Spouse's Hospitalization Can Take Heavy Toll

Stress boosts death risk for healthy partner, study finds

WEDNESDAY, Feb. 15, 2006 (HealthDay News) -- The stress of having a husband or wife hospitalized raises your risk for death, a new study suggests.

In other words, it may be true that "you can die of a broken heart -- not only when your spouse dies, but when your spouse gets ill," said lead researcher Dr. Nicholas A. Christakis, a professor of health-care policy at Harvard Medical School.

He believes the finding -- which is based on a study of thousands of Medicare records -- has implications not only for families, but for doctors and society in general.

The study appears in the Feb. 16 issue of the New England Journal of Medicine.

Christakis, along with co-researcher Paul D. Allison, a statistician at the University of Pennsylvania, studied the records of more than half a million couples enrolled in Medicare from 1993 to 2001.

"I take care of terminally ill patients, and I have seen the toll on loved ones of having a spouse hospitalized," Christakis said. So when he and Allison started the study, they looked at couples who experienced not only death, but hospitalization as well.

Experts have long known that the death of a husband or wife increases the chance that the surviving spouse will die soon afterward.

The new study enlarges on that picture, suggesting that having a husband or wife hospitalized for a serious illness is about a one-quarter as tough on the other spouse as having that loved one die.

The nature of the illness also plays a large role in the mental and physical toll hospitalization takes on a healthy spouse. For example, among men, 6.4 percent died within a year of their wife's hospitalization for colon cancer, 6.9 percent when the cause was stroke, 7.5 percent when the cause was a psychiatric disease and 8.6 percent when the cause was dementia, including Alzheimer's disease.

Among women, the one-year death rate was 3 percent when a husband was hospitalized for colon cancer, 3.7 percent when the cause was stroke, 5.7 percent when the cause was psychiatric disease, and 5 percent when the cause was dementia.

"The 'disablingness' of the disease -- more than whether it kills you -- can harm the health of a partner," Christakis said.

He noted that the death rate after a spouse's hospitalization followed a U-shaped curve -- there's a spike soon after hospitalization, a gradual drop and then a slow rise again. That second rise probably occurs as the impact of having a spouse away from home takes hold, Christakis said.

Married couples tend to parcel out daily functions, often with the husband looking after finances and the wife in charge of social life, Christakis explained. This means a wife must suddenly deal with the new challenge of writing out checks if the husband is gone, or the husband slips into gradual isolation as his social ties fray.

There's a message here for the grown-up, 'baby boomer' children of today's elderly, added Dr. Suzanne Salamon, associate chief of geriatric psychiatry at Beth Israel Deaconess Hospital in Boston.

She pointed out that today's elderly grew up in the Great Depression, when most were trained to hide their feelings amid general suffering.

That means their grown offspring "should trust their instincts and not accept what [their parents] say when they say they are feeling fine, because they may be covering up," Salamon said.

The findings may also have implications for doctors and health-care policy, Christakis said. "The realization that the health of people is interconnected can influence health care," he said.

Christakis gave the example of hip replacement surgery, which some physicians might hesitate to do because of its high cost. "Knowing that replacement of a hip can save the life of a partner might affect our decision," he said.

More information

Health information for older people is offered by the U.S. National Institutes of Health.

SOURCES: Nicholas D. Christakis, professor, health-care policy, Harvard Medical School, Boston; Suzanne Salamon, M.D., associate chief, geriatic psychiatry, Beth Israel Deaconess Hospital, Boston; Feb. 16, 2006, New England Journal of Medicine
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