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Mortality after the Hospitalization of a Spouse
Open accessAbstract
BACKGROUND: The illness of a spouse can affect the health of a caregiving partner. We examined the association between the hospitalization of a spouse and a partner's risk of death among elderly people. METHODS: We studied 518,240 couples who were enrolled in Medicare in 1993. We used Cox regression analysis and fixed-effects (case-time-control) methods to assess hospitalizations and deaths during nine years of follow-up. RESULTS: Overall, 383,480 husbands (74 percent) and 347,269 wives (67 percent) were hospitalized at least once, and 252,557 husbands (49 percent) and 156,004 wives (30 percent) died. Mortality after the hospitalization of a spouse varied according to the spouse's diagnosis. Among men, 6.4 percent died within a year after a spouse's hospitalization for colon cancer, 6.9 percent after a spouse's hospitalization for stroke, 7.5 percent after a spouse's hospitalization for psychiatric disease, and 8.6 percent after a spouse's hospitalization for dementia. Among women, 3.0 percent died within a year after a spouse's hospitalization for colon cancer, 3.7 percent after a spouse's hospitalization for stroke, 5.7 percent after a spouse's hospitalization for psychiatric disease, and 5.0 percent after a spouse's hospitalization for dementia. After adjustment for measured covariates, the risk of death for men was not significantly higher after a spouse's hospitalization for colon cancer (hazard ratio, 1.02; 95 percent confidence interval, 0.95 to 1.09) but was higher after hospitalization for stroke (hazard ratio, 1.06; 95 percent confidence interval, 1.03 to 1.09), congestive heart failure (hazard ratio, 1.12; 95 percent confidence interval, 1.07 to 1.16), hip fracture (hazard ratio, 1.15; 95 percent confidence interval, 1.11 to 1.18), psychiatric disease (hazard ratio, 1.19; 95 percent confidence interval, 1.12 to 1.26), or dementia (hazard ratio, 1.22; 95 percent confidence interval, 1.12 to 1.32). For women, the various risks of death after a spouse's hospitalization were similar. Overall, for men, the risk of death associated with a spouse's hospitalization was 22 percent of that associated with a spouse's death (95 percent confidence interval, 17 to 27 percent); for women, the risk was 16 percent of that associated with death (95 percent confidence interval, 8 to 24 percent). CONCLUSIONS: Among elderly people hospitalization of a spouse is associated with an increased risk of death, and the effect of the illness of a spouse varies among diagnoses. Such interpersonal health effects have clinical and policy implications for the care of patients and their families.
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“For example, spouses of those who were hospitalized and had dementia were more likely to die in the following year than caregivers whose spouses were hospitalized but did not have dementia (after accounting for differences in caregiver age).530”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [530]
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“For example, spouses of hospitalized care recipients with dementia were more likely to die in the following year than caregivers whose spouses were hospitalized but did not have dementia (after accounting for differences in caregiver age). 578”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [578]
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“Upon having provided written informed consent, ICs were randomly allocated to either the ERT-C or a waitlist condition as described in the previous publication establishing the efficacy of ERT-C (11).”
From Moderators and mediators of emotion regulation therapy for psychologically distressed caregivers of cancer patients: secondary analyses from a randomized controlled trial. (2021) · cites this paper as [11]
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“Caregiver burden is also associated with a range of physical health complications, including sleep difficulties and fatigue 10, 11, cardiovascular disease 12, 13, poor immune functioning 14, 15, and increased mortality 16, 17.”
From Cognitive behavioral therapies for informal caregivers of patients with cancer and cancer survivors: a systematic review and meta-analysis (2017) · cites this paper as [17]
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Metadata
- Authors
- Christakis, N. A., & Allison, P. D.
- Affiliations
- Harvard University (US)
- University of Pennsylvania (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2006-02-16
- Volume
- 354
- Issue
- 7
- Pages
- 719-730
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2031439369
- Cited by
- 501
- References
- 38
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 13 · 2023: 10 · 2022: 11 · 2021: 20 · 2020: 18 · 2019: 14 · 2018: 16 · 2017: 60 · 2016: 25 · 2015: 29 · 2014: 34 · 2013: 35 · 2012: 32
- FWCI
- 93.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institute on Aging (R-01AG17548-01, R01AG017548)
- Topics
- 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
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- spousal caregiving, older couples, hospitalization, colon cancer, stroke, dementia, mental illness, congestive heart failure, hip fracture, sex differences
- MeSH terms
- Aged, Bereavement, Female, Follow-Up Studies, Medicare, Hospitalization, Humans, Male, Mortality, Risk, United States, Proportional Hazards Models, Odds Ratio, Case-Control Studies, Caregivers, Spouses
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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