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寡居与死亡率:一项荟萃分析。

Widowhood and mortality: a meta-analysis.

机构信息

Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts, United States of America.

出版信息

PLoS One. 2011;6(8):e23465. doi: 10.1371/journal.pone.0023465. Epub 2011 Aug 17.

Abstract

BACKGROUND

While the "widowhood effect" is well known, there is substantial heterogeneity in the magnitude of effects reported in different studies. We conducted a meta-analysis of widowhood and mortality, focusing on longitudinal studies with follow-up from the time of bereavement.

METHODS AND FINDINGS

A random-effects meta-analysis was conducted to calculate the overall relative risk (RR) for subsequent mortality among 2,263,888 subjects from 15 prospective cohort studies. We found a statistically significant positive association between widowhood and mortality, but the widowhood effect was stronger in the period earlier than six months since bereavement (overall RR = 1.41, 95% CI: 1.26, 1.57) compared to the effect after six months (overall RR = 1.14, 95% CI: 1.10, 1.18). Meta-regression showed that the widowhood effect was not different for those aged younger than 65 years compared to those older than 65 (P = 0.25). There was, however, a difference in the magnitude of the widowhood effect by gender; for women the RR was not statistically significantly different from the null (overall RR = 1.04, 95% CI: 1.00, 1.08), while it was for men (overall RR = 1.23, 95% CI: 1.18, 1.28).

CONCLUSIONS

The results suggest that further studies should focus more on the mechanisms that generate this association especially among men.

摘要

背景

尽管“鳏寡效应”广为人知,但不同研究报告的效应大小存在很大差异。我们对鳏寡与死亡率进行了荟萃分析,重点关注从丧偶开始随访的纵向研究。

方法和发现

我们对来自 15 项前瞻性队列研究的 2263888 名受试者进行了随机效应荟萃分析,以计算随后死亡率的总体相对风险(RR)。我们发现丧偶与死亡率之间存在统计学显著的正相关,但在丧偶后六个月内(总体 RR=1.41,95%CI:1.26,1.57)丧偶效应比六个月后(总体 RR=1.14,95%CI:1.10,1.18)更强。元回归表明,丧偶效应在年龄小于 65 岁的人群和年龄大于 65 岁的人群中没有差异(P=0.25)。然而,丧偶效应在性别上存在差异;对于女性,RR 与零值无统计学显著差异(总体 RR=1.04,95%CI:1.00,1.08),而对于男性,RR 则有统计学显著差异(总体 RR=1.23,95%CI:1.18,1.28)。

结论

研究结果表明,进一步的研究应该更加关注产生这种关联的机制,特别是在男性中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/457b/3157386/a4ae15d2234c/pone.0023465.g001.jpg

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