scholarly journals Short-Term Mental Health Sequelae of Bereavement Predict Long-Term Physical Health Decline in Older Adults: U.S. Health and Retirement Study Analysis

Author(s):  
Benjamin W Domingue ◽  
Laramie Duncan ◽  
Amal Harrati ◽  
Daniel W Belsky

Abstract Objectives Spousal death is a common late-life event with health-related sequelae. Evidence linking poor mental health to disease suggests the hypothesis that poor mental health following death of a spouse could be a harbinger of physical health decline. Thus, identification of bereavement-related mental health symptoms could provide an opportunity for prevention. Methods We analyzed data from N = 39,162 individuals followed from 1994 to 2016 in the U.S. Health and Retirement Study; N = 5,061 were widowed during follow-up. We tested change in mental and physical health from prebereavement through the 5 years following spousal death. Results Bereaved spouses experienced an increase in depressive symptoms following their spouses’ deaths but the depressive shock attenuated within 1 year. Bereaved spouses experienced increases in disability, chronic-disease morbidity, and hospitalization, which grew in magnitude over time, especially among older respondents. Bereaved spouses were at increased risk of death compared to nonbereaved respondents. The magnitude of depressive symptoms in the immediate aftermath of spousal death predicted physical-health decline and mortality risk over 5 years of follow-up. Discussion Bereavement-related depressive symptoms indicate a risk for physical health decline and death in older adults. Screening for depressive symptoms in bereaved older adults may represent an opportunity for intervention to preserve healthy life span.

2019 ◽  
Author(s):  
Benjamin W. Domingue ◽  
Laramie Duncan ◽  
Amal Harrati ◽  
Daniel W. Belsky

AbstractObjectiveDeath of a spouse is a common late-life event with mental- and physical-health sequelae. Whereas mental-health sequelae of spousal death tend to be transient, physical-health sequelae may persist, leading to disability and mortality. Growing evidence linking poor mental health to aging-related disease suggests the hypothesis that transient poor mental health following death of a spouse could be a harbinger of physical health decline. If so, identification of bereavement-related mental health symptoms could provide an opportunity for prevention.MethodsWe analyzed data from N=35,103 individuals followed from 1994-2014 in the US Health and Retirement Study (HRS) and identified N=4,629 who were widowed during follow-up. We tested change in mental and physical health from pre-bereavement through the 5-year period following spousal death.ResultsBereaved spouses experienced an immediate increase in depressive symptoms following their spouses’ deaths but the depressive shock attenuated within one year. Bereaved spouses also experienced increases in disability, chronic-disease morbidity, and hospitalization, which grew in magnitude with time since spousal death, especially among older HRS participants. Bereaved spouses were at increased risk of death compared to HRS participants who were not bereaved. The magnitude of depressive symptoms in the immediate aftermath of spousal death predicted physical-health decline and mortality risk over 5 years of follow-up.ConclusionsBereavement-related depressive symptoms provide an indicator of risk for physical health decline and death in older adults. Screening for depressive symptoms in bereaved older adults may represent an opportunity for intervention to preserve healthy lifespan.Plain Language SummaryThe clinical significance of depressive symptoms during bereavement for long-term health is not well understood. We analyzed longitudinal data tracking mental and physical health of more than 4,000 older adults who were widowed during follow-up. Widows and widowers who experienced more severe depressive symptoms immediately following their spouse’s death were at increased risk for incident disability, chronic disease, hospitalization, and mortality over the five years following their spouse’s death. Transient depressive symptoms related to bereavement may provide a clinical indicator of risk for long-term physical health decline in older adults. Findings motivate increased integration of psychiatric assessment in geriatric care.


2016 ◽  
Author(s):  
Benjamin W. Domingue ◽  
Hexuan Liu ◽  
Aysu Okbay ◽  
Daniel W. Belsky

AbstractExperience of stressful life events is associated with risk of depression. Yet many exposed individuals do not become depressed. A controversial hypothesis is that genetic factors influence vulnerability to depression following stress. This hypothesis is most commonly tested with a “diathesis-stress” model, in which genes confer excess vulnerability. We tested an alternative model, in which genes may buffer against the depressogenic effects of life stress. We measured the hypothesized genetic buffer using a polygenic score derived from a published genome-wide association study (GWAS) of subjective wellbeing. We tested if married older adults who had higher polygenic scores were less vulnerable to depressive symptoms following the death of their spouse as compared to age-peers who had also lost their spouse and who had lower polygenic scores. We analyzed data from N=9,453 non-Hispanic white adults in the Health and Retirement Study (HRS), a population-representative longitudinal study of older adults in the United States. HRS adults with higher wellbeing polygenic scores experienced fewer depressive symptoms during follow-up. Those who survived death of their spouses during follow-up (n=1,829) experienced a sharp increase in depressive symptoms following the death and returned toward baseline over the following two years. Having a higher polygenic score buffered against increased depressive symptoms following a spouse's death. Effects were small and clinical relevance is uncertain, although polygenic score analyses may provide clues to behavioral pathways that can serve as therapeutic targets. Future studies of gene-environment interplay in depression may benefit from focus on genetics discovered for putative protective factors.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 581-581
Author(s):  
Lauren Brown

Abstract Most studies of middle-aged adults find blacks have higher levels of psychological distress compared to whites but have lower risk of common psychiatric disorders. For instance, there is evidence of lower rates of depressive and anxiety disorders among blacks relative to whites despite large disparities in stress, discrimination and physical health in midlife—commonly referred to as the black-white mental health paradox. We examine evidence of the black-white paradox in anxiety and depressive symptoms among older adults. Data come from 6,019 adults ages 52+ from the 2006 Health and Retirement Study. Unadjusted models show older blacks report more anxiety and depressive symptoms than whites. After adjusting for socioeconomic factors, everyday discrimination, chronic conditions, and chronic stress, there are no black-white differences in anxiety and depressive symptoms. Findings suggest the black-white mental health paradox only extends into older adulthood for blacks living under similar stress and health landscapes as whites.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S215-S215
Author(s):  
Maria Monserud

Abstract Studies in developed countries indicate that social activities can make a difference in mental health in later life. Yet, research on potential benefits of social activities for older adults in developing countries, including Mexico, has been scarce. This study uses the two most recent waves (2012, 2015) of the Mexican Health and Aging Study to investigate the impact of social activities on depressive symptoms among older men (n = 4, 749) and women (n = 6,527), aged 50+, in Mexico. The results of Ordinary Least Squares regressions indicate that it is important to differentiate among specific social activities in later life. Particularly, not only group-based but also solitary social activities were predictive of better mental health. Moreover, the findings demonstrate several gender differences and similarities. Participation in clubs, communication with relatives and friends, physical exercise, and watching television were beneficial for mental health among men, whereas volunteering, playing games, and making crafts were associated with fewer depressive symptoms among women. At the same time, reading as well as doing household chores were related to better mental health among older Mexicans, regardless of gender. Furthermore, this study shows that self-reported health, functional limitations, chronic conditions, and frequent pain might shape the implications of social activities for depressive symptoms among older adults in Mexico. The insights from this study can be helpful for intervention programs that are being developed to promote benefits of group-based and solitary social activities for mental health among older men and women with different levels of physical health.


Author(s):  
Harriet Ward ◽  
Lynne Moggach ◽  
Susan Tregeagle ◽  
Helen Trivedi

AbstractThe chapter explores the progress made by the 93 adoptees in the core follow-up sample in terms of physical and mental health and education from the time they entered their adoptive homes until they were followed up, on average 18 years later. It draws on data collected through responses to an online survey concerning 93 adoptees (44% of the cohort) completed at follow-up, and interviews focusing on 24 adult adoptees. On entering their placements, 40% of adoptees were developmentally delayed; 13% had poor physical health; 38% were in poor mental health. Emotional and behavioural problems affected their academic progress; 76% required specialist help. After placement, 74% improved in physical health, 66% in mental health and 68% in academic performance. The challenges faced by adoptive parents provide a powerful case for careful preparation and long-term post-adoption support.


2019 ◽  
pp. 135910531988392
Author(s):  
Elisabeth B Xie ◽  
Rachel J Burns

Depression is common among individuals with diabetes and contributes to poorer prognoses. Optimism is associated with enhanced mental health. Therefore, this study tested whether optimism buffered against increases in depressive symptoms following a diabetes diagnosis. Participants were drawn from the Health and Retirement Study ( n = 328, Mage = 65.8). Optimism, assessed before diagnosis, was inversely associated with depressive symptoms within 2 ( B = −.30, p = .004, Δ R2 = .02) and 6 ( B = −.29, p = .008, Δ R2 = .02) years of a diabetes diagnosis. Results suggest that optimism is a protective factor for comorbid depressive symptoms.


2020 ◽  
Author(s):  
Christopher L Crowe ◽  
Benjamin W Domingue ◽  
Gloria Hu ◽  
Katherine M Keyes ◽  
Dayoon Kwon ◽  
...  

Background. Loneliness and social isolation are emerging public health challenges for aging populations. Methods. We followed N=11,305 US Health and Retirement Study (HRS) participants aged 50-95 from 2006-2014 to measure persistence of exposure to loneliness and social isolation. We tested associations of longitudinal loneliness and social-isolation phenotypes with disability, morbidity, mortality, and biological aging through 2018. Results. During follow-up, 18% of older adults met criteria for loneliness and, for 6%, symptoms persisted across two or more follow-up assessments. For social isolation, these fractions were 21% and 8%. HRS participants who experienced loneliness and social isolation were at increased risk for disease, disability, and mortality. Older adults experiencing persistent loneliness were at a 59% increased hazard of mortality compared to those who were never lonely. For social isolation, the increase was 28%. Effect-sizes were somewhat larger for counts of prevalent activity limitations and somewhat smaller for counts of prevalent chronic diseases. Covariate adjustment for socioeconomic and psychological risks attenuated but did not fully explain associations. Older adults who experienced loneliness and social isolation also exhibited physiological indications of advanced biological aging (Cohen's-d for persistent loneliness and social isolation=0.26 and 0.21, respectively). For loneliness, but not social isolation, persistence of symptoms was associated with increased risk. Conclusion. Deficits in social connectedness prevalent in a national sample of older adults in the US were associated with morbidity, disability, and mortality and with more advanced biological aging. Bolstering social connection to interrupt experiences of loneliness may promote healthy aging.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S348-S348 ◽  
Author(s):  
Benjamin Domingue ◽  
Laramie Duncan ◽  
Amal Harrati ◽  
Daniel Belsky

Abstract Death of a spouse (bereavement) is associated with poor mental and physical health outcomes in older adults. But it is unknown how mental- and physical-health sequelae of bereavement are related and the clinical significance of bereavement-related depression has been questioned. We analyzed US Health and Retirement Study (HRS) data tracking mental and physical health of 36,034 older adults during 1992-2016. Post-bereavement data were available for N=4,985 participants with recorded date of spousal death. We analyzed longitudinal repeated-measures data on survivors’ depression, disease, disability, and mortality. Bereavement effects on depression were immediate, but short-lived, attenuating within the year. In contrast, bereavement effects on physical health and mortality persisted over follow-up. Critically, the magnitude of short-lived effects on depression correlated with the magnitude of longer-lasting effects on disease, disability, and mortality. Results reveal connections between mental and physical health and aging and suggest bereavement-related depression as a biomarker of enduring health risk.


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