Spousal caregiving, widowhood, and cognition: A systematic review and a biopsychosocial framework for understanding the relationship between interpersonal losses and dementia risk in older adulthood

E. Lydia Wu-Chung, Stephanie L. Leal, Bryan T. Denny, Samantha L. Cheng, Christopher P. Fagundes

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Accumulating research suggests that stressful life events, especially those that threaten close intimate bonds, are associated with an increased risk of dementia. Grieving the loss of a spouse, whether in the form of caregiving or after the death, ranks among 'life's most significant stressors’, evoking intense psychological and physiological distress. Despite numerous studies reporting elevated dementia risk or poorer cognition among spousal caregivers and widow(er)s compared to controls, no review has summarized findings across cognitive outcomes (i.e., dementia incidence, cognitive impairment rates, cognitive performance) or proposed a theoretical model for understanding the links between partner loss and abnormal cognitive decline. The current systematic review summarizes findings across 64 empirical studies. Overall, both cross-sectional and longitudinal studies revealed an adverse association between partner loss and cognitive outcomes. In turn, we propose a biopsychosocial model of cognitive decline that explains how caregiving and bereavement may position some to develop cognitive impairment or Alzheimer's disease and related dementias. More longitudinal studies that focus on the biopsychosocial context of caregivers and widow(er)s are needed.

Original languageEnglish (US)
Article number104487
JournalNeuroscience and Biobehavioral Reviews
Volume134
DOIs
StatePublished - Mar 2022

Keywords

  • Alzheimer's disease
  • Close relationships
  • Cognition
  • Cognitive decline
  • Cognitive impairment
  • Dementia
  • Depression
  • Glucocorticoids
  • Inflammation
  • Interpersonal loss
  • Spousal caregiving
  • Stress
  • Widowhood

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience

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