Bereavement, Memorial Attendance, and Mental Health During the COVID-19 Pandemic: Longitudinal Results from the Nurses' Health Study

Background: Mortality increased during the COVID-19 pandemic. Many bereaved individuals were not able to gather to memorialize their loved ones, yet it is unknown if this contributed to worsening mental health. Objective: Examine the association of bereavement in the early part of the COVID-19 pandemic with subsequent psychological distress and the role of memorial attendance in reducing psychological distress among the bereaved. Design, Settings, Subjects: In May 2020, 39,564 older females from the Nurses' Health Study II enrolled in a longitudinal COVID-19 substudy (meanage = 65.2 years, SD = 4.5). Methods: Linear regression analyses esti-mated associations of bereavement reported between March and October, 2020 with subsequent psychological distress between January and October 2021, adjusting for sociodemographic and prepandemic depression symptoms. Sec-ondary models examined associations between memorial attendance and psy-chological distress. Results: Bereavement during the early part of the COVID-19 pandemic was associated with higher psychological distress (adjusted b = 0.21, 95% CI: 0.15, 0.26) assessed over the next year. Among the bereaved, memorial attendance was associated with lower psychological distress (in -per-son: adjusted 13 = -0.41, 95% CI: -0.53, -0.29; online: adjusted 13 = -0.24, 95% CI: -0.46, --0.02). Conclusion: Attending memorials was associated with lower subsequent psychological distress among bereaved older females.