MGH Study: Widowhood May Accelerate Cognitive Decline; Women Most at Risk
The death of a partner can trigger a cascade of devastating emotional and even physical symptoms. The loss of intimacy, companionship and support facing life’s everyday and long-term challenges can change how a person thinks, feels and behaves in some profound ways.
And according to a recent study by researchers from Massachusetts General Hospital (MGH) and Brigham and Women’s Hospital, widowhood may also cause a more rapid decline in thinking skills and memory. Researchers analyzed older, cognitively healthy adults enrolled in the Harvard Aging Brain Study, determining their marital status and beta-amyloid protein levels, among other important factors at the start of the study. The investigators found that individuals who were widowed experienced a sharper cognitive decline than their married peers. This was particularly significant among those who had high beta-amyloid levels. In a brain affected by Alzheimer’s disease, beta-amyloid protein forms plaques that collect in between neurons, harming their function.
“We know that social relationships can be an important buffer against cognitive decline,” says senior author Nancy Donovan, MD, of the Division of Geriatric Psychiatry at Brigham and Women’s Hospital and an associate researcher at MGH. “Being married provides opportunity for more social engagement and emotional support from a spouse, it expands one’s social network and it provides more opportunity for cognitive stimulation. All of these benefits are lost in widowhood. Importantly, loss of a spouse is a highly stressful life event which can have deleterious effects on the brain.”
Widowhood and Cognition
This study underscores the findings of previous research linking widowhood and a variety of thinking skills challenges. A 2004 study involving more than 4,000 older adults, for example, found that women more than men tend to experience declines in executive function (organizing, planning, problem-solving) in the first two years after losing a partner. However, executive function then tends to improve over time.
Other studies have found that grief-related stress is associated with reduced volume of the hippocampus and other memory structures in the brain. And a 2018 study of nearly 7,000 middle-aged men and women found a strong association between accelerated cognitive decline and widowhood. In that study, however, having a high level of education or having at least one living sibling appeared to protect somewhat against cognitive decline associated with widowhood.
Having close siblings or friends may help buffer against the loneliness that too often accompanies widowhood. Loneliness is a significant risk factor for cognitive decline and mood disorders in older adults.
Mental Health Risks
Indeed, the most serious depression and anxiety symptoms often appear in the first year after losing a partner. In a study of more than 120,000 women several years ago, researchers found that those who were widowed within the previous year reported substantially higher rates of depressed mood, poorer social functioning, and lower physical and mental health functioning than women who had been widowed for more than a year. And because women are more likely than men to become widowed, women are at a higher risk for worse outcomes.
The key, experts agree, is to share your thoughts and feelings about your loss with friends and relatives or consider seeing a grief counselor or other type of therapist or joining a support group as soon as you can. Opening up sooner than later can making the grieving process easier.
You should also accept offers of help and invitations to spend time with others. Social interaction may be difficult in some circumstances, but its protective benefits against mental and cognitive decline are undeniable.
Looking Ahead
There is still much to learn about the cognitive and emotional effects of widowhood and how one of life’s great stressors can be best managed.
The MGH study findings, published in JAMA Network Open, suggest that widowhood may be an important, yet understudied, risk factor for cognitive decline associated with Alzheimer’s disease. The researchers are hopeful that the results can be replicated in future studies.
“Our division has become very interested in understanding the physiological effects of widowhood so that we can develop interventions to try to alter these trajectories,” says Dr. Donovan. “Our findings also suggest that researchers engaged in Alzheimer’s disease prevention trials may want to pay particular attention to widowed older adults to tailor interventions for this especially susceptible group of patients.”
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