Cancer Bereavement and Depression Symptoms in Older Spouses: The Possible Modifying Role of the Circadian Rest-Activity Rhythm

Clin Gerontol. 2021 Mar-Apr;44(2):126-132. doi: 10.1080/07317115.2020.1812787. Epub 2020 Aug 28.

Abstract

Objectives: This study examines the associations of cancer death and aspects of the 24-h circadian rest-activity rhythm (RAR) on depression symptoms in older spouses.

Methods: Participants included 46 adults aged 60-94 years (M = 73 years) who experienced the death of a spouse. We tested a multivariate model using cancer death (vs. non-cancer death) and RAR variables as correlates of depression symptoms while controlling for age, sex, physical illness burden, and preparedness for death. We also present a case example to describe the behavioral activity patterns of a participant bereaved by cancer.

Results: Cancer death was associated with elevated levels of depression symptoms. However, the timing of the RAR moderated this association. Cancer bereavement was associated with depression symptoms when participants "settled-down" after 11:00 PM. The case example illustrates how intrusive thoughts about death quality impacts a widower's drive to stay busy with daily activities.

Conclusions: Settling down earlier in the evening is important for older spouses bereaved by cancer, in terms of fewer symptoms of depression.

Clinical implications: Objectively specifying the activity patterns of older spouses bereaved by cancer is a promising avenue for interventions that aim to reduce depression symptoms.

Keywords: Cancer death; aging; bereavement; circadian rhythms; depression.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Bereavement*
  • Depression
  • Grief
  • Humans
  • Mental Disorders*
  • Neoplasms* / complications
  • Spouses