English terms for emotional distress are often wrapped up in the language of physical maladies: Being heartsick, sick with grief, heartbroken. The Old English word for grief, heartsarnes, literally means soreness of the heart; heartache originates from the Old English heortece, originally used to refer to heart disease. The words hurt and pain can apply equally to suffering of the mind or of the body.

In fact, medical knowledge suggests that our bodies already know what our words have long implied: that grief can, quite literally, sicken.

And now, new research may shed a little more light on part of the reason why. A study recently published in the journal Ageing and Immunity found that among the elderly, in particular, the recent loss of a loved one may leave a person more vulnerable to infectious diseases.

“You know when you hear about an older couple and one of the spouses dies, and then a short time afterwards, even though the other one was relatively healthy, they die [as well]?” Anna Phillips, a professor of behavioral medicine at the University of Birmingham’s School of Sport, Exercise, and Rehabilitation Sciences said. “We wanted to get into the science behind that and see how this effect of bereavement was getting inside the body and speeding up mortality.”

Phillips and her colleagues studied two small groups of mourners, one with an average age of 32 and the other with an average age of 72, and similarly-aged control groups of people who had not recently experienced a loss. Members of the older group of mourners, they found, had reduced function in their neutrophils—a white blood cell used to fight off infections—compared to their non-bereaved peers.

“Even though [members of] the bereaved younger group were equally as psychologically affected, we didn’t see the physiological changes that you see in the older group,” Phillips said, a difference the researchers attribute to age-related hormone fluctuations. The effects of the stress hormone cortisol, which weakens the immune system, are balanced by a hormone called DHEA, which bolsters the effectiveness of neutrophils. But around age 30, a person’s DHEA levels start to drop, leaving their immune system more vulnerable to cortisol’s influence in times of stress.

A prolonged emotional response to something like a death, then, may leave someone of advanced age more prone to infection—but, the researchers noted, hormone therapy may offer promise in reversing this effect among the grieving: “Hormonal supplements or similar products could be used to help people at an increased risk of stress,” they said in a press release.

But the act of mourning can—as Phillips put it—“get inside the body” in other ways, too: Previous research has found that following the death of a spouse, people were likely to report more self-medication and worse overall health. Grief has also been found to aggravate physical pain, increase blood pressure and blood clots, and exacerbate appetite loss—possibly because it also caused people to find less pleasure in food. And in a previous study from Phillips, the flu vaccine was less effective in older people who had lost a loved one within the past year than those who had not.

Unsurprisingly, though, another chunk of medical research on grief has focused on its effects on the heart.

A 2012 study published in the journal Circulation  found that a person’s risk of having a heart attack increased 21 times over in the day immediately following the death of a loved one and six times over in the following week. Other research has found a similar effect over the longer term: Research published earlier this year in JAMA Internal Medicine found that the risk of heart attack or stroke after losing a partner stayed elevated for as long as a month.

And, yes, “broken heart syndrome” is a real thing. Formally known as takotsubo cardiomyopathy, it happens when extreme emotional stress causes one of the heart’s chambers to balloon, triggering symptoms similar to those of a heart attack. Unlike in a heart attack, though, the condition is usually reversible and very rarely fatal, according to the American Heart Association, with a recovery time as short as a few days.

In other words, putting all physical ailments aside, it’s difficult—though theoretically possible—to die of a broken heart.