The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.
Involvement in Caregiving and Adjustment to Death of a Spouse: Findings From the Caregiver Health Effects Study
Abstract
CONTEXT: Most deaths in the United States occur among older persons who have 1 or more disabling conditions. As a result, many deaths are preceded by an extended period during which family members provide care to their disabled relative. OBJECTIVE: To better understand the effect of bereavement on family caregivers by examining predeath vs postdeath changes in self-reported and objective health outcomes among elderly persons providing varying levels of care prior to their spouse's death. DESIGN AND SETTING: Prospective, population-based cohort study conducted in 4 US communities between 1993 and 1998. PARTICIPANTS: One hundred twenty-nine individuals aged 66 to 96 years whose spouse died during an average 4-year follow-up. Individuals were classified as noncaregivers (n = 40), caregivers who reported no strain (n = 37), or strained caregivers (n = 52). MAIN OUTCOME MEASURES: Changes in depression symptoms (assessed by the 10-item Center for Epidemiological Studies-Depression [CES-D] scale), antidepressant medication use, 6 health risk behaviors, and weight among the 3 groups of participants. RESULTS: Controlling for age, sex, race, education, prevalent cardiovascular disease at baseline, and interval between predeath and postdeath assessments, CES-D scores remained high but did not change among strained caregivers (9.44 vs 9.19; P =.76), while these scores increased for both noncaregivers (4.74 vs 8.25; F(1,116) = 14.33; P<.001) and nonstrained caregivers (4.94 vs 7.13; F(1,116) = 4.35; P =.04). Noncaregivers were significantly more likely to be using nontricyclic antidepressant medications following the death than the nonstrained caregiver group (odds ratio [OR], 12.85; 95% confidence interval [CI], 1.02-162.13; P =.05). The strained caregiver group experienced significant improvement in health risk behaviors following the death of their spouse (1.47 vs 0.66 behaviors; F(1,118) = 20.23; P<.001), while the noncaregiver and nonstrained caregiver groups showed little change (0.27 vs 0.27 [P =.99] and 0.46 vs 0.27 [P =.39] behaviors, respectively). Noncaregivers experienced significant weight loss following the death (149.1 vs 145.3 lb [67.1 vs 65.4 kg]; F(1,101) = 8.12; P =.005), while the strained and nonstrained caregiving groups did not show significant weight change (156.2 vs 155.2 lb [70.3 vs 69.8 kg] [P =.41] and 156.2 vs 154.0 lb [70.3 vs 69.3 kg] [P =.12], respectively). CONCLUSIONS: These data indicate that the impact of losing one's spouse among older persons varies as a function of the caregiving experiences that precede the death. Among individuals who are already strained prior to the death of their spouse, the death itself does not increase their level of distress. Instead, they show reductions in health risk behaviors. Among noncaregivers, losing one's spouse results in increased depression and weight loss.
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“Other longitudinal studies have found that caregivers show some improvement in psychological functioning after bereavement, albeit without returning to normative levels (7, 45, 46).”
From Chronic stress and age-related increases in the proinflammatory cytokine IL-6. (2003) · cites this paper as [45]
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Cites
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Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study
Schulz, R., & Beach, S. R. (1999) · JAMA · doi:10.1001/jama.282.23.2215 · Cited by 3,340 · cited 5×
“Participants were asked 6 yes or no questions about the following health risk behaviors: (1) missing at least 1 physician appointment in the last 6 months; (2) not having enough time to go to the physician; (3) not having enough time to exercise; (4) forgetting to take medication; (5) not getting enough rest in genera…”
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Pinquart, M., & Sörensen, S. (2003) · Psychology and Aging · doi:10.1037/0882-7974.18.2.250 · Cited by 2,857
Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11
Prigerson, H. G., Horowitz, M. J., Jacobs, S. C., Parkes, C. M., Aslan, M., Goodkin, K., Raphael, B., Marwit, S. J., Wortman, C., Neimeyer, R. A., et al. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000121 · Cited by 1,863
Health outcomes of bereavement.
Stroebe, M., Schut, H., & Stroebe, W. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61816-9 · Cited by 1,746
Chronic stress and age-related increases in the proinflammatory cytokine IL-6.
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Strength and vulnerability integration: A model of emotional well-being across adulthood.
Charles, S. T. (2010) · Psychological Bulletin · doi:10.1037/a0021232 · Cited by 1,313
Metadata
- Authors
- Schulz, R., Beach, S. R., Lind, B., Martire, L. M., Zdaniuk, B., Hirsch, C., Jackson, S., & Burton, L.
- Affiliations
- University of Pittsburgh (US)
- University of Washington (US)
- University of California, Davis (US)
- Wake Forest University (US)
- Johns Hopkins University (US)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2001-06-27
- Volume
- 285
- Issue
- 24
- Pages
- 3123
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2045262702
- Cited by
- 261
- References
- 17
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 6 · 2023: 3 · 2022: 6 · 2021: 7 · 2020: 3 · 2019: 8 · 2018: 6 · 2017: 5 · 2016: 12 · 2015: 9 · 2014: 10 · 2013: 14 · 2012: 18
- FWCI
- 13.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc085079-024, n01hc085086-022, 5r01mh046015-09)
- National Institute on Aging (U01AG013305, AG 13305, AG01532)
- National Heart, Lung, and Blood Institute (HL65111, HL65112, N01 HC85086, P50HL065112, P50HL065111, N01-HC85079)
- National Institute of Mental Health (T32MH019986, R01 MH-52247, R01 MH46015)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- caregiver burden, bereavement, death of a spouse, widowhood, depression, antidepressant use, health risk behaviors, weight change, older adults, family caregivers
- MeSH terms
- Aged, Aged, 80 and over, Antidepressive Agents, Bereavement, Death, Depression, Female, Follow-Up Studies, Humans, Male, Socioeconomic Factors, Weight Loss, Health Behavior, Caregivers, Spouses
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