Loneliness Predicts Progression of Frailty in Married and Widowed, but Not Unmarried Community Dwelling Older Adults.

BACKGROUND: Loneliness is highly prevalent among older adults and is associated with frailty. Most studies consider loneliness in isolation without consideration for structural and functional measures of social relationships - and longitudinal studies are scarce. OBJECTIVES: This study examined longitudinal associations between loneliness and frailty and analyzed how structural and functional social measures influence these associations. DESIGN: Linear mixed effects models examined longitudinal associations between loneliness and frailty assessed with the frailty index (scale 0-100). Models were adjusted for baseline age, gender, education, depressive symptoms, global cognition, and structural (e.g., social network, marital status), and functional social measures (e.g., social, cognitive, and physical activity, and social support). PARTICIPANTS: Loneliness and frailty data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project were examined (mean age 79.6 ± 7.7 years, 74.9% female). MEASUREMENTS: Baseline loneliness assessed by the de Jong Gierveld Loneliness Scale was the predictor of interest. RESULTS: Frailty increased significantly over a mean follow-up period of 4.6 years. Effects of loneliness on frailty were modified by marital status. Loneliness predicted an additional accumulation of 0.37 and 0.34 deficits on the frailty index per year in married and widowed individuals respectively, compared to those who were not lonely (married: p=0.009, CI 0.09, 0.64; widowed: p=0.005, CI 0.1, 0.58). Loneliness did not predict frailty progression in unmarried individuals. CONCLUSIONS: Loneliness predicts frailty progression, highlighting the importance of social determinants on physical health in aging.

How does social support affect subjective well-being among Chinese widowed older adults?

Background: Social support (SS) is an important factor influencing subjective well-being (SWB) in older adults. This is especially true for the special group of widowed older adults (WOA). Widowhood means that older adults have lost their most important SS, and therefore, the search for a guardian from outside the spouse becomes a central issue in ensuring the SWB of WOA. Methods: The data for this paper were obtained from CGSS 2021, a large national social survey in China. We operationalized SWB as an individual's overall perception of his or her experience of happiness using 'affective well-being' (i.e., emphasizing an individual's positive affective experiences), and scores were calculated using a Likert scale. This study used linear regression modeling to examine the impact of SS on the SWB of WOA (aged 60 and above). Results: It was found that, first, this study presents the role of different circles of SS on the SWB of WOA, fully highlighting the importance of social context. Specifically, daughters, neighbors, and relatives constitute the guardians of the SWB for WOA in rural, whereas daughters and friends constitute the guardians of the SWB for WOA in rural. Second, the protective resources provided by the guardians not only serve as a buffer for WOA in distress but also reduce the likelihood of negative events occurring, thereby increasing WOA's SWB. Discussion: This paper partially corroborates the findings of established studies on the topic of SS and SWB among older adults and the above findings not only help us to further explain the relationship between SS and SWB theoretically but also help us to rationalize the construction of SS for WOA practically.

Widowhood and mortality risk in Taiwan: a population-based matched cohort study.

BACKGROUND: Studying the causes of death among deceased spouses and surviving partners may provide insights into the underlying mechanisms of the association between widowhood and mortality. This study investigated the mortality risk of widowhood in Taiwan, examined the association of the cause of death between widowed individuals and their deceased spouses and explored potential modifying effects by age, gender and duration after widowhood. METHODS: This matched cohort study utilized Taiwan's National Health Insurance claims database and National Death Registry. In total, 204 010 widowed men and 596 136 widowed women were identified with a mean follow-up period of 6.9 and 7.9 years, respectively, and 816 040 comparison men and 2 384 544 comparison women were selected. RESULTS: Widowhood was associated with an increased mortality risk, with widowed men having a 1.32 increased risk and widowed women having a 1.27 increased risk. Age at spousal death and duration modified the associations after widowhood. The widowed individuals are more likely to die by the same cause as the deceased spouse if they died by suicide, accident, endocrine, gastrointestinal disorders or infection. CONCLUSIONS: The study suggests that healthcare policies and interventions should be developed to improve widowed individuals' health and overall welfare.

Exploring the meaning of a good life for older widows with extensive need of care: a qualitative in-home interview study.

INTRODUCTION: Studies of older women's life transitions is rare but gains relevance as the aging population, with older women as the majority, expands. PURPOSE: To explore the meaning of a good life for older widows with extensive home care needs. MATERIALS AND METHODS: Semi-structured interviews were carried out with eleven women, aged 80 and over (82-95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5-6 hours, mean 3). Data were analysed by reflexive thematic analysis. RESULTS: The theme "This Day in My Home, the frame of my life" reflects the women's experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely. CONCLUSION: A day at home may seem static, yet it mirrors life's dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.

Economics of widowhood mortality in adult women in India.

The economic consequence of widowhood on health is well-established, demonstrating that economic factors can significantly link with health outcomes, even the risk of mortality for widows. However, empirical evidence is restricted only to developed countries. Thus, this study assesses the role of economic factors (paid work, pension and household economic status) on the mortality of widows in broad age groups in India. We used two waves of the India Human Development Survey (IHDS), a nationally representative prospective dataset in India for 42,009 women (married and widows) aged 25 years and above at IHDS wave 1 whose survival status was observed between two waves. Further, 6,953 widows were considered for sub-sample analysis in this study. Logistic regression and propensity score matching (PSM) were applied to understand the association and causality between economic factors and mortality for widows. Poor household economic status, paid regular work, and receiving a widowed pension were significantly associated with lower mortality risk for young widows. In comparison, unpaid and paid regular work was linked with lower mortality risk for old widows. The result of causal analysis suggests that receiving a widows' pension had a slight impact on mortality reduction for young widows while engaging in paid regular work significantly reduced the mortality of old widows. This research confirms that the link between economic factors and mortality among widows is age dependent in the Indian context.

Widowhood and bereavement in late life.

Bereavement is a common and often challenging experience in late life. Evidence shows that while many older adults manage to adjust well and demonstrate resilience in response to the death of a close person, bereavement puts a substantial minority at risk of adverse mental and physical health impacts including mortality. Current research further indicates that 1) this is the case across different countries and cultures across the globe; 2) that the COVID-19 pandemic posed unprecedented challenges for coping with late-life bereavement; 3) that loneliness and social isolation among bereaved older adults tend to be prevalent and harmful, particularly under pandemic but also in nonpandemic circumstances; and, recently, 4) that bereavement may be a risk factor for cognitive decline in this population.

Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis.

Background: Transitioning from marriage to widowhood presents inevitable and significant challenges for many older adults. This study explored the impact of widowhood on a range of mental health outcomes, including pulse pressure and fasting blood glucose levels, among older adults in nursing homes. Methods: This cross-sectional study utilized cluster random sampling to recruit participants, with data analyzed from 388 older Chinese adults. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, and the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms and suicidal ideation. Propensity score matching (PSM) was employed to control for confounding factors. A multivariate linear regression analysis was performed to explore the relationship between widowhood, mental health outcomes, pulse pressure, and fasting blood glucose levels. Results: After applying PSM, the sample size was refined to 268 (N = 134 for both married and widowed groups) from the initial 388, excluding 120 unmatched cases. Widowed older adults were found to have notably lower family support (ß = -0.81, p = 0.002), increased depressive symptoms (ß = 1.04, p = 0.043), elevated pulse pressure (ß = 8.90, p < 0.001), and higher fasting blood glucose levels (ß = 3.22, p = 0.027). These associations exhibited greater beta values compared to pre-matching analysis. Conclusion: Our findings revealed that widowed participants had reduced family support, an increased risk of depressive symptoms, heightened pulse pressure, and elevated fasting blood glucose in comparison to their married counterparts. Interventions focusing on social support, mental health, and cardiovascular well-being could be advantageous for this at-risk group.

Bonding against the odds: Male prairie vole response to the "widow effect" among females.

Although pair bonding is the preferred mating tactic among socially monogamous prairie voles, naturalistic observations have demonstrated many males remain non-bonded. Moreover, although males readily re-bond after the loss of a partner, females do not (i.e., the "widow effect'). Few studies have attempted to address why so many males remain non-bonded or if a reluctance of re-bonding in females contributes to this outcome. We investigate how female bonding history impacts male pair bond formation. Specifically, we test two alternative hypotheses for how sexually naïve males will behave when paired with widow females. The fecundity hypothesis predicts males will avoid bonding with widow females and be more receptive to novel bond-naïve females. The preference to bond hypothesis predicts males will choose to bond and express a partner preference, irrespective of if a pair-mate is a widow or sexually naïve. Our results demonstrated that males expressed a partner preference for females regardless of their social history. These data support the preference to bond hypothesis and suggest natural variation in bonding may not be strongly due to males forgoing bonding opportunities.

Understanding evidence and provision of services around social isolation and loneliness of military widow/ers: A scoping review.

BACKGROUND: Whilst the uniqueness of loneliness and social isolation is now recognised for members of the Armed Forces Community, there is currently a lack of evidence examining these experiences within the Military Widow/er population. Therefore, this scoping review aimed to search and synthesise the current evidence base exploring experiences of loneliness and social isolation in this community. METHOD: Six databases were searched; ASSIA; CINAHL; ProQuest Dissertation & Theses Global; PsycArticles; Medline; Web of Science. Any article type was included if they focused on UK or international Military Widows and loneliness and social isolation. In the absence of loneliness and social isolation, related aspects were included, for example, social support. RESULTS: A thematic synthesis was completed on the nine eligible papers, where key findings were coded and generated into four themes; Experiences of Loneliness and Social Isolation, The Uniqueness of the Military, Access to Social Support, and The Importance of Peer Support. CONCLUSIONS: Evidence supports the need for military-specific support services with peers who recognise the individuals' unique experiences of loneliness and social isolation. None of the available evidence focused specifically on social isolation, however this was often prevalent in the results. All of the studies were carried out in the USA and Israel, with none including the views of widowers. Further evidence is required, particularly relating to a UK-context.

Widow spiders alter web architecture and attractiveness in response to same-sex competition for prey and mates, and predation risk.

Female-female competition in animals has rarely been studied. Responses of females that compete context-dependently for mates and prey, and seek safety from predators, are ideally studied with web-building spiders. Cobwebs possess unique sections for prey capture and safety, which can be quantified. We worked with Steaoda grossa females because their pheromone is known, and adjustments in response to mate competition could be measured. Females exposed to synthetic sex pheromone adjusted their webs, indicating a perception of intra-sexual competition via their sex pheromone. When females sequentially built their webs in settings of low and high intra-sexual competition, they adjusted their webs to increase prey capture and lower predation risk. In settings with strong mate competition, females deposited more contact pheromone components on their webs and accelerated their breakdown to mate-attractant pheromone components, essentially increasing their webs' attractiveness. We show that females respond to sexual, social and natural selection pressures originating from intra-sexual competition.

Effects of multimorbidity patterns and socioeconomic status on catastrophic health expenditure of widowed older adults in China.

Background: The high multimorbidity and lower socioeconomic status (SES) of older adults, can lead to catastrophic health expenditures (CHEs) for older adults' households. However, whether widowed older adults will bear such a financial burden has yet to be explored. The aim of this study was to investigate the influence of multimorbidity patterns and SES on CHE in Chinese widowed older adults. Methods: Data was obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS). This is a cross-sectional study. A total of 1,721 widowed participants aged 60 years and older were enrolled in the study. Latent class analysis was performed based on 14 self-reported chronic diseases to identify multimorbidity patterns. The logistic model and Tobit model were used to analyze the influence of multimorbidity patterns and SES on the incidence and intensity of CHE, respectively. Results: About 36.72% of widowed older adults generated CHE. The incidence and intensity of CHE were significantly higher in the cardiovascular class and multisystem class than in the minimal disease class in multimorbidity patterns (cardiovascular class, multisystem class, and minimal disease class). Among SES-related indicators (education, occupation and household per capita income), respondents with a middle school and above education level were more likely to generate CHE compared to those who were illiterate. Respondents who were in the unemployed group were more likely to generate CHE compared to agricultural workers. In addition, respondents aged 70-79 years old, geographically located in the east, having other medical insurance, or having fewer family members are more likely to generate CHE and have higher CHE intensity. Conclusion: Widowed older adults are at high risk for CHE, especially those in the cardiovascular and multisystem disease classes, and those with low SES. Several mainstream health insurances do not provide significant relief. In addition, attention should be paid to the high-risk characteristics associated with CHE. It is necessary to carry out the popularization of chronic disease knowledge, improve the medical insurance system and medical service level, and provide more policy preferences and social support to widowed older adults.

Social participation, psychological resilience and depression among widowed older adults in China.

BACKGROUND: Depression has become a challenging public health problem, and the loss of a spouse is one of the main causes of depression in older adults. Social participation and psychological resilience are protective factors that reduce depressive symptoms in adults. The purpose of this study was to explore the influences of social participation and psychological resilience on the depression of Chinese widowed older adults. METHODS: We carried out a cross-sectional study on 790 community-dwelling widowed older adults in Shaanxi, China, in 2019. A structured face-to-face interview was used to collect data. We used the ordinary least squares model (OLS), the generalized propensity score matching (GPSM) and the mediation model to test the relationship between social participation, psychological resilience and depression. RESULTS: We find a U-shaped relationship between social participation and depression, with the increase in social participation scores, the average depression level decreased and then increased. The psychological resilience of the widowed older adults was negatively associated with depression. The higher their psychological resilience, the lower their depression level. Among the four factors of psychological resilience, factor 2 (optimism and positive acceptance of change) and factor 3 (secure relationships and tolerance of negative affect) of psychological resilience were protective factors for depression after adjusting for demographic variables and physical health conditions. Psychological resilience plays a mediating role, as evident in factor 2 and factor 3 mediating the relationship between social participation and depression. CONCLUSION: An appropriate level of social participation will relieve the depression of widowed older adults. Social participation can reduce the depression level of widowed older adults by improving their psychological resilience. Community and family could reduce depression by intervening in the social participation of widowed older adults. Active social participation is crucial because it has a protective and resilient impact, which can help people recover from the stress of losing a spouse.

The effect of widowhood on depression of caregivers.

BACKGROUND: It is known that caregivers are more likely to be depressed compared to those without caregiving burden. The disappearance of caregiving burden after widowhood may alleviate depression, but at the same time the diminishment of marital resources caused by widowhood may exacerbate depression. So, what effect does widowhood have on depression among caregivers?, which was valuable for promoting the mental health of caregivers in the context of China's aging. METHODS: China Health and Retirement Longitudinal Study (CHARLS), a longitudinal data, was selected and the effect of widowhood on depression among middle-aged and elderly caregivers was explored by using Ordinary Least Squares and Propensity Score Matching methods based on 2018 CHARLS data. The channels and subgroup difference were also analyzed. RESULTS: Widowhood significantly increased CES-D scores of caregivers, and there were higher CES-D scores among women, the middle-aged, rural residents, and those with higher levels of education. Widowhood increased depression of caregivers through reducing personal economic resources, and increasing possibilities to live with children and participate in social activities. CONCLUSIONS: Caregivers who experienced widowhood tend to be depressed and concerted efforts are needed. On the one hand, more social security measures and economic subsidy policy should focus on the middle-aged adults and elderly who experienced widowhood. On the other one hand, it is helpful to relieve depression by providing more social support from society and families to the middle-aged adults and elderly who experienced widowhood.

Comparing the effect of a multisectoral agricultural intervention on HIV-related health outcomes between widowed and married women.

INTRODUCTION: Widowed women make up 18-40% of the 12 million women living with HIV in eastern and southern Africa. Widowhood has also been associated with greater HIV morbidity and mortality. We compared the effectiveness of a multisectoral climate adaptive agricultural livelihood intervention (called Shamba Maisha) on food insecurity, and HIV related health outcomes among widowed and married women living with HIV in western Kenya. METHODS: We implemented Shamba Maisha (NCT02815579) using a cluster-randomized control trial design. The intervention arm received an US$175 in-kind loan to purchase a micro-irrigation pump, seeds, and fertilizer, and received eight training sessions on sustainable agriculture and financial management. Study outcomes were measured every 6 months over a 24-month follow-up period and trends in outcomes assessed using multilevel mixed-effects models. RESULTS: The trial enrolled 232 (61.5%) married and 145 (38.5%) widowed women. Widowed women (mean age 42.8 ± 8.4 years) were older than married women (35.8 ± 9.0 years) (p < 0.01). Almost all widowed women (97.2%) self-identified as household heads compared to 10.8% of married women. Comparing widowed vs married women, reduction in food insecurity (-3.13, 95%CI -4.42, -1.84 vs. -3.08, 95%CI -4.15, -2.02), depressive symptoms (-0.21, 95%CI -0.36, -0.07 vs. -0.19, 95%CI -0.29, -0.08), internalized stigma (-0.33, 95%CI -0.55, -0.11 vs. -0.38, 95%CI -0.57, -0.19), and anticipated stigma (-0.46 95%CI -0.65, -0.28 vs. -0.35, 95%CI -0.50, -0.21) was similar for both groups. In contrast, improvements in social support (-2.22, 95%CI -3.85, -0.59 vs. -4.00, 95%CI -5.16, -2.84; p = 0.08) and reduction in enacted stigma (0.01, 95%CI -0.06, 0.08 vs. -0.14, 95%CI -0.20, -0.09; p < 0.01) were weaker for widowed than married women. CONCLUSIONS: Our study is among the first comparing the effect of a livelihood intervention on HIV health outcomes among widowed and married women. Widowed women experienced similar benefits as married women on individual-level outcomes, but weaker benefit on outcomes dependent on their external environment like enacted stigma and social support. Future trials and programs targeting widowed women should bolster stigma reduction and social support.

The economic circumstances of widows in Vietnam.

Information on the living conditions of widows in Vietnam is limited. Prior studies of gender gaps have identified widows as vulnerable to the risks of poverty. However, widows are only included as a sub-group in broader studies of women's well-being. Large gaps remain in the knowledge based on the factors affecting both widows' susceptibility to poverty and the conditions or circumstances that might minimize these risks. This paper attempts to help redress these knowledge gaps by contributing an analysis of data from the 2018 Vietnam Household Living Standard Surveys. The paper compares the likelihood of poverty for widowed and other households using probit regression. It also assesses whether widows who head up their households face different risks of poverty from those who live in other households. Finally, the paper examines the effects on the risk of poverty of a range of social, demographic and locational characteristics of widow households in Vietnam. Our results indicate that widowed households have experienced a higher probability of falling into poverty. Moreover, widow-headed households have faced more vulnerability to fresh water and housing, especially among widowed households. Policy implications have emerged based on the findings of this paper.

From i-coping to we-coping: A retrospective qualitative study on parent-child dyadic coping in widowed families.

In a widowed family, the surviving parent and children face the loss together. However, most previous research in bereavement has focused on individual experiences. Although the family perspective has been introduced into the field, neither theories nor empirical research has explored mutual interaction. Dyadic coping reflects the family perspective and has been proven to be an influential factor in couples facing life adversities. Nevertheless, it has not been explored in the context of bereavement-specific stressors, including loss- and restoration-related stressors, nor in the parent-child relationship. This research is the first exploration of parent-child dyadic coping in widowed families in the bereavement context and aims to form a comprehensive conceptualization of parent-child dyadic coping following bereavement. Qualitative semistructured interviews were conducted with 20 parents and children from widowed families in mainland China (11 surviving children and nine widowed parents, representing 19 families). Constructivist grounded theory was used to guide the analysis. The main themes identified were dyadic coping-related cognitions, loss-oriented dyadic coping, restoration-oriented dyadic coping, and contextual factors. Three foci (thou, we, and I) were identified for both loss- and restoration-oriented dyadic coping. A conceptualization model of bereavement dyadic coping within widowed families was developed. This study extends the single I-coping perspective in bereavement coping to a we-coping perspective, provides an interactional- and operational-level knowledge on dual-process coping, acknowledges the bilateral interaction in parent-child relationships, and offers implications for bereavement support practice for widowed families. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining sociocultural factors in widowhood and cognitive function among older Chinese immigrants: findings from the PINE study.

Objectives: Although there is growing evidence on widowhood and cognitive function, existing studies have shown mixed results. Little is known about protective factors that may contribute to resilience, thereby ameliorate the adverse effect of widowhood on cognition among older Asian immigrants. This study explored potential moderators (i.e. social support, acculturation, leisure activities) in the association between widowhood and cognitive function among older Chinese immigrants.Method: The study sample included 2,515 adults aged 60 or older who completed two waves (2011-2013 and 2013-2015) of the Population Study of Chinese Elderly in Chicago. Cognitive function was indexed by global cognitive function and episodic memory. Linear regression analyses were conducted with interaction terms.Results: Our results show that social support moderated the relationship between widowhood and global cognitive function, and acculturation moderated the relationship between widowhood and episodic memory. The adverse effect of widowhood on cognitive function was more pronounced at lower levels of social support and acculturation.Conclusion: Our findings indicate buffering roles of social support and acculturation in cognitive health among older Chinese immigrants who experience widowhood. Providing supportive programs and interventions to increase social support and acculturation is suggested to promote cognitive function in this population.

The Lived Experiences of Spousal Bereavement and Adjustment Among Older Chinese Immigrants in Calgary.

Spousal bereavement poses considerable challenges to adults in late life. Some populations, such as older immigrants, may experience heightened negative outcomes as a consequence of spousal bereavement, due to migratory stress and social isolation. Spousal bereavement is culturally embedded as it is related to cultural beliefs and attitudes concerning death and family relationships. However, studies on spousal bereavement or widowhood among older immigrants are extremely limited. This study aims to fill the gap by exploring, via a phenomenological approach, the lived experiences of widowed older Chinese immigrants in Calgary and responding to the question: What are the lived experiences of widowed Chinese older immigrants in coping with their spousal bereavement? With the data drawn from 12 in-depth qualitative interviews, findings were categorized into individual, family, community and societal levels. Study participants experienced long-lasting grief that was private and impacted by their culture and immigration status. Although family and ethno-cultural communities provided various types of supports during participants' widowhood, they did not directly assist them in coping with spousal loss. Most participants did not access social services for bereavement support, more often relying on cultural rituals and faith practices. Findings suggest the need for culturally appropriate bereavement supports and family/community involvement for older immigrant adults who have experienced spousal loss.