Widowhood Status as a Risk Factor for Cognitive Decline among Older Adults

Shin, Su Hyun; Kim, Giyeon; Park, Soohyun

doi:10.1016/j.jagp.2018.03.013

Cited by 59 publications

(56 citation statements)

References 34 publications

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“…In addition, given the mixed findings on the longitudinal link between widowhood and cognitive function, the present study considered both the changes in cognitive function over time and the rates of cognitive changes in relation to widowhood duration, which may be a unique contribution to the field. Consistent with previous research, we observed that the experience of widowhood was associated with the trajectories of cognitive decline among Korean older adults for up to 8 years of follow‐up. A significant duration effect on cognitive function was found in our unadjusted model, which suggests that the first 2 years after spousal loss was associated with a lower level of cognitive function.…”

Section: Discussionsupporting

confidence: 91%

“…In addition, we observed a steeper decline in cognitive function for those who had lost their spouse 4 to 6 years ago in the adjusted model. This may show a delayed reaction to such stressful life events as widowhood, which is in concordant with previous research that suggested a greater vulnerability to cognitive decline as the time since spousal loss increases . While unique and interesting, it should be explained further why only widowhood duration of 4 to 6 years showed a significant decline in cognitive function among Korean older adults.…”

Section: Discussionsupporting

confidence: 87%

“…This may show a delayed reaction to such stressful life events as widowhood, which is in concordant with previous research that suggested a greater vulnerability to cognitive decline as the time since spousal loss increases. 20 While unique and interesting, it should be explained Fourth and relatedly, the KLoSA datasets do not contain information regarding whether the spousal death was expected or unexpected, which may influence the impact of widowhood. Fifth, the K-MMSE we used in the present study is a relatively crude assessment of cognitive function.…”

Section: Growth Curve Model Resultsmentioning

confidence: 99%

“…Despite studies examining the link between widowhood status and cognitive function among older adults, few have investigated the longitudinal association between widowhood and cognition. Furthermore, the findings of these longitudinal studies are mixed, finding a positive link, no effect, or a negative link . This variability across different studies can be partly attributed to how they examined the longitudinal link between widowhood and cognition.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the findings of these longitudinal studies are mixed, finding a positive link, 15-18 no effect, 19 or a negative link. 20,21 This variability across different studies can be partly attributed to how they examined the longitudinal link between widowhood and cognition.…”

Section: Introductionmentioning

confidence: 99%

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Trajectories of cognitive decline by widowhood status among Korean older adults

Lyu

Min

Kim

2019

Int J Geriat Psychiatry

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Objectives Given the limited evidence regarding the longitudinal impact of widowhood on cognitive function in later life, the present study aimed to investigate the longitudinal effect of widowhood status on cognitive change among Korean older adults. Methods The study sample was drawn from a nationally representative data set, the Korean Longitudinal Study of Ageing (KLoSA); it consisted of 3,660 Korean adults aged 60 and over who were married at baseline. Our dependent variable, cognitive function, was measured by the Korean version of the Mini‐Mental State Examination (K‐MMSE). Widowhood status was measured with the combination of widowhood status and duration. Growth curve models were constructed using five waves of the KLoSA (2006‐2014) to examine the longitudinal trajectories of cognitive changes. Results In the unadjusted model, widowed older adults had significantly lower cognitive function than their nonwidowed counterparts regardless of widowhood duration. Adjusting for covariates, results from the growth curve models showed that widowed older adults with widowhood duration 4 to 6 years had a significantly steeper decline in cognitive function than nonwidowed older adults (P < 0.05). Conclusions These findings suggest that widowhood is detrimental for late‐life cognitive function. Further research is required to understand the mechanisms underlying this relationship. Policy and practice implications are discussed according to the cultural context.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

Section: Growth Curve Model Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Trajectories of cognitive decline by widowhood status among Korean older adults

Lyu

Min

Kim

2019

Int J Geriat Psychiatry

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Associations of Widowhood and β-Amyloid With Cognitive Decline in Cognitively Unimpaired Older Adults

et al. 2020

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IMPORTANCE To reduce the rising incidence of clinical impairment due to Alzheimer disease, it is essential to define older adults at highest risk. Widowhood may be an unrecognized factor contributing to accelerated clinical progression along the Alzheimer disease pathway among cognitively unimpaired older adults. OBJECTIVE To determine whether widowhood status and level of brain β-amyloid (ie, the Alzheimer disease pathologic protein) are additively or interactively associated with cognitive decline among cognitively unimpaired older adults. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, 257 married, widowed, and unmarried (ie, never married, divorced, or separated) participants from the Harvard Aging Brain Study longitudinal cohort underwent baseline evaluation of neocortical β-amyloid levels using Pittsburgh compound B positron emission tomography and 4 annual cognitive assessments. Data were

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Mortality and Function After Widowhood Among Older Adults With Dementia, Cancer, or Organ Failure

Rodin,

Smith,

Espejo

et al. 2024

JAMA Netw Open

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ImportanceThe widowhood effect, in which mortality increases and function decreases in the period following spousal death, may be heightened in older adults with functional impairment and serious illnesses, such as cancer, dementia, or organ failure, who are highly reliant on others, particularly spouses, for support. Yet there are limited data on widowhood among people with these conditions.ObjectiveTo determine the association of widowhood with function and mortality among older adults with dementia, cancer, or organ failure.Design, Setting, and ParticipantsThis longitudinal cohort study used population-based, nationally representative data from the Health and Retirement Study database linked to Medicare claims from 2008 to 2018. Participants were married or partnered community-dwelling adults aged 65 years and older with and without cancer, organ failure, or dementia and functional impairment (function score &lt;9 of 11 points), matched on widowhood event and with follow-up until death or disenrollment. Analyses were conducted from September 2021 to May 2024.ExposureWidowhood.Main Outcomes and MeasuresFunction score (range 0-11 points; 1 point for independence with each activity of daily living [ADL] or instrumental activity of daily living [IADL]; higher score indicates better function) and 1-year mortality.ResultsAmong 13 824 participants (mean [SD] age, 70.1 [5.5] years; 6416 [46.4%] female; mean [SD] baseline function score, 10.2 [1.6] points; 1-year mortality: 0.4%) included, 5732 experienced widowhood. There were 319 matched pairs of people with dementia, 1738 matched pairs without dementia, 95 matched pairs with cancer, 2637 matched pairs without cancer, 85 matched pairs with organ failure, and 2705 matched pairs without organ failure. Compared with participants without these illnesses, widowhood was associated with a decline in function immediately following widowhood for people with cancer (change, −1.17 [95% CI, −2.10 to −0.23] points) or dementia (change, −1.00 [95% CI, −1.52 to −0.48] points) but not organ failure (change, −0.84 [95% CI, −1.69 to 0.00] points). Widowhood was also associated with increased 1-year mortality among people with cancer (hazard ratio [HR], 1.08 [95% CI, 1.04 to 1.13]) or dementia (HR, 1.14 [95% CI, 1.02 to 1.27]) but not organ failure (HR, 1.02 [95% CI, 0.98 to 1.06]).Conclusions and RelevanceThis cohort study found that widowhood was associated with increased functional decline and increased mortality in older adults with functional impairment and dementia or cancer. These findings suggest that persons with these conditions with high caregiver burden may experience a greater widowhood effect.

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Widowhood Status as a Risk Factor for Cognitive Decline among Older Adults

Cited by 59 publications

References 34 publications

Trajectories of cognitive decline by widowhood status among Korean older adults

Trajectories of cognitive decline by widowhood status among Korean older adults

Associations of Widowhood and β-Amyloid With Cognitive Decline in Cognitively Unimpaired Older Adults

Mortality and Function After Widowhood Among Older Adults With Dementia, Cancer, or Organ Failure

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