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Prolonged grief disorder prevalence in adults 65 years and over: a systematic review
  1. Pia Thiemann1,
  2. Anna Naomi Street1,
  3. Sarah Eleanor Heath1,
  4. Thelma Quince1,
  5. Isla Kuhn2 and
  6. Stephen Barclay1
  1. 1 Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  2. 2 Medical Library, University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Pia Thiemann, University of Cambridge Department of Public Health and Primary Care, Cambridge CB2 0SR, UK; pt350{at}


Background Prolonged grief disorder (PGD) is a recently recognised mental health disorder with an estimated prevalence of 10% in the bereaved adult population. This review aims to appraise and summarise evidence relating to PGD in older adults (≥65 years), a growing population group, most likely to experience bereavement and often assumed to cope well.

Method Literature from Medline, PsycINFO, CINAHL, Cochrane Library and Web of Science was searched. Epidemiological and non-epidemiological studies including data on frequency of PGD in older adults bereaved by mainly natural causes were included and a descriptive analysis undertaken.

Results From 2059 records, three epidemiological and six non-epidemiological studies were included. Most studies had good internal but not external validity. Conditional prevalence for PGD ranged between 3.2% and 48.8%. Heterogeneity in sample characteristics and study methodology contributed to this variability resulting in a descriptive analysis. The prevalence rate of 9.1% by Kersting et al was the best available estimate for PGD in older adults for western countries. The small number of epidemiological studies and the use of varying PGD-constructs which did not match International Classification of Diseases 11th Revision and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria were the main limiting factors.

Conclusion This first review on PGD prevalence in older adults suggests that, despite studies’ methodological short comings, a similar proportion of older adults experience PGD as the general bereaved adult population (1:10). With older adults forming the largest subgroup among the bereaved, health and social care systems need to adapt their provision of care to address the specific needs of older adults.

  • bereavement
  • psychological care

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  • Correction notice This article has been updated since it was first published. The article type has been changed to Systematic review.

  • Contributors SB and PT developed the project with PT leading on the project and writing the manuscript and SB providing support throughout. IK conducted the systematic literature search. SH, AS and PT screened the literature, SH and AS extracted the data and AS and PT conducted the quality assessment. SH, AS and TQ assisted PT in interpreting the results. All authors critically reviewed the manuscript and provided final approval for submission.

  • Funding The project was funded by the Dowager Countess Eleanor Peel Trust. The funder was not involved in planning, conducting or publishing of the research or interpreting of results. SB is part funded by the National Institute for Health Research (NIHR) Applied Research Collaboration East of England (ARC EoE) programme. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.