Spousal bereavement, mortality and risk of negative health outcomes among older adults: a population-based study

Lucas Morin; Jonas W Wastesson; Stefan Fors; Neda Agahi; Kristina Johnell

We also performed three sets of post-hoc analyses, which were not prespecified. First, we considered the possibility that an increased risk of adverse health outcomes among the bereaved may be partially due to the experience of caring for a seriously ill spouse nearing the end of life. To investigate this potential mechanism, we stratified the main analysis in four distinct subgroups according to the illness trajectory of the deceased spouse: (i) cancer, (ii) organ failure, (iii) dementia and neurodegenerative disorders, and (iv) sudden death. Individuals were assigned to a single illness trajectory by using a methodology described elsewhere. 48 Second, we compared the effect estimate of spousal bereavement on subsequent mortality according to the Hospital Frailty Risk Score at baseline to assess whether the excess risk of death was observed only among the frailest and most vulnerable individuals or not.