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J Nurs Res. 2013 Jun;21(2):110-9. doi: 10.1097/jnr.0b013e3182921ff6.

The impacts of widowhood, chronic disease, and physical function on mortality among older people.

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Department of International Business, Ling Tung University.



Age-related physical and mental health is well documented. The numbers of widows and widowers are rising in Taiwan. Thus, it is worthwhile to consider factors affecting survival rates after the death of a spouse.


This study examined the impacts of widowhood, chronic disease, and physical function on mortality risk among the older people in Taiwan.


A panel data design was applied to investigate the hazard ratio of mortality among the older people. Subject data were obtained from the 2003 Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan and linked to the 2003-2007 national death registry data. Cox proportional hazard models were used to examine the relationships between survival rates and factors including status as a widower or widow, chronic disease, and physical function disability.


After controlling for potentially confounding variables, survival analysis indicated a relatively higher mortality risk among the widowed compared with those whose spouses were still alive. Of these, widowers showed a higher mortality risk than widows. In addition, incidence of tumor and stroke significantly influenced mortality among both married men and women. Bronchitis, pneumonia, and other respiratory disease significantly raised the risk of mortality for married men but not for married women. Moreover, physical function variables were significant predictive factors related to mortality hazard, with instrumental activities of daily living showing the strongest predictive relationship.


The study confirmed that widowhood, chronic disease, and physical function were strongly associated with mortality hazard in older people. Therefore, greater attention should be paid to these factors to reduce elderly mortality risk. Research results should be useful in developing welfare strategies for this group.

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