Widowhood and cognitive decline in adults aged 50 and over: A systematic review and meta-analysis

Singham, Timothy; Bell, Gary; Stott, Joshua

doi:10.1016/j.arr.2021.101461

Cited by 15 publications

(9 citation statements)

References 47 publications

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“…A possible explanation for the negative impact of widowhood on mental health may be the increased stress caused by the loss of a spouse, resulting in decreased emotional support and lack of financial support [29,30]. The widowed elderly reported increased anxiety, grief, depression [31] and emotional and social loneliness. Depression is a mental state characterized by a loss of interest or happiness, accompanied by other symptoms, such as inattention or decision-making errors, fatigue, sleeping problems, alterations in appetite or body weight, feelings of worthlessness or excessive guilt, or thoughts of death or suicide, nearly every day [32,33].…”

Section: Discussionmentioning

confidence: 99%

Health of Widowed Elderly and Related Factors in China

Hua¹,

Chen²

2022

JOMH

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Background:The widowed elderly are in poor health, but studies mainly focus on their mental health, physiological response, chronic disease, or death. The aim of this study was to investigate the health of the widowed elderly and related factors in China from the three dimensions of self-reported health, objective physical health and mental health. Methods: Data were obtained from the Chinese Longitudinal Health Longevity Survey (CLHLS-2018). 3320 participants aged 65 years and older were selected, included 1573 widowed elderly and 1747 non-widowed elderly. A simplified version of the center for epidemiological research depression scale (CES-D-10) was used to assess depressive symptoms. The differences of depression and chronic diseases between widows and widowers were tested by independent sample t-test. A fully aligned polygonal graphical indexing method and binary logistic regression analysis were used to explore health and related factors of the widowed elderly. Results: Of the 1573 widowed elderly 70.88% were female, 59.19% were aged 80-99, 48.00% and 36.75% were from rural and urban areas respectively, and 92.05% lived with their families. Depressive symptoms were found in 20.15% of widowers and 49.33% of widows, and 60.26% of widowers and 64.75% of widows had more than one chronic disease. Statistically significant differences were found between widowers and widows in the above two. Self-reported health and mental health were slightly better than that of non-widowed elderly, with the exception of objective physical health. The variables of life restriction, physical exercise, life satisfaction and depressive symptoms were significant factors that influenced the widowed elderly health. Conclusions: Strengthening the monitoring and management of negative emotions and physiological functions of the widowed elderly, improving their awareness of physical and mental health and then promoting communication were found to be effective intervention measures.

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Section: Discussionmentioning

confidence: 99%

Health of Widowed Elderly and Related Factors in China

Hua¹,

Chen²

2022

JOMH

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“…7,39 Findings from the few international studies that have examined incidence of these events in community-based populations are generally consistent with our findings. 19,20,[40][41][42][43] While recent studies of widowhood have examined the association between widowhood and risk of incident dementia, 44,45 our study flips this equation to examine the association between dementia and risk of widowhood. By considering both medical-surgical and social potentially disruptive events as conceptually linked, we expand our examination of such events beyond a medically-focused paradigm to a paradigm that incorporates the social sphere, which may have equal or greater consequences on one's health.…”

Section: Discussionmentioning

confidence: 99%

Incidence of potentially disruptive medical and social events in older adults with and without dementia

Hunt

Gan

Espejo

et al. 2022

J American Geriatrics Society

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Background Potentially disruptive medical, surgical, and social events—such as pneumonia, hip fracture, and widowhood—may accelerate the trajectory of decline and impact caregiving needs in older adults, especially among people with dementia (PWD). Prior research has focused primarily on nursing home residents with dementia. We sought to assess the incidence of potentially disruptive events in community‐dwelling people with and without dementia. Methods Retrospective cohort study of participants aged 65+ enrolled in the Health and Retirement Study between 2010 and 2018 (n = 9346), including a subset who were married–partnered at baseline (n = 5105). Dementia was defined with a previously validated algorithm. We calculated age‐adjusted and gender‐stratified incidence per 1000 person‐years and incidence rate ratios of: 1) hospitalization for pneumonia, 2) hip fracture, and 3) widowhood in people with and without dementia. Results PWD (n = 596) were older (mean age 84 vs. 75) and a higher proportion were female (67% vs. 57%) than people without dementia (PWoD) (n = 8750). Age‐adjusted incidence rates (per 1000 person‐years) of pneumonia were higher in PWD (113.1; 95% CI 94.3, 131.9) compared to PWoD (62.1; 95% CI 54.7, 69.5), as were hip fractures (12.3; 95% CI 9.1, 15.6 for PWD compared to 8.1; 95% CI 6.9, 9.2 in PWoD). Point estimates of widowhood incidence were slightly higher for PWD (25.3; 95% CI 20.1, 30.5) compared to PWoD (21.9; 95% CI 20.3, 23.5), but differences were not statistically significant. The association of dementia with hip fracture—but not pneumonia or widowhood—was modified by gender (male incidence rate ratio [IRR] 2.24, 95% CI 1.34, 3.75 versus female IRR 1.31 95% CI 0.92,1.86); interaction term p = 0.02). Conclusions Compared to PWoD, community‐dwelling PWD had higher rates of pneumonia and hip fracture, but not widowhood. Knowing how often PWD experience these events can aid in anticipatory guidance and care planning for this growing population.

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“…All papers included in this review were assessed for risk of bias using the Newcastle-Ottowa scale (Wells et al, 2014), with a maximum score of 9. Studies were considered 'low risk' if they scored 7-9, 'medium risk' for 4-6, and 'high risk' if they scored 3 or below (Singham et al, 2021). Results are presented in Appendix B.…”

Section: Risk Of Bias (Quality) Assessmentmentioning

confidence: 99%