Short-Term Mental Health Sequelae of Bereavement Predict Long-Term Physical Health Decline in Older Adults: U.S. Health and Retirement Study Analysis

J Gerontol B Psychol Sci Soc Sci. 2021 Jun 14;76(6):1231-1240. doi: 10.1093/geronb/gbaa044.


Objectives: Spousal death is a common late-life event with health-related sequelae. Evidence linking poor mental health to disease suggests the hypothesis that poor mental health following death of a spouse could be a harbinger of physical health decline. Thus, identification of bereavement-related mental health symptoms could provide an opportunity for prevention.

Methods: We analyzed data from N = 39,162 individuals followed from 1994 to 2016 in the U.S. Health and Retirement Study; N = 5,061 were widowed during follow-up. We tested change in mental and physical health from prebereavement through the 5 years following spousal death.

Results: Bereaved spouses experienced an increase in depressive symptoms following their spouses' deaths but the depressive shock attenuated within 1 year. Bereaved spouses experienced increases in disability, chronic-disease morbidity, and hospitalization, which grew in magnitude over time, especially among older respondents. Bereaved spouses were at increased risk of death compared to nonbereaved respondents. The magnitude of depressive symptoms in the immediate aftermath of spousal death predicted physical-health decline and mortality risk over 5 years of follow-up.

Discussion: Bereavement-related depressive symptoms indicate a risk for physical health decline and death in older adults. Screening for depressive symptoms in bereaved older adults may represent an opportunity for intervention to preserve healthy life span.

Keywords: Bereavement; CESD; Depression; Mortality; Physical health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Attitude to Health
  • Bereavement*
  • Depression / psychology*
  • Female
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Health / statistics & numerical data*
  • Middle Aged
  • Spouses / psychology*
  • United States
  • Widowhood / psychology*