Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Statistics Denmark, Copenhagen, Denmark.
PLoS One. 2023 Mar 22;18(3):e0282892. doi: 10.1371/journal.pone.0282892. eCollection 2023.
Spousal bereavement is a life event that affects older people differently. We investigated the impact of spousal bereavement on medical expenditures and mortality in the general population, emphasizing on age and sex.
Data are from a population-based, retrospective cohort study following 924,958 Danish citizens over the age of 65 years, within 2011-2016. Changes in health care expenditures in those who suffer bereavement were compared with time matched changes among those who did not. Mortality hazards were analysed with time to event analysis.
A total of 77,722 (~8.4%) individuals experienced bereavement, 65.8% being females. Among males, bereavement was associated with increase of expenditures the year after, that was 42 Euros per week (95% CI, 36 to 48) larger than the non-bereaved group. The corresponding increase for females was 35 Euros per week (95% CI, 30 to 40). The increase of mortality hazards was highest in the first year after bereavement, higher in males than females, in young old and almost absent in the oldest old. Compared with the reference, mortality the year after spousal loss was 70% higher (HR 1.70 [95% CI 1.40 to 2.08]) for males aged 65-69 years and remained elevated for a period of six years. Mortality for females aged 65-69 years was 27% higher in the first year (HR 1.27, [1.07 to 1.52]), normalizing thereafter.
Bereavement affects older people differently with younger males being most frail with limited recovery potential.
配偶丧亡是影响老年人的不同的生活事件。我们研究了配偶丧亡对一般人群的医疗支出和死亡率的影响，重点是年龄和性别。
数据来自一项基于人群的回顾性队列研究，该研究在 2011 年至 2016 年间跟踪了 924958 名 65 岁以上的丹麦公民。对丧亲者的医疗支出变化与未丧亲者的同期变化进行了比较。采用生存时间分析对死亡率进行了分析。
共有 77722 人（约 8.4%）经历了丧亲之痛，其中 65.8%为女性。在男性中，丧亲之痛与一年后支出的增加有关，比未丧亲者每周多 42 欧元（95%可信区间，36 至 48）。女性每周增加 35 欧元（95%可信区间，30 至 40）。丧偶后第一年死亡率的上升幅度最大，男性高于女性，在年轻老人中最高，在最年长老人中几乎不存在。与参考组相比，丧偶后一年的死亡率男性增加了 70%（HR 1.70 [95%CI 1.40 至 2.08]），65-69 岁的男性死亡率最高，此后持续升高六年。65-69 岁的女性死亡率在第一年增加了 27%（HR 1.27，[1.07 至 1.52]），此后恢复正常。
丧偶对老年人的影响不同，年轻男性最脆弱，恢复潜力有限。
