When a person over 65 is debilitated, the
odds of dying within a year can increase dramatically
for the spouse, a new study shows.
If a man is diagnosed with dementia,
for example, the risk of death skyrockets 28 percent for
his wife over the next year. If it's the woman who suffers
dementia, the husband's death risk climbs 22 percent.
The increase in risk varies dramatically by condition,
however. The partner of a spouse hospitalized for cancer
typically incurs no heightened odds of death. For a stroke,
the risk to the partner goes up about 5 percent.
The differences depend largely on how disabling a condition
is, explained study leader Nicholas Christakis of Harvard
Medical School. People with cancer often function relatively
normally between treatments, while dementia patients require
constant care.
Higher Odds
Increased risk of death of a partner within one year
after the hospitalization of a spouse, if the partner
is the ...
Husband Wife Dementia 22%
28% Psychiatric disease 19% 32% Serious fracture 15% 11%
Chronic obstructive pulmonary disease 12% 13% Congestive
heart failure 12% 15% Stroke 6% 5% Ischemic heart disease
5% 0 Sepsis 9% 0 Pneumonia 6% 6% Abdominal surgical disease
4% 0 Leukemia or lymphoma 0 0 Pancreatic Cancer 0 0 Colon
Cancer 0 0 Lung Cancer 0 0 All other forms of cancer 0 0
All other diagnoses 2% 0
SOURCE: Nicholas Christakis, Harvard Medical School;
based on people over age 65
"Diseases that are very mentally or physically disabling
are really harmful to the spouse,"Christakis said
in a telephone interview. "Families should be aware.
‘Gee, Grandpa is sick. Boy that's bad for Grandma.'”
Previous studies have shown that the loss of a loved
one can help spell the end for a partner. But no one has
done a comprehensive study on how illness alone affects
a spouse.
The new study examined the records of more than 1 million
people (518,240 couples) who were on Medicare in 1993.
Over the next nine years, more than two-thirds of them
were hospitalized and more than one-third died. The results
are detailed in the Feb. 16 issue of the
New England Journal of Medicine.
"This highly innovative study—in an enormous
sample of older people—demonstrates yet another
important connection between social networks and health,"
said Richard Suzman, associate director of the National
Institute on Aging, which supported the research. "We
don't yet know the full extent to which social networks
affect health. We need to explore the mechanisms behind
the stresses.”
The study confirms the "widower effect" that
has been shown in other research. For those over age 65,
the death of a wife increases a husband's risk of death
53 percent for 30 days, and the death of a husband increases
his wife's risk by 61 percent during that month, according
to the new study.
The widower effect over one year amounts to a 21 percent
increased risk of death to a surviving husband and 17
percent for a surviving wife.
But the most significant findings are the social effects
of mere hospitalization.
"Over the first 30 days it can be almost as bad
for you to have a sick spouse as a dead spouse,"
Christakis said.
Spouses suddenly charged with providing more care can
be just as suddenly without social, emotional or economic
support, Christakis points out. They might start drinking
or engage in other harmful behaviors. Stress
can weaken their immune systems.
Christakis said doctors should be mindful of these risks
to a patient's spouse. And the findings might play into
how health care decisions are made. Hip replacement surgery,
for example, could be viewed as being more beneficial
if it stands to save two lives rather than just one, he
suggested.
