The association of marital status with cognitive function and the role of gender in Chinese community-dwelling older adults: a cross-sectional study

Aging Clin Exp Res. 2021 Aug;33(8):2273-2281. doi: 10.1007/s40520-020-01743-5. Epub 2020 Nov 6.

Abstract

Background: Evidence of the association between marital status and cognitive function in Chinese older adults is limited.

Aims: To examine the relationship between marital status and cognitive function and to explore the role of gender amongst older adults from three Chinese communities.

Methods: A total of 1376 participants aged 60 years or over were included in this cross-sectional study. Cognitive function was assessed using the Chinese version of the mini-mental state examination (MMSE). Marital status and other variables were collected using a standardized questionnaire. Multiple linear regression models were used to examine associations between marital statuses and cognitive function amongst the target population. The moderating role of gender in these potential associations has also been explored.

Results: In univariate linear regression models, compared to being married, both being widowed (β [95% CI]: -1.46[-2.78 to - 0.13]) and being single (β [95% CI]: - 4.88[-6.43 to - 3.38]) were associated with lower MMSE scores. After adjustment for confounding factors, the significant association of being widowed with MMSE scores disappeared (β [95% CI: - 0.08[- 1.04 to 0.86]), but the association of being single with MMSE scores still existed (β [95% CI]: - 1.87[- 3.17 to - 0.58]). Furthermore, the association of being single with MMSE scores was statistically significant in men (β [95% CI]: - 5.25[- 7.17 to - 3.33]) but not in women (β [95% CI: 0.88[- 0.87 to 2.64]).

Discussion and conclusions: Being single was associated with poorer cognitive function compared with their married counterparts in older Chinese men but not in women. More preventive measurements should be implemented for single men to reduce or delay cognitive decline. This is particularly important in the context of an aging population in China.

Keywords: Aging; China; Cognitive function; Gender; Marital status.

MeSH terms

  • Aged
  • China / epidemiology
  • Cognition
  • Cognitive Dysfunction* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Independent Living*
  • Male
  • Marital Status