Longitudinal Studies Centre-Scotland, University of St Andrews, St Andrews, Scotland, United Kingdom.
Epidemiology. 2011 Jan;22(1):1-5. doi: 10.1097/EDE.0b013e3181fdcc0b.
We consider whether widowhood increases mortality risk. Although commonly observed, this "widowhood effect" could be due to selection effects, as married couples share various characteristics related to the risk of death. We therefore consider the widowhood effect by various causes of spousal death; some causes of death are correlated with shared characteristics in couples, while others are not.
Using data from the Scottish Longitudinal Study, we compare outcomes for men and women by the causes of death of their spouse, controlling for a range of individual- and household-level characteristics.
The widowhood effect in these data is greater than has been found in other recent studies, with adjusted hazard ratios of 1.40 (95% confidence interval = 1.33-1.47) for men and 1.36 (1.30-1.44) for women. The risk is highest shortly after widowhood, but remains raised for at least 10 years. There was little evidence that these hazard ratios differed by any classification of the cause of death of the spouse, but interactions were found for those with pre-existing illness or other risk factors. The hazard ratios for widowhood were lower for persons with preexisting risks.
Our analysis of the widowhood effect uses 3 methods of classifying the causes of spousal death in an attempt to control for potential selection effects. Our results are highly consistent and suggest that this is a causal effect, rather than a result of selection.
我们研究丧偶是否会增加死亡风险。尽管这种“丧偶效应”很常见,但它可能是由于选择效应所致,因为已婚夫妇具有许多与死亡风险相关的共同特征。因此,我们考虑了各种原因导致的丧偶对死亡率的影响;一些死因与夫妻之间的共同特征相关,而另一些则不相关。
我们使用苏格兰纵向研究的数据,根据配偶的死因比较了男性和女性的结果,同时控制了一系列个人和家庭层面的特征。
这些数据中的丧偶效应大于最近其他研究中的丧偶效应,调整后的男性危险比为 1.40(95%置信区间=1.33-1.47),女性为 1.36(1.30-1.44)。风险在丧偶后不久最高,但至少在 10 年内仍然升高。几乎没有证据表明这些危险比因配偶死因的任何分类而有所不同,但对于那些有预先存在的疾病或其他风险因素的人,则存在交互作用。对于那些有预先存在的风险的人来说,丧偶的危险比更低。
我们对丧偶效应的分析使用了 3 种方法对配偶死因进行分类,以试图控制潜在的选择效应。我们的结果高度一致,表明这是一种因果效应,而不是选择效应的结果。