Abstract
In addition to increasing the mortality among older adults, spousal death (SD) increases their risk of depression. This study explored the factors affecting depression among widowed older adults to provide health care strategies for successful aging. A total of 710 adults older than 60 years completed a questionnaire before and after their spouses’ deaths. The survey data included age, sex, ethnic group, education level, financial station socioeconomic status, SD (including time point), smoking status, alcohol consumption, self-rated health status, Center for Epidemiologic Studies Depression Scale score, mobility, and degree of support from relatives and friends. The proportion of participants with depression after SD was 1.7 times that of before SD (p < 0.0001). Worsened mobility (odds ratio [OR] = 1.3, p < 0.01), low self-rated health status (OR = 0.5, p < 0.01), and a high degree of support from relatives and friends (OR = 1.5, p < 0.01) had a significant positive correlation with depression after SD. The proportion of depression that occurred within 6 months after SD was 6.0 times higher than that of depression before SD. Participants who lived alone after losing their spouses who were healthy before their deaths exhibited a significantly increased proportion of depression after their spouses’ deaths. Male sex, spouse’s health, and the period of 6 months after SD are risk factors for depression in older adults. The maintenance of mobility, positive self-rated health status, and a shorter period of depression after a spouse’s death result in more favorable adaptability among women. Social workers or family members should focus on older adults whose spouses died unexpectedly or within the last 6 months. Living with family members after SD can alleviate depression in older adults.
Highlights
Spousal death (SD) has a wide range of health effects on older adults like mental, social, behavioral, and biological issues [1]
Our findings indicate that male sex, spouse’s health, and the period of 6 months after SD are risk factors for depression in elderly
The strength of our study: (1) as a longitudinal study, this study can provide clearer causal relationship between SD and depression, (2) TLSA is a national survey that has a representative sample of old people in Taiwan, (3) this study used self-matched to explore the effect of SD on depression in older adults
Summary
Spousal death (SD) has a wide range of health effects on older adults like mental, social, behavioral, and biological issues [1]. The lifestyle changes caused by SD increase the incidence of almost all types of cancer [7]. It is a risk factor for stroke [8] and is related to the severity of cardiovascular disease [9]; widowed men have an increased risk of type II diabetes [10]. In 1980, a study demonstrated that in addition to medical technology and drugs, a decrease in the proportion of SD was a reason for the decline in disabilities among older adults in the United States [11]
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