Journal Article

Is impending or actual death of a spouse with dementia bad for mental health? Antidepressant use surrounding widowhood

Einiö, E., Metsä-Simola, N., Saarioja, S., Martikainen, P., Korhonen, K.
European Journal of Public Health, 30:5, 953–957 (2020)
Open Access

Abstract

Background: 
Previous studies have shown that the risk of death is elevated after the death of a spouse. Limited evidence is available on changes in mental health before and after bereavement among individuals whose spouse dies of dementia.
Methods:
We analyzed changes in the 3-month prevalence of antidepressant use for 5 years before and 3 years after widowhood for individuals whose spouses died of either dementia or other causes. The study used data of 41 855 widowed individuals and repeated-measures logistic regression analyses. Antidepressant use was based on the prescription register of Finland in 1995–2007.
Results:
Five years before widowhood, the 3-month prevalence for antidepressant use was 4% among widowing men and 6–7% among widowing women, regardless of whether the spouse died of dementia or other causes. Further changes in antidepressant use depended on a spouse’s cause of death. Women whose spouses died of dementia experienced large increase in antidepressant use starting from 3 to 4 years prior to widowhood, whereas other widows did not experience large increase until after widowhood. The trajectories for men were similar. Antidepressant use following the death of a spouse with dementia stayed at a new heightened level after widowhood.
Conclusions:
The trajectories of antidepressant use indicate that the process of losing a spouse to dementia is bad for mental health, already a few years prior to widowhood. There are no clear improvements in mental health after the death of a spouse with dementia. Support services for individuals whose spouses’ dementia progresses are needed.

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