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 first major conclusion of the present study is that spousal bereavement in old age seems to have a substantial causal effect on mortality and on a wide range of poor health outcomes. Our finding of a 66% increase in the risk of death from any cause during the first year of follow-up is in the upper range of previously reported estimates, both in Sweden and in other countries. 3, 4 The association between bereavement and acute cardiovascular events was similar in direction and magnitude to the findings of Carey and colleagues in the United Kingdom, despite a markedly higher rate of acute strokes among bereaved older adults in the present cohort. 18 Not surprisingly, we found that the mortality and health disadvantage after spousal loss was greater among men than among women-with the notable exceptions of hip fractures and self-harm. Men have been shown to be more vulnerable to the acute health consequences of grief than women, most likely because of gender differences in social support, coping styles, and health behaviours around the time of bereavement. 49,50 However, contrary to a study that investigated the relative risk of suicide after the loss of a partner in 1994 -1998 women were found to a greater excess risk of self-harm and suicide than men after spousal loss. This was, however, mostly explained by a higher baseline incidence of self-harm among married men in the matched control group. The dramatic increase in self-harm and suicides speaks of the seriousness of the psychological distress experienced by older adults facing the loss of a partner.