The impact of widowhood on the mental health of older adults and the buffering effect of social capital.

Background: Widowhood is one of the most serious issues affecting the mental health of older persons. China currently has tens of millions of widowed older adult, which is a huge group. It is of great significance to study the impacts of widowhood on their mental health and put forward some measures for improvement. Method: We used China Family Panel Studies (CFPS) data in 2020, which included 4,184 older adults. Linear regression is used to examine the relationship among widowhood, mental health, and social capital. Results: Both short-term and medium- and long-term widowhood lead to a significant increase in depression, which seriously affects the mental health of older people. At the same time, community-level and family-level social capital have significant buffering effects on the loss of mental health caused by widowhood, but this effect is heterogeneous, with different types of social capital playing different roles among different gender groups. Conclusion: The provision of care support by children and good neighborhood relationships can help mitigate the psychological impact of widowhood, and these are areas where social policy can make a difference.

Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals.

Background: Physical activity is associated with improved health and function in older adults, yet most older adults are sedentary. Loneliness is associated with decreased physical activity at the cross-section, but longitudinal studies are scarce. We examined longitudinal associations between loneliness and physical activity-and whether they were modified by marital status and network size (the number of children, relatives, and friends a person interacts with at least once a month). Methods: We analyzed data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project with a mean follow-up of 4.8 years (mean age 79.6 ± 7.7, 74.9% women). Loneliness was assessed using the de Jong Gierveld Loneliness Scale. Physical activity was assessed as the frequency with which participants engaged in five categories of activities (e.g., walking, gardening, calisthenics, bicycling, and swimming). Linear mixed effects models examined associations between baseline loneliness and change in physical activity over time after adjusting for demographics, depressive symptoms, global cognition, disability, network size, marital status, social support, and social and cognitive activities. We assessed for effect modification by marital status and network size. Results: Associations between loneliness and physical activity differed by marital status. In widowed individuals, baseline loneliness was associated with a 0.06 h/week greater decrease in physical activity per year compared to those who were not lonely (p = 0.005, CI -0.1, 0.02)-which equaled a 150% decrease in physical activity per year. Loneliness did not predict a statistically significant decrease in physical activity in married or unmarried individuals. Discussion: Loneliness is associated with decreased physical activity in widowed older adults and should be considered in the design of interventions to prevent or slow the decline in physical activity and promote healthy aging.

Unraveling the Impact of Widowhood Duration on Depression: Does Time Heal All Wounds?

China's aging population has witnessed a surge in widowed older adults, raising concerns about their mental health. Losing a spouse is a profoundly distressing experience with enduring effects on well-being. Despite the proverbial belief in time's healing power, existing studies often neglect the potential decline in depressive symptoms during widowhood. Drawing data from the 2015 and 2018 China Health and Retirement Longitudinal Study, this study delved into the impact of widowhood duration on depression among 8370 older adults and uncovered significantly higher depression scores among widowed individuals, particularly in the initial three years. This study revealed that widowhood contributes to heightened depression levels even after accounting for sociodemographic factors. Although the depressive impact lessens over time, it persists beyond three years, underscoring the need for heightened awareness and support for this vulnerable population.

Interaction of widowhood, gender, and age in predicting loneliness among older adults in China.

BACKGROUND: Loneliness is a significant issue for the elderly, and widowhood is considered a major risk factor. However, research on the intersectional effects of gender, age, and widowhood on loneliness is limited, especially within the Chinese cultural context. METHODS: Using six waves (2002-2018) of national longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (N = 22,777), this study employed multilevel mixed-effects ordered logistic regression to analyze the impact of widowhood on loneliness. Moderating roles of gender and age were examined through interaction effects. RESULTS: Widowhood significantly increased loneliness across genders and age groups, but this effect diminished with age. Widowed men experienced greater loneliness than women, but this difference converged by age 90. The buffering effect of age on the widowhood-loneliness link was less pronounced among older women. CONCLUSION: The study unravels the complexity of how gender, age, and widowhood interact to shape loneliness in later life. Targeted interventions considering these intersections are needed to alleviate loneliness among Chinese widowed elderly.

Restoring Balance-A Woman's Expressions of Lived Experience of Everyday Life During a Period of Aging: A Case Study.

Bereaved older people face stressors from the changes in roles associated with the death of a spouse. To illustrate the lived experience of everyday life during a period of aging after a woman's loss of her spouse. One woman born in 1918 was followed between 74 and 80 years of age after her husband died. Data consisted of daily diary. The text from the diaries were analyzed with a phenomenological hermeneutical approach. Everyday life after becoming a widow is characterized by balancing between personal resources to manage everyday life and vulnerability. In health and social care, it is important to identify experiences of vulnerability because these are associated with poor health.

How Widowhood and Gender Shape the Impact of Maternal Favoritism on Adult Children's Psychological Well-Being.

OBJECTIVES: Our goal was to extend research on within-family differences in mother-child relations in later life by focusing on 2 social structural characteristics of mothers and offspring that may play important roles in shaping the impact of maternal favoritism on adult children's depressive symptoms-mother's marital status and child's gender. METHODS: Mixed-methods data were collected as part of the Within-Family Differences Study from 641 adult children nested within 273 families in which: (a) there were at least 2 living adult siblings, and (b) mothers were married or widowed. RESULTS: Multilevel analyses indicated that perceiving oneself as the child to whom one's mother was most emotionally close was a strong predictor of higher depressive symptoms among daughters of widowed mothers; in contrast, perceptions of favoritism did not predict depressive symptoms among sons of either widowed or married mothers, or daughters of married mothers. Qualitative analyses revealed that daughters, but not sons, of widowed mothers tended to attribute their greater closeness with their mothers to their roles as their mothers' "emotional caregivers," particularly solo caregivers, during times when mothers faced negative life events that neither they nor their children could control or ameliorate. DISCUSSION: The quantitative and qualitative findings we present underscore how social structural positions-in this case, mother's marital status and child's gender-combine with social psychological processes to shape how parent-child relations affect children's well-being in adulthood.

The association of widowhood and living alone with depression among older adults in India.

Widowhood is a catastrophic event at any stage of life for the surviving partner particularly in old age, with serious repercussions on their physical, economic, and emotional well-being. This study investigates the association of marital status and living arrangement with depression among older adults. Additionally, the study aims to evaluate the effects of factors such as socio-economic conditions and other health problems contributing to the risk of depression among older adults in India. This study utilizes data from the nationally representative Longitudinal Ageing Study in India (LASI-2017-18). The effective sample size was 30,639 older adults aged 60 years and above. Descriptive statistics and bivariate analysis have been performed to determine the prevalence of depression. Further, binary logistic regression analysis was conducted to study the association between marital status and living arrangement on depression among older adults in India. Overall, around nine percent of the older adults suffered from depression. 10.3% of the widowed (currently married: 7.8%) and 13.6% of the older adults who were living alone suffered from depression. Further, 8.4% of the respondents who were co-residing with someone were suffering from depression. Widowed older adults were 34% more likely to be depressed than currently married counterparts [AOR: 1.34, CI 1.2-1.49]. Similarly, respondents who lived alone were 16% more likely to be depressed compared to their counterparts [AOR: 1.16; CI 1.02, 1.40]. Older adults who were widowed and living alone were 56% more likely to suffer from depression [AOR: 1.56; CI 1.28, 1.91] in reference to older adults who were currently married and co-residing. The study shows vulnerability of widowed older adults who are living alone and among those who had lack of socio-economic resources and face poor health status. The study can be used to target outreach programs and service delivery for the older adults who are living alone or widowed and suffering from depression.

Effects of divorce and widowhood on subsequent health behaviours and outcomes in a sample of middle-aged and older Australian adults.

Marital disruption is a common life event with potential health implications. We examined the prospective association of divorce/widowhood with subsequent lifestyles, psychological, and overall health outcomes within short and longer terms using three waves of data from the 45 and Up Study in Australia (T1, 2006-09; T2, 2010; T3, 2012-16). Marital status and health-related outcomes were self-reported using validated questionnaires. Nine outcomes were examined including lifestyles (smoking, drinking, diet and physical activity), psychological outcomes (distress, anxiety and depression) and overall health/quality of life. Logistic regression was adjusted for sociodemographic characteristics and baseline health outcomes. Of the 33,184 participants who were married at T1 (mean age 59.5 ± 9.3 years), after 3.4 years, 2.9% became divorced and 2.4% widowed at T2. Recent divorce was positively associated with smoking, poor quality of life, high psychological distress, anxiety and depression at T2. Similar but weaker associations were observed for widowhood. However, these associations were much attenuated at T3 (5 years from T2). Marital disruption in midlife or at an older age can be detrimental to health, particularly psychological health in the short term. Public awareness of the health consequences of spousal loss should be raised. Resources, including professional support, should be allocated to help individuals navigate these difficult life transitions.

A controlled trial of two mind-body interventions for grief in widows and widowers.

Objective: Following bereavement, yearning and grief rumination are repetitive cognitive processes that can lead to disordered grief. Mindfulness training (MT) has been shown to reduce maladaptive repetitive thought. The current quasi-randomized controlled trial examined the feasibility, acceptability, and preliminary efficacy of MT for bereavement-related grief. Method: Ninety-five widow(er)s (Mage = 67.5, 79% women, 98% White) between 6 months to 4 years post-loss were assigned to a 6-week MT intervention or a progressive muscle relaxation (PMR) intervention, or a wait-list condition. Outcome measures were grief severity (Revised Inventory of Complicated Grief), yearning (Yearning in Situations of Loss), rumination (Utrecht Grief Rumination Scale), and decentering (Experiences Questionnaire-Decentering) assessed at baseline, Weeks 2 and 4 of intervention, post-intervention, and 1-month post-intervention. Growth curve analysis examined group differences in rates of improvement in outcomes through follow-up and associations with improvement in grief severity. Results: The MT and PMR groups showed significant rates of decline in grief severity and yearning, though only the PMR group showed a greater rate of decline in grief severity than wait-list. All groups showed significant rates of decline in grief rumination. The PMR and wait-list groups showed significant rates of increase in decentering compared to the MT group. Conclusions: Results support the feasibility and acceptability of MT and PMR for widow(er)s as well as the preliminary efficacy of PMR for improving grief severity in widow(er)s compared to a wait-list control condition. With replication, PMR could be a standalone intervention for non-disordered grief or a component of treatment for disordered grief. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Immigration Background and the Widowhood Effect on Mortality.

OBJECTIVES: Widowhood is a stressful life event with one of the most profound negative effects on health and longevity. Immigrant populations are growing and aging throughout Western nations, and marginalization and cultural differences may make some immigrants especially vulnerable to the stressors of widowhood. However, studies have yet to systematically explore whether the widowhood effect differs between immigrant and native-born individuals. METHODS: Using Danish population register data from 1980 to 2014, this study assesses whether the relationship between widowhood and mortality differs between immigrants from 10 countries and native-born Danes aged 50 and older at 0-2, 3-5, and 6 and more years post-widowhood. RESULTS: We find that immigrant men are at higher risk of dying in the first 2 years after experiencing widowhood than Danish-born men, but these mortality differences dissipate over longer periods. Immigrant women have a higher risk of having died 3 and more years after a spouse's death than Danish women. Patterns vary further by country of origin. DISCUSSION: The results suggest that some immigrants may suffer more from widowhood than native-born individuals, giving insight into how immigration background may influence the health effects of negative life events. They also underscore the potential vulnerabilities of aging immigrant populations to stressors encountered in older age.

Experiences of becoming widowed in old age - a cross-countries study with qualitative interviews from Denmark and quantitative measures of association in a Swedish sample.

Purpose: Becoming widowed is a stressful health-threatening event causing major life changes. We explored how widowed people experience becoming widowed and examined if these experiences are quantitatively associated with widowhood. Methods: A multi-methods study using an exploratory sequential mixed-methods approach including a qualitative descriptive study with widowed people from Denmark and a Swedish cohort study. Qualitative interviews (n = 9) were analysed using qualitative content analysis, describing experiences as explained by the widowed people. The quantitative association of the experiences was examined by identifying proxies for the qualitative experiences of widowhood in the cohort study and examining the occurrence in widowed people compared to married people (n = 1,095). Results: Six categories of experiences emerged: the circumstances around spousal death, mental health and well-being, physical health, social relations, activities and practicalities. The quantitative examination showed a significant association with widowhood regarding mental and physical health problems. Conclusion: The circumstances around spousal death and the time before spousal death, in general, were important to how participants felt being widowed. Being ill negatively affected mental health and well-being, partly because of the inability to participate in activities and social relations. This is important, as health problems are more common among widowed people than married people.

Gender influence on loneliness and family and nonfamily support among older adults: The confounding role of widowhood.

Based on interviews with 465 community elders in Ekiti-State, Nigeria, this study addressed the questions: (a) Do older men and women differ in self-reported loneliness, family and nonfamily support?; and (b) If so, is this relationship maintained when controlling for widowhood, age, social-engagements, extroversion, and neuroticism? Three independent models were tested using one-way MANOVA and MANCOVA. Compared to males, females reported more loneliness and less family support. However, these outcomes became nonexistent after excluding widowhood. Gender maintained significance after excluding other covariates. The study buttresses the primary importance of widowhood in the gender differences found in later-life loneliness and family supports.

Loneliness Following Widowhood: The Role of the Military and Social Support.

OBJECTIVES: Increased loneliness is a common consequence of widowhood in later life. However, individuals with high levels of perceived social support from friends tend to cope more effectively following major social losses like widowhood. Military service is associated with cultivation of strong social support structures. This effect may not only influence those who serve, but also their spouses. Roughly half of older women today are married to veterans, which could shape how they cope with widowhood. We tested two hypotheses: (a) widows of veterans will be less lonely following widowhood compared to their nonveteran counterparts, and (b) this effect will be explained by perceived social support from friends. METHODS: We used the Health and Retirement Study (HRS) to examine changes in loneliness following widowhood among wives of veterans and nonveterans. We used Ordinary Least Squares regression and mediation tests to address our hypotheses. RESULTS: Net of baseline differences, widows of veterans reported statistically lower levels of loneliness (p < .05) following widowhood compared to widows of nonveterans. Widows of veterans retained the same level of perceived social support from friends pre- and postwidowhood, whereas nonveteran wives experienced a loss. Perceived social support from friends mediated the association between veteran status of the deceased spouse and loneliness. DISCUSSION: Our findings suggest wives of veterans may have more resilient social support structures than nonveteran spouses, helping them cope at widowhood. Future research should explore whether these effects persist in association with other major stressful events in later life.

Depressive symptoms among elderly men and women who transition to widowhood: comparisons with long term married and long term widowed over a 10-year period.

This study explores gender differences in mental health sequelae of transition to widowhood among old-old retirement community dwellers. Data are based on a prospective panel survey of 748 older adults (mean age = 78) with follow-ups over a 10-year period. Mixed-effects models suggest that elderly widows and widowers experienced sharp increases of depressive symptoms subsequent to spousal loss. Men showed stable increases of depressive symptoms after widowhood whereas an inverted U-shape curve of depressive symptoms was prominent for older women. Findings indicate that women are more resilient and are better able to cope with spousal loss than are their male counterparts.

Short-Term Mental Health Sequelae of Bereavement Predict Long-Term Physical Health Decline in Older Adults: U.S. Health and Retirement Study Analysis.

OBJECTIVES: Spousal death is a common late-life event with health-related sequelae. Evidence linking poor mental health to disease suggests the hypothesis that poor mental health following death of a spouse could be a harbinger of physical health decline. Thus, identification of bereavement-related mental health symptoms could provide an opportunity for prevention. METHODS: We analyzed data from N = 39,162 individuals followed from 1994 to 2016 in the U.S. Health and Retirement Study; N = 5,061 were widowed during follow-up. We tested change in mental and physical health from prebereavement through the 5 years following spousal death. RESULTS: Bereaved spouses experienced an increase in depressive symptoms following their spouses' deaths but the depressive shock attenuated within 1 year. Bereaved spouses experienced increases in disability, chronic-disease morbidity, and hospitalization, which grew in magnitude over time, especially among older respondents. Bereaved spouses were at increased risk of death compared to nonbereaved respondents. The magnitude of depressive symptoms in the immediate aftermath of spousal death predicted physical-health decline and mortality risk over 5 years of follow-up. DISCUSSION: Bereavement-related depressive symptoms indicate a risk for physical health decline and death in older adults. Screening for depressive symptoms in bereaved older adults may represent an opportunity for intervention to preserve healthy life span.

Aging and social networks: A perspective on gender disparity in India.

In India, the "feminization of aging" is one of the areas in which prejudice most frequently occurs. Noticeably, poverty, isolation, changes in residential care, and weak institutional support push women into several vulnerabilities. This study demonstrates that elderly women are often denied basic rights and are compelled to reside in old-age homes; the situation is worse for elderly widowed women. We examine the claims that the lives of elderly women are more precarious due to their lower literacy, limited social exposure, and monetary dependence. Being women, old, and widowed, they are affected by triple vulnerabilities that require concrete policy implications.

Community-Dwelling and Recently Widowed Older Adults: Effects of Spousal Loss on Psychological Well-Being, Perceived Quality of Life, and Health-Care Costs.

This study is on the effects of spousal loss among older adults who continue to live independently after bereavement. Little longitudinal studies focus on this group, which is of special interest, since in many countries, care policy and system reform are aimed at increasing independent living among older adults. Using longitudinal data from a Dutch public data repository, we investigate the effects of spousal loss on psychological well-being, perceived quality of life, and (indication of) yearly health-care costs. Of the respondents who had a spouse and were living independently (N = 9,400) at baseline, the majority had not lost their spouse after 12 months (T12, n = 9,150), but 2.7% (n = 250) had lost their spouse and still lived independently. We compared both groups using multivariate regression (ordinary least squares) analyses. The results show that spousal loss significantly lowers scores on psychological well-being and perceived quality of life, but we found no effect on health-care costs.

Communication, self-esteem and prolonged grief in parent-adolescent dyads, 1-4 years following the death of a parent to cancer.

PURPOSE: Talking and grieving together may be advantageous for maintaining belief in a meaningful future and can help bereaved adolescents and their parents to cope better with the situation. The aim of this study was to explore communication, self-esteem and prolonged grief in adolescent-parent dyads, following the death of a parent to cancer. METHOD: This study has a descriptive and comparative design. Twenty family dyads consisting of parentally bereaved adolescents (12-19 years) and their widowed parents completed the Parent and Adolescent Communication Scale, Rosenberg Self-Esteem Scale and Prolonged Grief-13, 1-4 years following the death of a parent. RESULTS: Twelve family dyads reported normal-high parent-adolescent communication, 11 dyads rated normal-high self-esteem. Two adolescents and three parents scored above the cut-off for possible prolonged grief disorder (≥35), none of these were in the same dyads. There was a difference (p < .05) between boys (mean 40.0) and girls (mean 41.9) with regard to open family communication, as assessed by parents. Girls reported lower self-esteem (mean 26.0) than boys (mean 34.1, p < .01). CONCLUSIONS: This study provides insights from parentally bereaved families which indicate that despite experiencing the often-traumatic life event of losing a parent or partner, most participants reported normal parent-adolescent communication, normal self-esteem and few symptoms of prolonged grief. The potential usefulness of identifying families who may need professional support in family communication following the death of a parent is discussed.

Widowhood and mortality: a Danish nationwide register-based cohort study.

AIMS: Widowed people have increased mortality compared to married people of the same age. Although most widowed people are of older age, few studies include the oldest old. As life expectancy is increasing, knowledge of widowhood into older age is needed. This study aimed to examine mortality and widowhood in older age by comparing mortality in widowed and married people by sex, age, time since spousal loss and cause of death. METHODS: A Danish register-based matched cohort study of 10% of widowed persons ⩾65 years in the years 2000-2009. For each randomly drawn widowed person, five married persons were matched on sex and age. Mortality rate ratios (MRR) were calculated using Poisson regression, and stratified according to sex and 5-year age intervals. MRRs were furthermore calculated by time since spousal loss and by specific cause of death. RESULTS: The study included 82 130 persons contributing with 642 914.8 person-years. The overall MRR between widowed and married persons with up to 16 years of follow-up was 1.25 (95% CI 1.23-1.28). At age ⩾95 years for men, and ⩾90 years for women, no differences in mortality rates were seen between widowed and married persons. Mortality in widowed persons was increased for most specific causes of death, with the highest MRR from external causes (MRR 1.53 [1.35-1.74]) and endocrine diseases (MRR 1.51 [1.34-1.70]). CONCLUSIONS: Widowhood was associated with increased mortality in older age for both men and women until age ⩾95 and ⩾90 years, respectively. Increased mortality was observed for almost all causes of death.

Urgent engagement in 9/11 pregnant widows and their infants: Transmission of trauma.

The potential effects of maternal trauma on mother-infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother-infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4-6 months. Split-screen videotaped interaction was coded on a one-second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self-contingency and interactive contingency of behavior by time-series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper-contingent, high-arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.