Cause-specific mortality after spousal bereavement in a Danish register-based cohort.
| Title: | Cause-specific mortality after spousal bereavement in a Danish register-based cohort. |
|---|---|
| Authors: | Sloth MMB; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. mathilde.sloth@sund.ku.dk.; Data Science Lab, Statistics Denmark, Copenhagen, Denmark. mathilde.sloth@sund.ku.dk.; Hruza J; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Mortensen LH; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Data Science Lab, Statistics Denmark, Copenhagen, Denmark.; The ROCKWOOL Foundation, Ny Kongensgade 6, 1472, Copenhagen K, Copenhagen, Denmark.; Bhatt S; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Department of Infectious Disease Epidemiology, Imperial College London, London, UK.; Katsiferis A; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Data Science Lab, Statistics Denmark, Copenhagen, Denmark. |
| Source: | Scientific reports [Sci Rep] 2025 Feb 20; Vol. 15 (1), pp. 6240. Date of Electronic Publication: 2025 Feb 20. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : Nature Publishing Group, copyright 2011- |
| MeSH Terms: | Spouses*/psychology ; Bereavement*; Denmark/epidemiology ; Cardiovascular Diseases/mortality ; Humans ; Male ; Female ; Aged ; Registries ; Cause of Death ; Cohort Studies ; Aged, 80 and over ; Risk Factors |
| Abstract: | Spousal bereavement is associated with increased all-cause mortality, but less is known for cause-specific mortality. We estimated the average effect of bereavement on cause-specific mortality. Furthermore, we developed and evaluated the performance of prediction models estimating individualized mortality risks. This matched cohort study leveraged nationwide registry data on 223,500 married Danish individuals aged ≥ 65 years. Individuals were followed from bereavement date until death, emigration, or 3-year end of follow-up. G-estimation was used to estimate the average effect of bereavement on cause-specific mortality. Risk prediction models were developed and internally validated using logistic regression and Extreme Gradient Boosting utilizing information on sociodemographic factors and healthcare expenditures prior to bereavement. Among males, bereavement was associated with increased 3-year mortality from cardiovascular disease (CVD) (Risk Difference: 8 deaths/1000 individuals [95% confidence intervals (CI) 3;13]), digestive diseases (3 [95% CI 1;5]), psychiatric diseases/suicide (3 [95% CI 1;5]), and respiratory diseases (4 [95% CI 1;8]) and decreased 3-year mortality for dying from dementia/Parkinson's disease (-4 [95% CI -6;-2]). Among females, bereavement was only associated with increased 3-year mortality from CVD (5 [95% CI 3;7 ]) and from psychiatric diseases/suicide (1 [95% CI 1;2]). The prediction models developed using sociodemographic information and healthcare expenditures showed limited accuracy in identifying cause-specific mortality risk. On average, spousal bereavement slightly elevated the risk for most causes of death for males and less so for females. Despite incorporating comprehensive healthcare and sociodemographic data, accurately predicting individual cause-specific mortality remains challenging.; (© 2025. The Author(s).) |
| Competing Interests: | Declarations. Competing interests: The authors declare no competing interests. Ethics Declaration: All methods were performed in accordance with the relevant guidelines and regulations. Danish legislation allows for register-based research of this type to be conducted without the consent of participants and without ethical committee approval37. The study was conducted according to the rules of the Danish Data Protection Agency. All data was held at Statistics Denmark, which is the Danish national statistical institution. |
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| Grant Information: | NNF20OC0059309 Novo Nordisk Fonden; NNF17OC0027594 Novo Nordisk Fonden |
| Contributed Indexing: | Keywords: Cause-specific mortality; Cohort study; Counterfactuals; Machine learning; Prediction; Spousal bereavement |
| Entry Date(s): | Date Created: 20250220 Date Completed: 20250509 Latest Revision: 20250509 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11842573 |
| DOI: | 10.1038/s41598-025-90657-1 |
| PMID: | 39979402 |
| Database: | MEDLINE |
Journal Article