Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses
Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses
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DOI：
10.1093/pubmed/fdt101
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发表时间：
2014-09-01
影响因子：
4.4
通讯作者：
Subramanian, S. V.
中科院分区：
文献类型：
--
作者：
Moon, J. Robin;Glymour, M. Maria;Subramanian, S. V.
过去的研究表明，配偶死亡会增加幸存配偶的死亡风险。然而，大多数先前的研究都没有充分控制社会经济地位（SES），目前还不清楚这种“丧偶效应”是否会随着时间的推移而持续下去。健康与退休研究参与者年龄在50岁以上，1998年结婚（n = 12 316），跟踪到2008年的丧偶状态和死亡率（2912例死亡）。离散时间生存分析用于比较丧偶与已婚者的死亡率。丧偶后前3个月的死亡率明显高于已婚者（男性比值比（OR）= 1.87，95% CI：1.27，2.75;女性OR = 1.47，95% CI：0.96，2.24）在模型中调整年龄，性别，种族和基线SES（教育，家庭财富和家庭收入），行为风险因素和合并症。丧亲后12个月，男性经历了死亡率的边缘升高，（OR = 1.16，95% CI：1.00，1.35），而女性则没有（OR = 1.07，95% CI：0.90，1.28），尽管性别差异不显著。“丧偶效应”并不能通过调整前尤其是在丧偶后的头几个月内升高。这些关联没有性别差异。
Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this 'widowhood effect' persists over time.Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio (OR) for men = 1.87, 95% CI: 1.27, 2.75; OR for women = 1.47, 95% CI: 0.96, 2.24) in models adjusted for age, gender, race and baseline SES (education, household wealth and household income), behavioral risk factors and co-morbidities. Twelve months following bereavement, men experienced borderline elevated mortality (OR = 1.16, 95% CI: 1.00, 1.35), whereas women did not (OR = 1.07, 95% CI: 0.90, 1.28), though the gender difference was non-significant.The 'widowhood effect' was not fully explained by adjusting for pre-widowhood SES and particularly elevated within the first few months after widowhood. These associations did not differ by sex.