CHICAGO – Highlighting the deep bonds between longtime husbands and wives, new research suggests that when an older person falls seriously ill, his or her spouse faces a heightened risk of death.
“We showed that you can die of a broken heart not just when your partner dies, but also when your partner falls ill,” said Dr. Nicholas Christakis, lead author of the study and a professor at Harvard Medical School.
The study, published Thursday in the New England Journal of Medicine, followed more than 518,000 elderly couples for nine years. It found the risk of death rose nearly 5 percent for a husband whose wife was hospitalized – a marker for the onset of serious illness – and nearly 3 percent for a wife whose husband took ill.
The risk of a husband or wife dying increased if the sick spouse became severely disabled. For instance, a woman whose husband was hospitalized with dementia was 28 percent more likely to die than if her husband had remained healthy; for congestive heart failure, the figure was 15 percent.
Christakis’ findings highlight how interconnected the health of married couples can become after a long life together.
“I see this all the time. When one partner gets sick, the other one frequently winds up doing poorly and often dying also,” said Dr. Roman Kozyckyj, a palliative care physician at Advocate Christ Hospital in the Oak Lawn section of Chicago.
Though it has long been known that widows or widowers often die soon after their spouse passes away – a phenomenon known as the “bereavement effect” – Christakis’ research is the first to look at the impact of serious illness on husbands and wives’ death.
It shows that medical risks to a spouse appear to be highest immediately after a medical crisis. In the first 30 days following a wife’s hospitalization, a husband’s risk of dying rises 35 percent, the Harvard study found. During the first month after a husband’s hospitalization, a wife’s risk of dying soars 44 percent.
Stress appears to be a major factor in the causes of death, which include heart attacks, accidents, infections and suicide, Christakis said.
Last year, a study in the New England Journal of Medicine cited the dangers of what researchers described as “broken heart syndrome” – a stress-related shock to the heart that can result in sudden death.
Carol Levine, director of the families and health care project at United Hospital Fund in New York, remembers feeling a deep sense of panic after her husband was hospitalized with a brain stem injury 15 years ago after a car crash.
“You’re in an upside-down world where you have no control,” she said.
Years after the onset of a husband or wife’s serious illness, the spouse remains at a smaller but still elevated risk of dying, the Christakis study discovered. Increased social isolation, the long-term burden of caregiving and personal neglect may be factors, he speculated.
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Bertha Martinez, who lives in Chicago suburb of Lemont, experienced all these difficulties after her husband Javier collapsed in the hospital almost four years ago.
Martinez stopped eating regularly and lost 25 pounds, she said. Beset by anxiety, she has trouble sleeping at night. Every day she worries that something new could go wrong with her husband, a former semi-professional soccer player who is permanently disabled after suffering two strokes.
“It’s a continuous fear that I’ll lose him, that suddenly he’ll be gone,” said Martinez, who cares for her husband around the clock.
Even when a large lump appeared in her throat, Martinez put off scheduling doctors’ visits. Friends told her bluntly: “You look older than Javier. You have to take care of yourself,” she recalled. “And I’m like, oh, well, who has the time? I’m so stressed already, how can I think about that?”
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Dr. Martin Gorbien, director of geriatric medicine at Rush University Medical Center in Chicago, said it’s common for so-called “well” spouses to neglect themselves and decline physically when caring for a seriously ill husband or wife.
When an older woman comes in with her sick husband, “I try to say, “Mrs. Jones, I know you’re not my patient, but I want to make sure you have a doctor and you’re attending to your needs,’
” Gorbien said. “You don’t want to let two ships sink when one person becomes sick, if you can help it.”
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Suzanne Mintz, president of the National Family Caregivers Association, said the Harvard study reinforced the need for a new question on every older patient’s medical history – “Do you care for a loved one who’s chronically ill or disabled?”
Dr. Vince Bufalino, president of Midwest Heart Specialists, said the message to physicians here is: “Hey guys, we need to be paying more attention.”
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AP-NY-02-15-06 1956EST
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