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New review article examines phenomenon
of unexpected death of Elderly Surviving Spouses
due to cardiovascular events

High Survivor Mortality Patterns and Ways to Decrease Mortality, Published in Southern Medical Journal

MIAMI, Jan. 24 /PRNewswire/ -- A newly released review article shows that a surviving elderly spouse has a substantially increased risk of death within two years after losing a spouse. This is the focus of a new article entitled, "Depression as a Mediator Between Spousal Bereavement and Mortality From Cardiovascular Disease," published in the January 2005 issue of Southern Medical Journal, Vol. 98, No. 1.

These deaths are often due to cardiovascular events, even in survivors with no known cardiovascular disease (CVD). According to medical data compiled and analyzed in the study, author J. Richard Williams, MD, former vice chairman and chief patient care officer for VITAS Healthcare Corporation, also finds that healthy bereaved men are twice as likely to die as healthy men who are not grieving.

"The subject of this review is one that has puzzled both laymen and medical experts for years," observed Dr. Williams, a noted end-of-life care expert, speaker and author of "The Surviving Spouse," a handbook published by VITAS Healthcare Corporation and the VITAS Charitable Foundation that examines the effects of grief on spouses.

This newly published review notes that depression carries an increased incidence of death from cardiovascular events, perhaps because of physiologic processes similar to those implicated in acute cardiac death, such as increased release of catecholamine, changes in platelet activation and higher levels of stress hormones.

"The study underscores the role of depression and the reasons why men and women sometimes simply 'give up' after a life partner has died," explains Dr. Williams. "It also emphasizes the importance of developing social networks, monitoring the normal and abnormal reactions to stress, and initiating beneficial health behaviors for the surviving spouse."

In the article, Dr. Williams notes the results from a 12-month structured program of psychological support, including support groups, provided for bereaved spouses by a hospice. Surviving spouses used hospitals and clinics significantly less than spouses in nonintervention and limited-intervention groups. Although these results to date have not shown a reduction in CVD events or mortality rates from psychosocial or pharmacologic antidepressant therapy, such treatments do reduce depressive symptoms.

The article also confirms that personal activities, such as social or religious activities, can add value and purpose to life and have a positive influence on survival and health. It also reports that among 265 recently bereaved adults, higher religious coping scores correlated with better health and lower use of healthcare services.

The study concludes with a caution to physicians to be alert for major depression or traumatic grief in survivors, especially elderly survivors. When these symptoms are present, physicians should consider intervening with psychotherapy and/or antidepressants.

Dr. Williams is currently adjunct Assistant Professor, Department of Nursing, Western Carolina University, Cullowhee, North Carolina.

For a copy of the article, please visit http://www.smajournalonline.com/. To order The Surviving Spouse handbook, please visit the National Hospice and Palliative Care Organization's marketplace at http://www.nhpco.org/marketplace.