Cause-specific mortality after spousal bereavement in a Danish register-based cohort
File(s)
Published version
Author(s)
Marie Brünnich Sloth, Mathilde
Hruza, Johannes
Mortensen, Laust Hvas
Bhatt, Samir
Katsiferis, Alexandros
Type
Journal Article
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.
Date Issued
2025-02-20
Date Acceptance
2025-02-14
Citation
Scientific Reports, 2025, 15
ISSN
2045-2322
Publisher
Nature Portfolio
Journal / Book Title
Scientific Reports
Volume
15
Copyright Statement
© The Author(s) 2025 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1038/s41598-025-90657-1
Subjects
Spousal bereavement
Cause-specific mortality
Cohort study
Counterfactuals
Machine learning
Prediction
Publication Status
Published
Article Number
6240
Date Publish Online
2025-02-20