Marital status and cognitive impairment in the United States: evidence from the National Health and Aging Trends Study

Publication Abstract

Liu, Hui, Yang Zhang, Sarah Burgard, and Belinda L. Needham. 2019. "Marital status and cognitive impairment in the United States: evidence from the National Health and Aging Trends Study." Annals of Epidemiology, 38: 28-34.e2.

Purpose: We provide population-based longitudinal evidence of marital status differences in the risk of cognitive impairment and dementia in the United States.

Data were from the longitudinal National Health and Aging Trends Study, 2011-2018. The sample included 7508 respondents aged 65 years and older who contributed 25,897 person-year records. We estimated discrete-time hazard models to predict the risk of dementia and cognitive impairment, not dementia (CIND), as well as impairment in three major cognitive domains: memory, orientation, and executive function.

Relative to their married counterparts, divorced and widowed elders had higher odds of dementia and CIND, as well as higher odds of impairment in each of the cognitive domains. Never-married elders had higher odds of impairment in memory and orientation than their married counterparts but did not differ significantly in the odds of impaired executive function, dementia, or CIND. Cohabiting elders did not differ significantly from married respondents on any measure of cognitive impairment. We found no gender differences in the associations between marital status and the measures of cognitive impairment.

Marital status is a potentially important but overlooked social risk/protective factor for cognitive impairment. Divorced and widowed older adults are particularly vulnerable to cognitive impairment.


Cognitive impairment Dementia Marital status Divorce Widowhood

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