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Losing a spouse late in life linked to cognitive decline

By Carolyn Crist

(Reuters Health) - Older adults who lose a spouse may be more vulnerable to cognitive decline in subsequent years and require extra support and monitoring, researchers say.

In the study of nearly 7,000 middle aged and older men and women, cognitive functioning declined over time for everyone, but it degraded slightly more and slightly faster for those who had been widowed, regardless of whether they remarried.

At the same time, having a high level of education or at least one living sibling appeared to protect against the decline associated with widowhood, the study team reports in the American Journal of Geriatric Psychiatry.

"We've all come to know the importance of cognitive functioning among older adults," said study co-author Giyeon Kim, a psychology researcher at Chung-Ang University in Seoul, South Korea.

"While we expected to find the effect of widowhood status on cognitive decline, we were fascinated by our findings on the protective effects of having at least one living sibling and higher education," Kim told Reuters Health by email.

On the theory that stress contributes over time to cognitive decline, and widowhood would bring added stress, the researchers analyzed data on 6,766 U.S. adults over age 50 who took part in the 1996-2012 Health and Retirement Study. The study team assessed widow/widower status, cognitive functioning test scores and other factors such as bereavement, education, remarriage, health status, race and living family members.

The cognitive functioning score was based on several tasks, including immediate word recall, delayed word recall, counting backwards from 20, and ability to name objects, data and current president and vice president.

The analysis found that 2,742 adults overall experienced widowhood, and in the oldest age group - over age 70 - the majority of individuals were widowed by the end of the study period.

Cognitive scores for widows/widowers were consistently more than half a point lower than for peers who were not widowed. Further, every additional year of widowhood decreased individuals' cognition score by a quarter of a point. The decline occurred regardless of remarriage status or the spouse's condition before death, the researchers note.

The loneliness associated with widowhood may be a major part of the cognitive decline, and having living siblings, adult children and friends can provide that social interaction to prevent some decline, said Anna Sundstrom of Umea University in Sweden, who wasn't involved in the study.

"Widowhood has a deep negative impact on both mental and physical health," Sundstrom said in an email. "The growth of the aging population worldwide may bring with it an increasing number of lonely elderly."

"There are also things you can do now to protect your cognition as you age," said Keith Fargo, director of scientific programs and outreach at the Alzheimer's Association in Chicago, who wasn't involved in the study.

The Alzheimer's Association offers a resource called 10 Ways to Love Your Brain (https://bit.ly/2xXvEE4) listing lifestyle habits that help stave off cognitive decline. For instance, healthy eating, exercise, sleep, education and social activity help the brain to age slower, Fargo said.

"It's easy to fall into a fatalistic attitude that our cognition will get worse as we get older, but we can do things now to keep it as healthy as we can," he said in a telephone interview.

"Now is the time to start," Fargo added. "Don't wait until something negative such as widowhood happens. These are lifelong habits that you can't start too soon."

SOURCE: https://bit.ly/2vtMD4i American Journal of Geriatric Psychiatry, online March 26, 2018.

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