The health impact of remarriage behavior on chronic obstructive pulmonary disease: findings from the US longitudinal survey

Tatsuya Noda,Toshiyuki Ojima,Shinya Hayasaka,Akihito Hagihara,Ryoichi Takayanagi,Koichi Nobutomo

doi:10.1186/1471-2458-9-412

Tatsuya Noda, Toshiyuki Ojima + Show 4 more

Open Access

https://doi.org/10.1186/1471-2458-9-412

Copy DOI

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is a major disease among adults, and its deterioration was reported to be associated with psychological imbalance. Meanwhile, bereavement and divorce have proven harmful to the health status of a surviving spouse. But few studies have been conducted to evaluate the remedial effect on survivors' health outcome by remarriage after bereavement. The present study thus examined the associations between remarriage and the onset of COPD.MethodsOur cohort was drawn from Health and Retirement Study participants in the United States, and consisted of 2676 subjects who were divorced or bereaved from 1992 to 2002. We then followed them for up to 11 years and assessed the incidence rate of COPD using a Cox proportional hazard model after adjusting for marital status, age, gender, education and the number of cigarettes smoked.ResultsAmong all subjects, 224 who remarried after bereavement or divorce tended to be younger and more male dominated. Remarriage after bereavement/divorce was associated with significantly decreased risk of COPD onset for overall subjects [hazard ratio (HR): 0.51, 95% confidence interval (95% CI): 0.28-0.94], female subjects [HR: 0.36, 95% CI: 0.13-0.98], and for those under 70 years old [HR: 0.36, 95% CI: 0.17-0.79].ConclusionThis study investigates the impact of remarriage on health outcome based on a large-scale population survey and indicates that remarriage significantly correlates with reduced risk of COPD incidence, even after adjusting smoking habit.

Highlights

Chronic obstructive pulmonary disease (COPD) is a major disease among adults, and its deterioration was reported to be associated with psychological imbalance
We examined the relationship between remarriage after bereavement and the onset of disease, especially chronic obstructive pulmonary disease (COPD) which is known to have a large negative impact on health-related quality of life in the elderly [20,21]
The Cox proportional hazards model was used to examine the effect of remarriage after divorce or bereavement on the incidence rate of COPD (Table 2)

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a major disease among adults, and its deterioration was reported to be associated with psychological imbalance. Bereavement and divorce have proven harmful to the health status of a surviving spouse. Few studies have been conducted to evaluate the remedial effect on survivors' health outcome by remarriage after bereavement. The present study examined the associations between remarriage and the onset of COPD. Studies on the health impact of bereavement have been conducted from the nineteenth century and still remain an important issue [1,2,3,4,5,6,7]. Spousal loss in later life is irreparable and unavoidable unless one divorces or dies before a partner, so it is meaningful to seek for modifiable social factors which might soften the impact of late life spousal bereavement. We focused on remarriage after bereavement as a possible rescue factor against the bereavement effect because remarriage is a joyful event in general and remarriage is possible after the onset of bereavement

Methods

Results

Discussion

Conclusion