardiovascular risk in bereavement.

Cited by 57 publications

References 59 publications

Risk of Acute Myocardial Infarction After the Death of a Significant Person in One's Life

Risk of Acute Myocardial Infarction After the Death of a Significant Person in One's Life

Family member deaths across adulthood predict Alzheimer's disease risk: The Cache County Study

Mortality After Bereavement: The Role of Cardiovascular Disease and Depression

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