title: Marital Status and Cognitive Impairment among Community-Dwelling Chinese Older Adults: The Role of Gender and Social Engagement.
abstract: OBJECTIVE
  To examine the association between marital status and cognitive impairment among community-dwelling Chinese older adults.
  
  
  METHODS
  We analyzed data from 2,498 Chinese aged 55 and older from the Singapore Longitudinal Aging Study cohort. Cognitive impairment was defined as a Mini-Mental State Examination total score of 23 or below. Odds ratios of associations were reported and adjusted for potential confounders in logistic regression models.
  
  
  RESULTS
  The prevalence of cognitive impairment was 12.2% (n = 306). Being single was associated with about 2.5 times increased odds of cognitive impairment compared to being married (adjusted OR = 2.53, 95% CI: 1.41-4.55). The association between marital status and cognitive impairment was much stronger in men compared to that in women, and was indeed statistically significant only for men. Among the single and widowed persons social engagement was associated with a lower risk of cognitive impairment. Compared with subjects in the lowest tertile of social engagement scores, the odds of having cognitive impairment was lowered by 50% for subjects in the second and the third tertile.
  
  
  CONCLUSIONS
  Being single or widowed was associated with higher odds of cognitive impairment compared to being married in a cohort of older Chinese men but not women.
authors.affiliation: Department of Psychological Medicine, Yong Loo Lin School of Medicine, Singapore.
authors.forename: Lei
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Statistics and Applied Probability, National University of Singapore.
authors.forename: Xue-Ting
authors.initials: XT
authors.lastname: Ng
authors.affiliation: Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore.
authors.forename: Philip
authors.initials: P
authors.lastname: Yap
authors.affiliation: Department of Statistics and Applied Probability, National University of Singapore.
authors.forename: Jialiang
authors.initials: J
authors.lastname: Li
authors.affiliation: Neurobehavioral Disorders Program, Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Tih-Shih
authors.initials: TS
authors.lastname: Lee
authors.affiliation: Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Krister
authors.initials: K
authors.lastname: Håkansson
authors.affiliation: Department of Psychological Medicine, Yong Loo Lin School of Medicine, Singapore.
authors.forename: Ee-Heok
authors.initials: EH
authors.lastname: Kua
authors.affiliation: Department of Psychological Medicine, Yong Loo Lin School of Medicine, Singapore.
authors.forename: Tze-Pin
authors.initials: TP
authors.lastname: Ng
keywords: Chinese older adults; Cognitive impairment; Marital status; Mini-Mental State Examination; Social engagement