Short-Term Mental Health Sequelae of Bereavement Predict Long-Term Physical Health Decline in Older Adults: U.S. Health and Retirement Study Analysis

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.

Prolonged grief disorder and depression are distinguishable syndromes: A latent transition analysis for bereaved family caregivers of cancer patients

“…Our finding that bereaved caregivers were predominantly in the resilient or subthreshold depression‐dominant states confirms that bereaved individuals endure well and can gradually recover from the loss of their beloved. However, specific and effective interventions 2 should be provided to the minority of bereaved who suffer from prominent depressive symptoms independently or conjointly with PGD symptoms to avoid the substantial costs to individuals, their family, and society 7‐10 . Healthcare professionals should also be alerted to our finding that once PGD is present, it commonly co‐occurs with depressive symptoms.…”

“…Healthcare professionals should also be alerted to our finding that once PGD is present, it commonly co‐occurs with depressive symptoms. Therefore, when PGD is suspected, bereaved individuals should be assessed for the potential comorbidity of MDD, and effective interventions should be provided during the early bereavement trajectory to prevent their transitioning into a PGD‐depression comorbid state, thus benefiting individuals, families, and society 7‐10 …”

“…The presence of unrelenting distress is a crucial characteristic distinguishing normal grief from bereavement‐related mental disorders, for example, prolonged grief (PGD) and major depressive disorder (MDD). Both PGD and MDD take a toll not only on personal psychological and physical well‐being, 7,8 but also place a heavy economic burden on society at large 9,10 …”

Bereavement from COVID-19, Gender, and Reports of Depression among Older Adults in Europe

“…There is a reason to suspect that these results foreshadow the pandemic's lingering mental health effects. Research shows that depressive symptoms immediately following bereavement can predict physical health problems down the line (Domingue et al, 2020). Targeted efforts to address COVID-19 bereavement may especially benefit older women in countries with severe COVID-19 mortality crises, as well as those personally affected.…”

“…This framework posits that various stressors stemming from bereavement correspond with a range of poor health outcomes, from mental health problems to elevated mortality risk (Elwert & Christakis, 2008a, 2008bStroebe et al, 2007). In the short term, the health challenges associated with bereavement can manifest as mental health problems, which often foreshadow physical health declines (Domingue et al, 2020). Research highlights adverse consequences of COVID-19 mitigation strategies (quarantine, social distancing) for older adults' mental health (Czeisler et al, 2021;Pfefferbaum & North, 2020;Simon et al, 2020), while related work draws attention to COVID-19 bereavement among older adults (Carr et al, 2020;Stroebe & Schut, 2021).…”