# Death of a loved one: Prevalence, risk, and protective factors for prolonged grief disorder

> **NIH NIH R01** · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2024 · $843,442

## Abstract

Bereavement is highly prevalent among older adults, a rapidly growing demographic of the US population that
is projected to double by 2050. Estimates suggest that 3%- 10% of bereaved adults experience clinically
significant levels of prolonged grief disorder (PGD), with older adults at higher risk. Recognition, prevention,
and effective treatment of PGD is critical to reduce excess mortality among older adults, yet the capacity to
identify and refer cases has lagged because PGD has not historically been included in the major psychiatric
diagnostic manuals until the most recent editions of the Diagnostic and Statistical Manual of Mental Disorders
5th Edition Text Revision (DSM-5-TR) and International Classification of Diseases 11th Revision (ICD-11). As a
result, it is only now possible to fill the historical knowledge gap around the prevalence and risk/protective
factors for this highly impairing condition. The long-term goal of our work is to ascertain and validate PGD case
status among older adults enrolled in an ongoing longitudinal study and identify modifiable factors that improve
health outcomes for at-risk people. The central aim of this proposal is to use the unparalleled epidemiological
resources of three >30-year longitudinal studies to characterize prevalent PGD consistent with newly
introduced criteria in the DSM-5-TR for the first time in an ongoing cohort with exceptionally high response
rates. First, we will ascertain probable PGD case status among 91,630 older adults with >30 years of
prospective longitudinal data in the Nurses’ Health Study (NHS), NHS II, and Health Professionals Follow-Up
Study (HPFS) and validate PGD case status among a randomly sampled bereaved subcohort of 27,115 adults.
We will test apriori hypotheses regarding prevalence: a) PGD increases with age; b) After adjusting for sex
differences in survival via inverse probability of censoring weighting, the prevalence of PGD does not
meaningfully differ by sex; and c) Inclusion of sex and age in models will improve accuracy, as quantified using
the mean absolute difference metric of model adequacy. Second, we will harness a novel data science
approach to identify risk factors associated with PGD based on more than 30 years of prospective longitudinal
data spanning biomarkers, genetics, psychosocial variables, and prior psychiatric history. Third, using a similar
analytic approach, we will identify protective factors guided by the NIH Common Fund-supported Science of
Behavior Change framework associated with reduced risk for PGD. Impact: The recent inclusion of PGD as a
diagnostic category in the DSM-5-TR and ICD-11 affords healthcare professionals an infrastructure to identify
and mobilize targeted bereavement-related services. The proposed project will address a gap in our
understanding of PGD among older adults, thus advancing NIMH Strategic Goal 2: Charting mental illness
trajectories to determine when, where, and how to intervene. Results will deliver insights ...

## Key facts

- **NIH application ID:** 10943864
- **Project number:** 1R01MH137201-01
- **Recipient organization:** HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH
- **Principal Investigator:** Christy Ann Denckla
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $843,442
- **Award type:** 1
- **Project period:** 2024-07-12 → 2029-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10943864

## Citation

> US National Institutes of Health, RePORTER application 10943864, Death of a loved one: Prevalence, risk, and protective factors for prolonged grief disorder (1R01MH137201-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10943864. Licensed CC0.

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