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

The risk of mortality and adverse health outcomes during the year after spousal loss was compared between bereaved older adults and their matched married counterparts. For the main analysis, we considered a 1-year period to be the most clinically relevant based on previous reports showing that the effect of bereavement was often rapid, 1,3,15,18 but we decided a priori to also report health outcomes during the entire available observation time (namely, up to 31 December 2015 with a median followup time of 1.9 years). The burden of chronic diseases 25 and the Hospital Frailty Risk Score 26 at baseline were assessed by applying validated algorithms based on data reported during the 5 years before spousal loss (Supplementary Table S4 ). Prior history of smoking-related cancer, alcohol-related diseases and mental health problems was captured in the National Patient Register for the same period of time (Supplementary Table S5 ). We analysed medication use at baseline by using information from the Swedish Prescribed Drugs Register. 27 In addition, the socioeconomic position of study participants was described by using routinely collected administrative data about their highest educational attainment, their equivalised disposable income during the year before spousal loss, as well as a composite measure of the area level of social deprivation (Supplementary Table S6) .