Former US first lady Barbara Bush, the only woman to see her husband and son both sworn in as president, died on Tuesday, the Bush family said. She was 92.

Bush was the wife of the 41st president, George H.W. Bush, and mother of the 43rd George W. Bush.

The Bush family had said in a statement on Sunday that she was in failing health, had decided not to seek further medical treatment and instead would focus on ‘comfort care.’

According to some media reports, Bush had been battling chronic obstructive pulmonary disease and congestive heart problems in recent years.

‘Barbara Bush was a fabulous First Lady and a woman unlike any other who brought levity, love and literacy to millions,’ George W. Bush said in a statement. ‘To us, she was so much more. Mom kept us on our toes and kept us laughing until the end.’

Dubbed ‘The Silver Fox’ by her husband and children, Bush was known for her snow-white hair and for being fiercely protective of her family.

She was first lady when her husband was in the White House from 1989 to 1993. Her son, Republican George Walker Bush, triumphed in the disputed 2000 US election and was president from 2001 to 2009. The father-and-son presidents were sometimes referred to as ‘Bush 41’ and ‘Bush 43.’

The Bushes celebrated their 73rd wedding anniversary in January.

Bush had an independent streak and could be sharp-tongued. As first lady, she promoted literacy and reading but said she was more interested in running a household than helping her husband run the country.

She discouraged speculation that she wielded political influence with the president like her predecessors - Ronald Reagan’s wife, Nancy Reagan, and Jimmy Carter’s wife, Rosalynn Carter.

‘I don’t fool around with his office and he doesn’t fool around with my household,’ she once said.

‘She’ll speak her mind but only to him,’ said Jack Steel, a longtime Bush aide.