Association between mid-life marital status and cognitive function in later life: population based cohort study.
OBJECTIVE
To evaluate whether mid-life marital status is related to cognitive function in later life.


METHODS
Prospective population based study with an average follow-up of 21 years.


METHODS
Kuopio and Joensuu regions in eastern Finland.


METHODS
Participants were derived from random, population based samples previously investigated in 1972, 1977, 1982, or 1987; 1449 individuals (73%), aged 65-79, underwent re-examination in 1998.


METHODS
Alzheimer's disease and mild cognitive impairment.


RESULTS
People cohabiting with a partner in mid-life (mean age 50.4) were less likely than all other categories (single, separated, or widowed) to show cognitive impairment later in life at ages 65-79. Those widowed or divorced in mid-life and still so at follow-up had three times the risk compared with married or cohabiting people. Those widowed both at mid-life and later life had an odds ratio of 7.67 (1.6 to 40.0) for Alzheimer's disease compared with married or cohabiting people. The highest increased risk for Alzheimer's disease was in carriers of the apolipoprotein E e4 allele who lost their partner before mid-life and were still widowed or divorced at follow-up. The progressive entering of several adjustment variables from mid-life did not alter these associations.


CONCLUSIONS
Living in a relationship with a partner might imply cognitive and social challenges that have a protective effect against cognitive impairment later in life, consistent with the brain reserve hypothesis. The specific increased risk for widowed and divorced people compared with single people indicates that other factors are needed to explain parts of the results. A sociogenetic disease model might explain the dramatic increase in risk of Alzheimer's disease for widowed apolipoprotein E e4 carriers.
Håkansson
Krister
K
School of Social Sciences, Department of Psychology, Växjö University, Sweden.
Rovio
Suvi
S
Helkala
Eeva-Liisa
EL
Vilska
Anna-Riitta
AR
Winblad
Bengt
B
Soininen
Hilkka
H
Nissinen
Aulikki
A
Mohammed
Abdul H
AH
Kivipelto
Miia
M
D000368:Aged; D000544:Alzheimer Disease / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D053327:Apolipoprotein E4 / Q000378:metabolism; D003072:Cognition Disorders / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013997:Time Factors
D053327:Apolipoprotein E4