Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts, United States of America.
PLoS One. 2011;6(8):e23465. doi: 10.1371/journal.pone.0023465. Epub 2011 Aug 17.
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.
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).
The results suggest that further studies should focus more on the mechanisms that generate this association especially among men.
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。
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）。
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。
