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Mortality After Bereavement: The Role of Cardiovascular Disease and Depression

Sarah T Stahl1, Alice M Arnold, Jia-Yuh Chen

  • 1From the Departments of Psychiatry (Stahl, Schulz) and Biostatistics (Chen, Anderson) and University Center for Social and Urban Research (Stahl, Schulz), University of Pittsburgh, Pittsburgh, Pennsylvania; and Department of Biostatistics (Arnold), University of Washington, Seattle, Washington.

Psychosomatic Medicine
|February 20, 2016
PubMed

Insights

Late-life bereavement impacts mortality differently for men and women. Bereavement reduced mortality in women with cardiovascular disease (CVD) but increased it in men without CVD.

Area of Science:

  • Gerontology
  • Cardiovascular Health
  • Psychosocial Epidemiology

Background:

  • Late-life bereavement is a significant stressor linked to increased mortality risk.
  • Understanding the interplay between bereavement, cardiovascular disease (CVD), and mental health is crucial for older adults.

Purpose of the Study:

  • To investigate the associations between bereavement, CVD, and depressive symptoms with mortality in older adults.
  • To determine if these associations differ by sex and CVD status.

Main Methods:

  • Analysis of data from the prospective Cardiovascular Health Study cohort.
  • Comparison of mortality between bereaved (n=593) and non-bereaved (n=593) older adults using Cox regression.
  • Examination of interaction effects of bereavement with sex, CVD, and depressive symptoms on 3-year all-cause mortality.

Main Results:

  • Overall, bereavement showed no significant association with mortality (HR=0.98).
  • Significant interactions were found between bereavement and sex (p<0.001) and CVD (p=0.010).
  • Bereavement decreased mortality risk in women (HR=0.67) and increased it in men (HR=1.77). This effect varied by CVD status and was modulated by depressive symptoms in men without CVD.

Conclusions:

  • The relationship between bereavement and mortality is sex-specific and influenced by cardiovascular disease status.
  • Bereavement conferred a survival advantage for women with CVD and a disadvantage for men without CVD.
  • These findings highlight the complex interplay of grief, physical health, and mental well-being in late-life mortality.
Abstract

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