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

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About: Spousal bereavement, mortality and risk of negative health outcomes among older adults: a population-based study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Spousal bereavement, mortality and risk of negative health outcomes among older adults: a population-based study
Creator	Agahi, Neda Fors, Stefan Johnell, Kristina Morin, Lucas Wastesson, Jonas
source	MedRxiv
abstract	Objective: to examine whether spousal bereavement increases the risk of death and negative health outcomes and among older people. Design: cohort study and self-controlled cohort crossover study Setting: routinely collected administrative and healthcare data with individual-level linkage between several national registries in Sweden. Participants: older persons (>65 years) living in the community whose spouse died in 2013-2014, individually matched with controls. Main outcome measures: death from any cause (primary outcome), acute cardiovascular events, pneumonia, hip fracture, and intentional self-harm (secondary outcomes). In the cohort study, incidence rate ratios were estimated with conditional fixed-effect Poisson regression models adjusted for potential confounders. In the self-controlled cohort crossover study, relative incidence ratios were estimated over the 12 months before and after spousal loss with unadjusted conditional fixed-effect Poisson regression including a bereavement-by-time interaction. Results: 42 918 bereaved older spouses were included and matched to an equal number of married controls (mean age 78.9 [SD 7.2] years, 68% women). During the first year of follow-up, the risk of death from any cause was 1.66 (95% confidence interval 1.53 to 1.80) times higher for bereaved cases than for married controls, and bereaved cases survived on average 4.2 days shorter than married controls. Bereaved cases also experienced an increased risk of acute cardiovascular events (incidence rate ratio 1.34, 1.24 to 1.44), hip fracture (1.48, 1.30 to 1.68), pneumonia (1.14, 1.04 to 1.25), and self-harm (3.49, 2.11 to 5.76). These associations were strongly time-dependent, increasing sharply immediately after spousal loss and weakening as time elapsed. In the self-controlled cohort crossover study, the relative incidence ratios increased for all four secondary outcomes, starting already during the 6-month period preceding spousal loss. Conclusion: Among older persons, the association between spousal bereavement and the risk of negative health outcomes and mortality is most likely causal. Our finding that the risk of adverse health consequences increases already during the 6 months prior to spousal loss indicates that palliative care services have an important role to play in providing timely bereavement care to spouses and other family caregivers.
has issue date	2020-04-19(xsd:dateTime)
bibo:doi	10.1101/2020.04.16.20067645
has license	medrxiv
sha1sum (hex)	d600d07469f8268d91c9790b6fa39607b6a5f89b
schema:url	https://doi.org/10.1101/2020.04.16.20067645
resource representing a document's title	Spousal bereavement, mortality and risk of negative health outcomes among older adults: a population-based study
resource representing a document's body	covid:d600d07469f8268d91c9790b6fa39607b6a5f89b#body_text
is schema:about of	named entity 'health' named entity 'LEVEL' named entity 'COHORT STUDY' named entity 'ADMINISTRATIVE' covid:arg/d600d07469f8268d91c9790b6fa39607b6a5f89b named entity 'bereavement' named entity 'bereavement' named entity 'older people' named entity 'cohort study' named entity 'individual-level' named entity 'IRR' named entity 'surviving spouse' named entity 'social scientists' named entity 'medRxiv' named entity 'bereavement' named entity 'bereavement support' named entity 'cardiovascular events' named entity 'relative risk' named entity 'medRxiv' named entity 'Negative control' named entity 'health outcomes' named entity 'confidence intervals' named entity 'older adults' named entity 'bereavement' named entity 'chronic diseases' named entity 'acute endocarditis' named entity 'depression' named entity 'health outcomes' named entity 'bereavement' named entity 'Covid-19 pandemic' named entity 'CC-BY-NC 4.0' named entity 'Sweden' named entity 'CC-BY-NC 4.0' named entity 'older adults' named entity 'hip fracture' named entity 'IRR' named entity 'psychological stress' named entity 'IRR' named entity 'widowhood effect' named entity 'older adults' named entity 'surviving spouses' named entity 'crossover design' named entity 'bereavement' named entity 'nursing home' named entity 'older people' named entity 'post-hoc analyses' named entity 'clinically meaningful' named entity 'study population' named entity 'dementia' named entity 'surviving spouse' named entity 'hazard ratio' named entity 'medRxiv' named entity 'self-harm' named entity 'medRxiv' named entity 'bereavement' named entity 'cardiovascular events' named entity 'Summary statistics' named entity 'older adults' named entity 'Parkinson's disease' named entity 'anticipatory grief' named entity 'bereavement' named entity 'bereavement' named entity 'hazard ratio' named entity 'mental health' named entity 'confidence intervals' named entity 'nursing home' named entity 'end of life' named entity 'quality of life' named entity 'clinically relevant' named entity 'suicide' named entity 'multimorbidity' named entity 'chronic diseases' named entity 'older people' named entity 'older people' named entity 'hip fractures' named entity 'Cary, NC' named entity 'medRxiv' named entity 'crossover design' named entity 'bereavement' named entity 'Palliative care' named entity '4.2'

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