In the largest study ever to quantify caregiver burden and the widower effect, researchers found that for people aged 65 and older, hospitalization of a spouse can harm the wellbeing of his or her partner and significantly contribute to that partner's death.
This risk also varies with the ill spouse's diagnosis. The study appears in the Feb. 16 New England Journal of Medicine. "Our study shows that people are connected in such a fashion that the health of one person is related to the health of another," reports Nicholas Christakis, MD, PhD, professor in the Department of Health Care Policy at Harvard Medical School.
With coauthor Paul Allison, PhD, professor and chair of the University of Pennsylvania Department of Sociology, Christakis examined the effect of illness in one spouse on the risk of illness in a partner--commonly called the "caregiver burden." Concurrently, they looked at the effect of the death of one spouse on the mortality of the other, known as the "widower effect." By considering these effects together for the first time, the authors were able to assess the implications of specific illnesses or diseases for a partner's risk of death.
The findings, says Christakis, are striking. "When a spouse is hospitalized, the partner's risk of death increases significantly and remains elevated for up to two years," he notes. The period of greatest risk is over the short run, within 30 days of a spouse's hospitalization or death. Over this time frame, hospitalization in a spouse can confer to a partner almost as much risk of dying as the actual death of a spouse.
"Spousal illness or death may impose stress on a partner or deprive a partner of social, emotional, economic, or other practical support," says Christakis. "When a spouse falls ill or dies, partners may increase harmful behavior, such as drinking. Stress and lack of social support may also adversely affect immunologic measures, so spousal hospitalization may have physiological effects on partners."
"This is a highly innovative study--in an enormous sample of older people--demonstrates yet another important connection between social networks and health," says Richard M. Suzman, PhD, associate director of the National Institute of Aging for Behavior and Social Research. "We don't yet know the full extent to which social networks affect health. We need to explore the mechanisms behind the stresses associated with these hospitalizations as we look for ways to protect people when their central relationships are disrupted."
The study found that certain illnesses in a spouse are more harmful to partners than others. The more a disease interferes with a spouse's physical or mental ability, and the more burdensome it is, the worse for the health of the partner.
The study also found that specific illnesses impacted the spouse differently. For instance, among men with hospitalized wives, if the wife was hospitalized for colon cancer, there was almost no effect on her husband's mortality. But if a wife was hospitalized with heart disease, her husband's risk of death was 12 percent higher than it would be if the wife was not sick at all. If a wife was hospitalized with dementia, her husband's risk was 22 percent higher. Similar effects were seen in women whose husbands were hospitalized.
Further analyses also confirmed that the death of a spouse within the past 30 days was harmful. The death of a wife in the previous 30 days increased her husband's risk of death 53 percent, and the death of a husband increased his wife's risk of death by 61 percent.