Marital Status and Dementia: Evidence from the Health and Retirement Study

Liu, Hui; Zhang, Zhenmei; Choi, S.; Langa, Kenneth M.

doi:10.1093/geronb/gbz087

Cited by 100 publications

(69 citation statements)

References 55 publications

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“…Specifically, the association between frequent engaging in hobby groups and frailty reduction is particularly pronounced for participants who are not married. According to the model of marital resource [ 27 ], married individuals have greater access to social, psychological, and economic resources than unmarried people and in turn promote health and longevity. The lack of marriage makes social engagement an important way for unmarried older people to obtain resources, such as social support and social integration, which therefore makes them more likely to pay attention to and enjoy the process of social engagement.…”

Section: Discussionmentioning

confidence: 99%

“…Marital status was divided into two categories, i.e., married and unmarried status (cohabiting, separated/divorced, widowed, or never married). Cohabiters were included in the unmarried groups, because they might not receive the same levels of socio-psychological and economic benefits as married individuals due to a lack of institutional legitimacy and less commitment based on previous studies [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

“…For example, married people tend to have lower risk of mortality [ 24 ] and suffer from fewer chronic conditions [ 25 ]. Theoretically, being married is associated with better social engagement, social support, and social integration [ 26 ]—all factors linked to better health and well-being [ 27 ], including less physical frailty. A recent systematic review [ 17 ] pooled 35 cross-sectional studies and finds being unmarried is associated with increased frailty.…”

Section: Introductionmentioning

confidence: 99%

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Social engagement and physical frailty in later life: does marital status matter?

2021

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Background Physical frailty is a common characteristic of older people with the ageing process and has been viewed as a major public health issue. The longitudinal association between different social engagement and physical frailty among older people has not been explored adequately in China. Marital status forms a critical context for the link between social engagement and frailty among older people, which might constitute a moderating process. The purpose of the present study is to investigate the longitudinal association between social engagement and the changes in physical frailty among Chinese older adults, and to examine whether the association between social engagement and frailty differs by marital status. Methods The data use in this study were from the data from the China Health and Retirement Longitudinal Study aged 60+ years from 2011 to 2015. A total of 6575 respondents who participated in at least one follow-up wave were included in the analysis. The relationship between social engagement and changes in frailty over time, and the moderating role of marital status were estimated using individual fixed-effects models. Sensitive analyses were conducted to test the robustness of the results. Results After adjusting the confounders, participants who interact with friends (Coef: -1.309, P < 0.001), engaging in hobby groups (Coef: -1.189, P < 0.001), engaging in sports groups (Coef: -0.945, P = 0.001), and volunteering (Coef: -1.957, P = 0.001) with a frequency of almost daily had a significantly lower frailty risk than participants who never engaging in those activities. The association between frequent engaging in hobby groups and physical frailty was strongest for unmarried than married older adults (Coef: -1.325, P = 0.031). Conclusions Frequent social engagement might help to decrease the risk of frailty in the Chinese older population. This finding has important implications for public health policy and encourages the incorporation of a broad range of social engagement into the daily lives of older individuals. Specially, encouraging unmarried older adults to engage in intellectual activities, such as playing chess or Mahjong with others, may be an effective way to reduce physical frailty.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Social engagement and physical frailty in later life: does marital status matter?

2021

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“…This model explains that being married is associated with unique social, psychological, and economic resources that promote health and longevity in the elderly by using compensatory cognitive approaches that increase neuronal plasticity and improve the cognitive reserve [ 51 ]. Conversely, divorced, single, or widowed older adults are more vulnerable to cognitive impairment because they are more likely to present alterations to different cognitive domains [ 47 ] and develop dementia than married people [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Cognitive Differences in the Older Adults Living in the General Community: Gender and Mental Occupational State Study

Calatayud

Salavera

Gómez-Soria

2021

IJERPH

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Older adults are particularly vulnerable to cognitive impairment with age, and gender differences are remarkable. However, there is very little evidence to identify both baseline cognitive and occupational gender differences prior to older adults’ retirement to design more efficient personalized cognitive interventions. This descriptive observational study examined gender differences in initial cognitive performance in 367 older adults with subjective memory complaints from a primary healthcare center in Zaragoza (Spain). To evaluate initial cognitive performance, the Spanish version of the Mini-Mental State Examination (MEC-35) and the set test were used to measure verbal fluency. Sociodemographic and clinical characteristics were evaluated, and cognitive and occupational differences were analyzed per gender. Men had higher educational and occupational levels, were older and more of them were married (p < 0.001) than women. Regarding cardiovascular risk factors, diabetes and cerebrovascular accidents were more frequent in women, while hypercholesterolemia and obesity were more frequent in men (p < 0.001). High blood pressure was more frequent in women, but not significantly so (p = 0.639). Global cognition was higher in men (p < 0.001) for attention, calculation, and language (p < 0.001). Verbal fluency was higher in women, but the difference was not statistically significant (p = 0.105). These results could be generalized to other health centers in the province and other Spanish autonomous communities as their sociodemographic variables are similar. Individualized interventions that adapt to gender, cognitive and initial occupational performance should be developed and adapted to elderly populations living in the general community to maintain their cognitive capacity and prevent their cognitive impairment and the social health costs this would imply.

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“…As concerns socioeconomic components, higher educational attainment appears to reduce dementia risk [6]. Conversely, living alone seems to increase the risk compared with living with a partner [22,23].…”

Section: Introductionmentioning

confidence: 99%

Environmental Risk Factors for Early-Onset Alzheimer’s Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy

Adani

Filippini

Garuti

et al. 2020

IJERPH

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Background: Early-onset dementia (EOD) is defined as dementia with symptom onset before 65 years. The role of environmental risk factors in the etiology of EOD is still undefined. We aimed at assessing the role of environmental risk factors in EOD etiology, taking into account its different clinical types. Methods: Using a case-control study, we recruited all EOD cases referred to Modena hospitals from 2016 to 2019, while the referent population was drawn from cases’ caregivers. We investigated residential history, occupational and environmental exposures to chemicals and lifestyle behaviors through a self-administered questionnaire. We computed the odds ratios of EOD risk (overall and restricting to the Alzheimer’s dementia (AD) or frontotemporal dementia (FTD) diagnoses) and the corresponding 95% confidence intervals using an unconditional logistic regression model. Results: Fifty-eight EOD patients (19 FTD and 32 AD) and 54 controls agreed to participate. Most of the investigated exposures, such as occupational exposure to aluminum, pesticides, dyes, paints or thinners, were associated with an increased odds ratio (OR) for FTD but not for AD. Long-term use of selenium-containing dietary supplements was associated with increased OR for EOD and, particularly, for FTD. For both EOD forms, smoking and playing football showed an increased odds ratio, while cycling was associated with increased risk only in FTD. Overall sports practice appeared to be a protective factor for both types. Conclusions: Our results suggest a role of environmental and behavioral risk factors such as some chemical exposures and professional sports in EOD etiology, in particular with reference to FTD. Overall sports practice may be associated with a reduced EOD risk.

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Marital Status and Dementia: Evidence from the Health and Retirement Study

Cited by 100 publications

References 55 publications

Social engagement and physical frailty in later life: does marital status matter?

Social engagement and physical frailty in later life: does marital status matter?

Cognitive Differences in the Older Adults Living in the General Community: Gender and Mental Occupational State Study

Environmental Risk Factors for Early-Onset Alzheimer’s Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy

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