title: Association between mid-life marital status and cognitive function in later life: population based cohort study.
abstract: 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.
authors: School of Social Sciences, Department of Psychology, Växjö University, Sweden.
authors: Krister
authors: K
authors: Håkansson
authors: Suvi
authors: S
authors: Rovio
authors: Eeva-Liisa
authors: EL
authors: Helkala
authors: Anna-Riitta
authors: AR
authors: Vilska
authors: Bengt
authors: B
authors: Winblad
authors: Hilkka
authors: H
authors: Soininen
authors: Aulikki
authors: A
authors: Nissinen
authors: Abdul H
authors: AH
authors: Mohammed
authors: Miia
authors: M
authors: Kivipelto
mesh_terms: 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
chemical_list: D053327:Apolipoprotein E4