Magazine article Clinical Psychiatry News

Widowhood Appears Not to Speed Onset of Dementia

Magazine article Clinical Psychiatry News

Widowhood Appears Not to Speed Onset of Dementia

Article excerpt

AT AAIC 2014

COPENHAGEN -- Losing a spouse has been associated with the broken heart syndrome and other adverse health outcomes, but the loss seems to have a paradoxical effect on the development of dementia.

An analysis of a large national database showed that individuals who had a mild cognitive impairment (MCI) and lost a spouse developed dementia significantly later than did those who hadn't lose a spouse.

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"Initially, we said this can't be right," Dr. Bryan K. Woodruff of the Mayo Clinic in Scottsdale, Ariz., said in an interview at the annual meeting of the Alzheimer's Association International Conference.

"But what we think is happening is when somebody loses their spouse and they've got MCI, that individual isn't going to continue to live independently, so we think extended family is coming in and recognizing that this person needs more help now that the spouse is gone, getting them into assisted living or other arrangements. And the married couple continues to plug along without getting extended support," Dr. Woodruff said.

The finding hints at the need for mobilizing more support for married couples, too, Dr. Woodruff said. "This needs to start at the MCI stage, to increase support for the MCI person and also the spouse."

Dr. Woodruff and his colleagues selected 3,783 married individuals with MCI using the National Alzheimer's Coordinating Center (NACC) database from September 2005 to September 2013. The subjects were enrolled in a National Institute of Aging-Alzheimer's Disease Center, and stayed in the study for up to 7.5 years. Those who were divorced or separated were excluded, and so were those without follow-up.

Of the remaining 2,457 individuals, 134 were widowed and the rest stayed married. A total of 1,078 developed dementia.

At first visit, the widowed individuals were significantly more often older, female, a carrier of the apolipoprotein E epsilon-4 (APOE epsilon-4) allele, and less educated.

Results showed that the median age of dementia onset in the widowed group was 92 years, compared with 83 years in the married group (hazard ratio, 0.36; 95% confidence interval, 0.26-0.48; P less than .001). Adjustment for sex, presence of an APOE epsilon-4 allele, and age did not substantially affect the hazard ratio calculated for the risk of dementia after losing a spouse, the authors wrote. …

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