Marriage is such a strong bond that if one partner falls seriously ill or dies, the healthy spouse is put at a significant risk of dying, suggests the largest study yet of couples over 65.
Numerous studies have shown the health benefits of marriage over single life. But if one spouse is hospitalised, the other partners chance of dying increases significantly for up to two years, researchers found.
They suggest that a couples鈥� combined health should be considered when treating elderly patients.
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鈥淥ur study shows that people are interconnected and so their health is interconnected,鈥� says Nicholas Christakis, at Harvard Medical School, Boston, US, who carried out the study with Paul Allison at the University of Pennsylvania.
Broken heart
The nine-year study followed over half a million elderly couples. In that time, 74% of husbands and 67% of wives were hospitalised at least once and 49% of husbands and 30% of wives died. Christakis and Allison quantified the 鈥渃aregiver burden鈥� 鈥� how illness in one partner affected the health of the other partner 鈥� and the 鈥渨idower effect鈥� 鈥� first described in 1848 as death from a broken heart.
The first 30 days after death of a spouse were the most risky for the other partner 鈥� risk of death for a surviving wife rose by 61% and for a husband by 53%. The odds were barely better for those whose partners had not died but were hospitalised. Stress, lack of social and practical support all combine to trigger illness in the healthy spouse, and they may increase risky behaviours such as heavy drinking, the researchers say.
However, the risks differed according to the type of illness, Christakis says. 鈥淔or example, if a wife is diagnosed with lung cancer her risk of dying within the year is 55%, and her husband鈥檚 risk of dying in that year is 5.6%. But if she is diagnosed with congestive heart failure, her risk of dying in a year is 25%, but the husband鈥檚 risk is 7.5%.鈥�
Intrinsically healthy
鈥淪o it is worse for a husband if his wife has the less serious heart problem 鈥� characterised by disability 鈥� than if she has lung cancer. The illnesses that confer the most risk on the other partner are those that are the most physically or mentally disabling for longest, since they are the most burdensome on the caregiving partner,鈥� he told New 杏吧原创.
However, marriage is intrinsically healthy 鈥� even the elevated health risks involved in losing a partner to illness or death are lower than for those who are single or who have never married, Christakis points out.
鈥淭his is a highly innovative study,鈥� says Richard Suzman, at the US National Institute on Aging, which funded the research. 鈥淲e need to explore the mechanisms behind the stresses associated with hospitalisations as we look for ways to protect people when their central relationships are disrupted.鈥�
Journal reference: New England Journal of Medicine (vol 354, p 719)
