title: Marital histories, marital support, and bone density: findings from the Midlife in the United States Study.
abstract: We examined the association between marital life history and bone mineral density (BMD) in a national sample from the US. In men, being stably married was independently associated with better lumbar spine BMD, and in women, more spousal support was associated with better lumbar spine BMD.
  
  
  
  Adult bone mass may be influenced by stressors over the life course. We examined the association between marital life history and bone mineral density (BMD) net socioeconomic and behavioral factors known to influence bone mass. We sought evidence for a gender difference in the association between marital history and adult BMD.
  
  
  
  We used data from 632 adult participants in the Midlife in the United States Study to examine associations between marital history and BMD, stratified by gender, and adjusted for age, weight, menopausal stage, medication use, childhood socioeconomic advantage, adult financial status, education, physical activity, smoking, and alcohol consumption.
  
  
  
  Compared to stably married men, men who were currently divorced, widowed, or separated, men who were currently married but previously divorced, widowed, or separated, and never married men had 0.33 (95% CI: 0.01, 0.65), 0.36 (95% CI: 0.10, 0.83), and 0.53 (95% CI: 0.23, 0.83) standard deviations lower lumbar spine BMD, respectively. Among men married at least once, every year decrement in age at first marriage (under age 25) was associated with 0.07 SD decrement in lumbar spine BMD (95% CI: 0.002, 0.13). In women, greater support from the spouse was associated with higher lumbar spine BMD.
  
  
  
  Our findings suggest that marriage before age 25 and marital disruptions are deleterious to bone health in men, and that marital quality is associated with better bone health in women.
authors.affiliation: Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA, 90095-1687, USA, danamill@ucla.edu.
authors.forename: D
authors.initials: D
authors.lastname: Miller-Martinez
authors.forename: T
authors.initials: T
authors.lastname: Seeman
authors.forename: A S
authors.initials: AS
authors.lastname: Karlamangla
authors.forename: G A
authors.initials: GA
authors.lastname: Greendale
authors.forename: N
authors.initials: N
authors.lastname: Binkley
authors.forename: C J
authors.initials: CJ
authors.lastname: Crandall
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000367:Age Factors; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D005260:Female; D005272:Femur Neck / Q000502:physiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008393:Marriage / Q000523:psychology / Q000706:statistics & numerical data; D008593:Menopause / Q000502:physiology; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D012727:Sex Characteristics; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology