Former US First Lady Barbara Bush has died at her home in Houston, Texas, aged 92.
A statement by the office of her surviving husband, former US President George HW Bush, described her as a "relentless proponent of family literacy" with a large extended family.
"Barbara Pierce Bush passed away Tuesday, April 17, 2018 at the age of 92," the statement read.
"She is survived by her husband of 73 years, President George HW Bush; five children and their spouses; 17 grandchildren; seven great grandchildren; and her brother, Scott Pierce.
"She was preceded in death by her second child, Pauline Robinson "Robin" Bush, and her siblings Martha Rafferty and James R Pierce."
On Monday, Ms Bush left hospital in "failing health", a statement at the time said, after deciding to forego further medical treatment instead focusing on "comfort care".
CNN reported that Bush was suffering from chronic obstructive pulmonary disease and congestive heart failure.
As first lady from 1989 until the start of 1993, Ms Bush was a popular national figure known for her sometimes blunt talk and self-deprecating wit.
Her husband, the 41st US president, is 93 years old. Her son, the 43rd US president, is 71.
Another son, Jeb, is a former governor of Florida who ran unsuccessfully for president in 2015 and early 2016.
Reuters / Newshub.
