Losing someone you love can worsen cognitive decline

BarcelonaWhen Enric and Flore were young, they shared everything they had. A good example is Flen, a small box they named with the first two letters of each of their names, where they kept all the pesetas they managed to collect during the post-war period. It didn't matter who put in more and who put in less; when they had enough money to buy a snack, they would empty it, divide the loot equally, and start the process again. It's just an anecdote of a lifelong friendship, but there are clearly many more.

As an adult, Enric suffered a severe stroke that left him with 13 years of sequelae. During all this time, Flore never stopped visiting him. Every midday he would go to see him, they would do some rehabilitation (despite his friend's complaints, already tired and clumsy), he would prepare caipirinhas for everyone present, and they would discuss current events until lunchtime. He did this every day for over a decade, and when Enric died at the age of 86, those who knew Flore said he was never the same again.

Although everyone agreed that Flore had declined after the death of his soulmate, no one could explain why, and now science may have an explanation. Researchers from the Hospital del Mar and the Universitat Autònoma de Barcelona (UAB) have discovered in a study that the loss of a loved one can accentuate cognitive decline in older adults.

The research published in the Colombian Journal of Psychiatry concludes that prolonged grief can cause alterations in immediate memory, attention, processing speed, executive functions, verbal fluency, and visuospatial ability. Therefore, researchers believe that more effort should be put into detecting and treating grief when attending to older adults, with the aim of preventing cognitive consequences.

Prolonged grief

Prolonged grief, considered a form of pathological grief, is an intense reaction that persists for more than six months after the loss of a loved one. It is a relatively common situation. It is estimated that between 7% and 10% of people over 60 years of age will suffer from complicated grief. Symptoms include intense longing, persistent worries, recurring thoughts about the deceased person, difficulty accepting the loss and resuming daily life, and also the feeling of having lost the meaning of life.

According to the research findings, in older adults this disorder can go beyond the emotional impact and also affect cognition. The analyzed data have indicated that prolonged grief is a risk factor for both the development of cognitive decline and for worsening it when it already exists. "Prolonged grief constitutes an independent risk factor for cognitive decline, distinguishable from other risk factors," explains Laura Maldonado-Liñán, a researcher in the department of clinical and health psychology at the UAB and first author of the study.

Attention to older adults

The most frequent affectations are linked to immediate memory, attention, processing speed, executive functions, verbal fluency, and visuospatial ability. For this reason, the authors defend the need to detect and treat prolonged or pathological grief in the comprehensive geriatric assessments of elderly patients to prevent its cognitive consequences.

"We need to monitor it and, within this monitoring, offer psychiatric and psychological treatment and, if necessary, pharmacological treatment to help the affected person properly process and overcome grief," assures Josep Deví, lead author of the study, neuropsychologist and adjunct clinical psychologist at the Mental Health Institute of Hospital del Mar.

In this regard, he also believes that if intervention is carried out in this way and the prolonged grief disorder disappears or the symptoms remit significantly, and there is no other associated neurological or cognitive pathology, "it is to be expected that the consequences of prolonged grief, both emotional and cognitive, can be reversible and remit."