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丧亲之痛对老年人短期心理健康的后续影响预测其长期身体健康状况下降:美国健康与退休研究分析。

Short-Term Mental Health Sequelae of Bereavement Predict Long-Term Physical Health Decline in Older Adults: U.S. Health and Retirement Study Analysis.

机构信息

Stanford Graduate School of Education and Stanford Population Health Sciences, California.

Stanford Department of Psychiatry and Behavioral Sciences, California.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2021 Jun 14;76(6):1231-1240. doi: 10.1093/geronb/gbaa044.

Abstract

OBJECTIVES

Spousal death is a common late-life event with health-related sequelae. Evidence linking poor mental health to disease suggests the hypothesis that poor mental health following death of a spouse could be a harbinger of physical health decline. Thus, identification of bereavement-related mental health symptoms could provide an opportunity for prevention.

METHODS

We analyzed data from N = 39,162 individuals followed from 1994 to 2016 in the U.S. Health and Retirement Study; N = 5,061 were widowed during follow-up. We tested change in mental and physical health from prebereavement through the 5 years following spousal death.

RESULTS

Bereaved spouses experienced an increase in depressive symptoms following their spouses' deaths but the depressive shock attenuated within 1 year. Bereaved spouses experienced increases in disability, chronic-disease morbidity, and hospitalization, which grew in magnitude over time, especially among older respondents. Bereaved spouses were at increased risk of death compared to nonbereaved respondents. The magnitude of depressive symptoms in the immediate aftermath of spousal death predicted physical-health decline and mortality risk over 5 years of follow-up.

DISCUSSION

Bereavement-related depressive symptoms indicate a risk for physical health decline and death in older adults. Screening for depressive symptoms in bereaved older adults may represent an opportunity for intervention to preserve healthy life span.

摘要

目的

丧偶是一种常见的晚年事件,会带来与健康相关的后果。有证据表明,心理健康状况不佳与疾病有关,这表明丧偶后心理健康状况不佳可能是身体健康状况下降的先兆。因此,识别与丧亲有关的心理健康症状可能为预防提供机会。

方法

我们分析了美国健康与退休研究中从 1994 年到 2016 年期间随访的 39162 名个体的数据;N=5061 人在随访期间丧偶。我们测试了丧偶前后 5 年内心理健康和身体健康的变化。

结果

丧偶的配偶在配偶去世后经历了抑郁症状的增加,但抑郁冲击在 1 年内减弱。丧偶的配偶经历了残疾、慢性病发病率和住院率的增加,这些增加随着时间的推移而增加,尤其是在年龄较大的受访者中。与未丧偶的受访者相比,丧偶的配偶死亡风险增加。丧偶后立即出现的抑郁症状严重程度预示着 5 年随访期间的身体健康下降和死亡风险。

讨论

与丧亲有关的抑郁症状表明老年人大幅健康下降和死亡的风险。对丧偶的老年患者进行抑郁症状筛查可能代表了通过干预来保持健康寿命的机会。

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