Spousal loss linked to higher risk of dementia, mortality among men, but not women

The loss of a spouse is an incredibly emotional and stressful experience, and as populations continue to live longer lives, more couples will experience this distress. But spousal bereavement appears to affect genders differently, according to a new study led by Boston University School of Public Health (BUSPH) and Chiba University.

Published in the Journal of Affective Disorders, the study examined spousal bereavement among older adults in Japan and found that widowed men experienced poorer physical and mental health and well-being, whereas widowed women showed only a short-term decrease in happiness and no change in other aspects of their health, and even improved their overall well-being in subsequent years.

Compared to non-widowed men, men who lost a spouse were at higher risk for dementia, mortality, and daily functioning, as well as depression and a decrease in happiness and social support, which all gradually subsided over time. Women, however, appeared to withstand these health effects after losing their husband, showing no increase in depressive symptoms, and often an increase in happiness and life satisfaction that lasted years after their loss.

Previous research has shown few gender differences in the health burdens of spousal bereavement and primarily focused on narrower lists of outcomes, so the new findings shed valuable insight into the wide-ranging dimensions of health and well-being after spousal loss and underscore the need for gender-specific strategies to support recovery after this difficult life event.

“Losing a spouse is a disruptive life event that can influence far more than grief alone,” says study senior author Dr. Koichiro Shiba, assistant professor of epidemiology at BUSPH. “We found that widowed men were hit harder in almost every way, while widowed women showed a surprising degree of resilience.”

The study’s lead author is Dr. Kenjiro Kawaguchi of the Center for Preventive Medical Sciences at Chiba University in Chiba, Japan.

For the analysis, researchers utilized data among nearly 26,000 participants in the Japan Gerontological Evaluation Study, of which 1,076 experienced spousal bereavement. The team examined 37 different health outcomes of spousal loss in three waves (2013, 2016, and 2019), analyzing differences by gender and duration over time.

Both widowed men and women became more socially active after the death of their spouse, but only men experienced a reduction in social support, suggesting that socializing didn’t always translate into the source of emotional support and connection that they needed during their grieving period. Men also reported an increase in alcohol consumption, while women became more sedentary.

These differences likely reflect long-held distinctions in cultural expectations for the role of each gender, Dr. Shiba says.

“In Japan, and in many cultures, men's lives tend to revolve more around work, and they often rely heavily on their spouse for emotional and practical support,” he says. As a result, men may have had fewer opportunities to invest in social connections and then feel isolated once they lose their spouse. Additionally, Dr. Shiba says, "women in Japan are much more likely to be the primary caregivers for their spouses. For some women, bereavement may partly involve relief from that burden, which could help explain the improvements we saw in well-being.”

More research on relationship quality, caregiving intensity, and other health factors is needed to fully understand the health consequences of spousal loss, but addressing these underlying imbalances in gendered social roles is a step in the right direction towards reducing these adverse outcomes for both widowed men and women. There are also health-protective actions that widowed spouses can take early on in their grieving period.

“The first year after bereavement appears to be a particularly high-risk period for men, so proactive outreach by family, friends, and clinicians may be useful,” Dr. Shiba says. “Monitoring for loneliness and unhealthy coping behaviors like increased alcohol use may also be important.”

Reference:

Kenjiro Kawaguchi, Atsushi Nakagomi, Kazushige Ide, Kokoro Shirai, Chie Koga, Yu-Ru Chen, Katsunori Kondo, Koichiro Shiba, Health and well-being after spousal loss among older men and women, bJournal of Affective Disorders, https://doi.org/10.1016/j.jad.2026.121391.