Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea.
Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea.
Psychiatry Clin Neurosci. 2022 Oct;76(10):490-504. doi: 10.1111/pcn.13439. Epub 2022 Jul 18.
Spouse bereavement is one of life's greatest stresses and has been suggested to trigger or accelerate cognitive decline and dementia. However, little information is available about the potential brain pathologies underlying the association between spouse bereavement and cognitive decline. We aimed to investigate that lifetime spouse bereavement is associated with in vivo human brain pathologies underlying cognitive decline.
A total of 319 ever-married older adults between the ages of 61 and 90 years underwent comprehensive clinical assessments and multimodal brain imaging including [ C] Pittsburgh compound B-positron emission tomography (PET), AV-1451 PET, [ F] fluorodeoxyglucose-PET, and magnetic resonance imaging. Participants were classified as experiencing no spouse bereavement or spouse bereavement, and comparisons using propensity score matching (59 cases and 59 controls) were performed.
Spouse bereavement was significantly associated with higher cerebral white matter hyperintensity (WMH) volume compared with no spouse bereavement. Interaction and subsequent subgroup analyses showed that spouse bereavement was significantly associated with higher WMH in the older (>75 years) subgroup and among those with no- or low-skill occupations. In addition, spouse bereavement at 60 years or older affects WMH volume compared with no spouse bereavement, whereas spouse bereavement at younger than 60 years did not. No group differences were observed in other brain pathologies between spouse bereavement categories.
The findings suggest that the spouse bereavement may contribute to dementia or cognitive decline by increasing cerebrovascular injury, particularly in older individuals and those with no- or low-skill occupations.
丧偶是人生最大的压力之一，有人认为它会引发或加速认知能力下降和痴呆。然而，关于丧偶与认知能力下降之间关联的潜在大脑病理学的信息却很少。我们旨在研究一生中丧偶与认知能力下降的潜在大脑病理学之间的关系。
共有 319 名年龄在 61 至 90 岁之间的已婚老年人接受了全面的临床评估和多模态脑成像，包括[C]匹兹堡化合物 B-正电子发射断层扫描（PET）、AV-1451 PET、[F]氟脱氧葡萄糖-PET 和磁共振成像。参与者分为丧偶和未丧偶两类，使用倾向评分匹配（59 例和 59 例对照）进行比较。
丧偶与脑白质高信号（WMH）体积增加显著相关，与未丧偶相比。交互作用和随后的亚组分析表明，丧偶与年龄较大（>75 岁）亚组和无技能或低技能职业人群中的 WMH 增加显著相关。此外，与未丧偶相比，60 岁或以上丧偶会影响 WMH 体积，而 60 岁以下丧偶则没有。在其他脑病理学方面，丧偶组之间没有观察到组间差异。
研究结果表明，丧偶可能通过增加脑血管损伤导致痴呆或认知能力下降，尤其是在年龄较大的人群和无技能或低技能职业人群中。
