Mendes de Leon C F, Kasl S V, Jacobs S
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT.
J Clin Epidemiol. 1993 Jun;46(6):519-27. doi: 10.1016/0895-4356(93)90124-j.
Mortality risk during early bereavement was examined in a community sample of 1046 married elderly persons 65 years and over, followed from 1982 to 1988. Cox' regression models with time-dependent covariates were computed to estimate mortality risk, while controlling for pre-widowhood sociodemographic and health-related variables. Elderly young-old (65-74) and old-old men (> or = 75) showed slightly elevated age-adjusted relative risks (RR) during the first 6 months of widowhood (RR = 1.69; 95% CI: 0.86-3.31 and RR = 1.79; 95% CI: 0.44-7.28 respectively). These RRs increased slightly after adjustment for pre-widowhood control variables. The age-adjusted RR during early widowhood for young-old women was 2.87 (% CI: 0.81-2.42), which increased to 3.86 (95% CI: 1.11-13.45) after adjustment for sociodemographic and health-related variables. This analysis stresses the usefulness of Cox' regression models with time-dependent covariates to calculate mortality risk for variable periods after onset of widowhood adjusted for pre-widowhood characteristics. However, the power of the study was limited, resulting in mostly insignificant risk estimates and wide confidence intervals.
在一个由1046名65岁及以上已婚老年人组成的社区样本中,对丧亲后早期的死亡风险进行了研究,随访时间为1982年至1988年。计算了具有时间依存性协变量的Cox回归模型来估计死亡风险,同时控制丧偶前的社会人口统计学和健康相关变量。年轻老年人(65 - 74岁)和高龄男性(≥75岁)在丧偶后的前6个月显示出年龄调整后的相对风险(RR)略有升高(RR分别为1.69;95%可信区间:0.86 - 3.31和RR = 1.79;95%可信区间:0.44 - 7.28)。在对丧偶前的控制变量进行调整后,这些RR略有增加。年轻老年女性在丧偶早期的年龄调整后RR为2.87(%可信区间:0.81 - 2.42),在对社会人口统计学和健康相关变量进行调整后增加到3.86(95%可信区间:1.11 - 13.45)。该分析强调了具有时间依存性协变量的Cox回归模型在计算丧偶后不同时间段、根据丧偶前特征进行调整后的死亡风险方面的有用性。然而,该研究的效能有限,导致大多数风险估计不显著且可信区间较宽。