Department of Sociology, Michigan State University, East Lansing, MI.
Department of Sociology, Michigan State University, East Lansing, MI.
Ann Epidemiol. 2019 Oct;38:28-34.e2. doi: 10.1016/j.annepidem.2019.08.007. Epub 2019 Aug 21.
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.
我们提供了基于人群的纵向证据，表明在美国，婚姻状况的不同与认知障碍和痴呆的风险有关。
数据来自于纵向的国家健康与老龄化趋势研究，时间范围为 2011 年至 2018 年。样本包括 7508 名年龄在 65 岁及以上的受访者，他们提供了 25897 人年的记录。我们估计了离散时间风险模型，以预测痴呆和认知障碍但非痴呆（CIND）以及三个主要认知领域（记忆、定向和执行功能）受损的风险。
与已婚同龄人相比，离婚和丧偶的老年人患痴呆和 CIND 的几率更高，每个认知领域受损的几率也更高。从未结婚的老年人在记忆和定向方面受损的几率高于已婚同龄人，但在执行功能、痴呆或 CIND 受损的几率方面没有显著差异。与已婚受访者相比，同居的老年人在任何认知障碍衡量标准上都没有显著差异。我们没有发现性别差异在婚姻状况与认知障碍衡量标准之间的关联。
婚姻状况是认知障碍的一个潜在重要但被忽视的社会风险/保护因素。离婚和丧偶的老年人尤其容易受到认知障碍的影响。
