The effect of widowhood on mortality by the causes of death of both spouses.
The effect of widowhood on mortality by the causes of death of both spouses.
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DOI：
10.2105/ajph.2007.114348
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发表时间：
2008-11
影响因子：
12.7
通讯作者：
Christakis NA
中科院分区：
文献类型：
--
作者：
Elwert F;Christakis NA
我们调查配偶丧亲之痛对死亡率的影响，我们通过记录特定原因的丧亲之痛对死亡原因的影响来扩展以前的工作，包括前死者配偶和丧亲幸存者。我们采用竞争风险模型和考克斯模型，研究了1993年至2002年美国373,189对老年已婚夫妇的全国代表性队列。协变量包括配偶双方的基线健康状况。在男子和妇女中，丧偶对死亡率的影响因配偶双方死亡原因的不同而有很大差异。配偶因几乎所有原因（包括各种癌症、感染和心血管疾病）而死亡，都会增加幸存配偶的死亡率，尽管程度不同。相反，配偶的死亡增加了幸存者几乎所有原因的特定原因死亡率，包括癌症，感染和心血管疾病，尽管程度不同。丧偶对死亡率的影响因配偶双方的死亡原因而有很大差异，这表明丧偶效应并不局限于人类生物学的一个方面。
We investigate the effect of spousal bereavement on mortality, and we extend prior work by documenting cause-specific bereavement effects by the causes of death both of the pre-decedent spouse and the bereaved survivor. We examined a nationally representative cohort of 373,189 elderly married couples in the United States, followed from 1993 to 2002, using competing-risk and Cox models. Covariates included the baseline health of both spouses. In both men and women, there is significant variation in the effect of widowhood on mortality as a function of the causes of death of both spouses. The death of a spouse due to almost all causes, including various cancers, infections, and cardiovascular diseases, increases the mortality of the surviving spouse, albeit to varying degrees. Conversely, the death of a spouse increases survivor’s cause-specific mortality for almost all causes, including cancers, infections, and cardiovascular diseases, albeit to varying degrees. The effect of widowhood on mortality varies substantially by the causes of death of both spouses, suggesting that the widowhood effect is not restricted to one aspect of human biology.