Widowhood and mortality: a meta-analysis

J Robin Moon, Naoki Kondo, M Maria Glymour, S V Subramanian, J Robin Moon, Naoki Kondo, M Maria Glymour, S V Subramanian

Abstract

Background: While the "widowhood effect" is well known, there is substantial heterogeneity in the magnitude of effects reported in different studies. We conducted a meta-analysis of widowhood and mortality, focusing on longitudinal studies with follow-up from the time of bereavement.

Methods and findings: A random-effects meta-analysis was conducted to calculate the overall relative risk (RR) for subsequent mortality among 2,263,888 subjects from 15 prospective cohort studies. We found a statistically significant positive association between widowhood and mortality, but the widowhood effect was stronger in the period earlier than six months since bereavement (overall RR = 1.41, 95% CI: 1.26, 1.57) compared to the effect after six months (overall RR = 1.14, 95% CI: 1.10, 1.18). Meta-regression showed that the widowhood effect was not different for those aged younger than 65 years compared to those older than 65 (P = 0.25). There was, however, a difference in the magnitude of the widowhood effect by gender; for women the RR was not statistically significantly different from the null (overall RR = 1.04, 95% CI: 1.00, 1.08), while it was for men (overall RR = 1.23, 95% CI: 1.18, 1.28).

Conclusions: The results suggest that further studies should focus more on the mechanisms that generate this association especially among men.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Flow Chart of Study Selection…
Figure 1. Flow Chart of Study Selection Process.
Figure 2. Forest Plot for Time Since…
Figure 2. Forest Plot for Time Since Bereavement of
Figure 3. Forest Plot for Time Since…
Figure 3. Forest Plot for Time Since Bereavement of ≥6 months.
Figure 4. Forest Plot for Men.
Figure 4. Forest Plot for Men.
Figure 5. Forest Plot for Women.
Figure 5. Forest Plot for Women.
Figure 6. Funnel Plot of Reporting Bias.
Figure 6. Funnel Plot of Reporting Bias.

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