The Effect of Unexpected Bereavement on Mortality in Older Couples

We sought to determine whether unexpected bereavement has a greater impact on mortality in the surviving partner than death of a partner with preexisting chronic disease or disability. In a UK primary care database (The Health Improvement Network), we identified 171,720 couples aged 60 years and old...

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Bibliographic Details
Published in:American journal of public health (1971) 2013-06, Vol.103 (6), p.1140-1145
Main Authors: SHAH, Sunil M, CAREY, Lain M, HARRIS, Tess, DEWILDE, Stephen, VICTOR, Christina R, COOK, Derek G
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging
Algorithms
Bereavement
Biological and medical sciences
Chronic Disease - mortality
Chronic illnesses
Couples
Death, Sudden
Disease
Epidemiology
Family Characteristics
Female
General aspects
Grief
Health care
Households
Humans
Male
Medical sciences
Middle Aged
Miscellaneous
Morbidity
Mortality
Mortality - trends
Older people
Palliative care
Patients
Primary care
Proportional Hazards Models
Public health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Registration
Research and Practice
Risk Factors
Socioeconomic Factors
Spouses
Studies
Time Factors
United Kingdom
Womens health
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Summary:We sought to determine whether unexpected bereavement has a greater impact on mortality in the surviving partner than death of a partner with preexisting chronic disease or disability. In a UK primary care database (The Health Improvement Network), we identified 171,720 couples aged 60 years and older. We compared the rise in mortality in the first year after bereavement in those whose partner died without recorded chronic disease (unexpected bereavement) to those whose deceased partner had a diagnosis of chronic disease (known morbidity). For unexpected bereavement (13.4% of all bereavements), the adjusted hazard ratio for death in the first year after bereavement was 1.61 (95% confidence interval [CI] = 1.39, 1.86) compared with 1.21 (95% CI = 1.14, 1.30) where the partner had known morbidity. Differences between bereaved groups were significant (P = .001) and present for both men and women. Unexpected bereavement has a greater relative mortality impact than bereavement preceded by chronic disease. Our findings highlight the potential value of preparing individuals for the death of a spouse with known morbidity and providing extra support after bereavement for those experiencing sudden unexpected bereavement.
ISSN:0090-0036
1541-0048
DOI:10.2105/ajph.2012.301050