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Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study

OBJECTIVE: This study investigates the association between bereavement and the mortality of a surviving spouse among Amish couples. We hypothesised that the bereavement effect would be relatively small in the Amish due to the unusually cohesive social structure of the Amish that might attenuate the...

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Autores principales: Seifter, Ari, Singh, Sarabdeep, McArdle, Patrick F, Ryan, Kathleen A, Shuldiner, Alan R, Mitchell, Braxton D, Schäffer, Alejandro A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902313/
https://www.ncbi.nlm.nih.gov/pubmed/24435888
http://dx.doi.org/10.1136/bmjopen-2013-003670
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author Seifter, Ari
Singh, Sarabdeep
McArdle, Patrick F
Ryan, Kathleen A
Shuldiner, Alan R
Mitchell, Braxton D
Schäffer, Alejandro A
author_facet Seifter, Ari
Singh, Sarabdeep
McArdle, Patrick F
Ryan, Kathleen A
Shuldiner, Alan R
Mitchell, Braxton D
Schäffer, Alejandro A
author_sort Seifter, Ari
collection PubMed
description OBJECTIVE: This study investigates the association between bereavement and the mortality of a surviving spouse among Amish couples. We hypothesised that the bereavement effect would be relatively small in the Amish due to the unusually cohesive social structure of the Amish that might attenuate the loss of spousal support. DESIGN: Population-based cohort study. SETTING: The USA. PARTICIPANTS: 10 892 Amish couples born during 1725–1900 located in Pennsylvania, Ohio and Indiana. All the participants are deceased. OUTCOME MEASURES: The survival time is ‘age’; event is ‘death’. Hazard ratios (HRs) of widowed individuals with respect to gender, age at widowhood, remarriage, the number of surviving children and time since bereavement. RESULTS: We observed HRs for widowhood ranging from 1.06 to 1.26 over the study period (nearly all differences significant at p<0.05). Mortality risks tended to be higher in men than in women and in younger compared with older bereaved spouses. There were significantly increased mortality risks in widows and widowers who did not remarry. We observed a higher number of surviving children to be associated with increased mortality in men and women. Mortality risk following bereavement was higher in the first 6 months among men and women. CONCLUSIONS: We conclude that bereavement effects remain apparent even in this socially cohesive Amish community. Remarriage is associated with a significant decrease in the mortality risk among Amish individuals. Contrary to results from previous studies, an increase in the number of surviving children was associated with decreased survival rate.
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spelling pubmed-39023132014-01-27 Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study Seifter, Ari Singh, Sarabdeep McArdle, Patrick F Ryan, Kathleen A Shuldiner, Alan R Mitchell, Braxton D Schäffer, Alejandro A BMJ Open Epidemiology OBJECTIVE: This study investigates the association between bereavement and the mortality of a surviving spouse among Amish couples. We hypothesised that the bereavement effect would be relatively small in the Amish due to the unusually cohesive social structure of the Amish that might attenuate the loss of spousal support. DESIGN: Population-based cohort study. SETTING: The USA. PARTICIPANTS: 10 892 Amish couples born during 1725–1900 located in Pennsylvania, Ohio and Indiana. All the participants are deceased. OUTCOME MEASURES: The survival time is ‘age’; event is ‘death’. Hazard ratios (HRs) of widowed individuals with respect to gender, age at widowhood, remarriage, the number of surviving children and time since bereavement. RESULTS: We observed HRs for widowhood ranging from 1.06 to 1.26 over the study period (nearly all differences significant at p<0.05). Mortality risks tended to be higher in men than in women and in younger compared with older bereaved spouses. There were significantly increased mortality risks in widows and widowers who did not remarry. We observed a higher number of surviving children to be associated with increased mortality in men and women. Mortality risk following bereavement was higher in the first 6 months among men and women. CONCLUSIONS: We conclude that bereavement effects remain apparent even in this socially cohesive Amish community. Remarriage is associated with a significant decrease in the mortality risk among Amish individuals. Contrary to results from previous studies, an increase in the number of surviving children was associated with decreased survival rate. BMJ Publishing Group 2014-01-15 /pmc/articles/PMC3902313/ /pubmed/24435888 http://dx.doi.org/10.1136/bmjopen-2013-003670 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Epidemiology
Seifter, Ari
Singh, Sarabdeep
McArdle, Patrick F
Ryan, Kathleen A
Shuldiner, Alan R
Mitchell, Braxton D
Schäffer, Alejandro A
Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study
title Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study
title_full Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study
title_fullStr Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study
title_full_unstemmed Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study
title_short Analysis of the bereavement effect after the death of a spouse in the Amish: a population-based retrospective cohort study
title_sort analysis of the bereavement effect after the death of a spouse in the amish: a population-based retrospective cohort study
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902313/
https://www.ncbi.nlm.nih.gov/pubmed/24435888
http://dx.doi.org/10.1136/bmjopen-2013-003670
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