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婚姻丧失与痴呆风险:种族和性别重要吗?

Marital loss and risk of dementia: Do race and gender matter?

机构信息

Department of Sociology, Michigan State University, USA.

Department of Sociology, Michigan State University, USA.

出版信息

Soc Sci Med. 2021 Apr;275:113808. doi: 10.1016/j.socscimed.2021.113808. Epub 2021 Mar 2.

Abstract

Recent studies have found that marital loss through divorce or widowhood is associated with a higher risk of dementia for older adults. However, whether these associations vary by race and gender is less clear. To address this gap, we drew upon longitudinal data from the Health and Retirement Study (2000-2016) to investigate the association between marital loss and dementia risk, separately for non-Hispanic Whites and non-Hispanic Blacks. We further examined gender variations in the link between marital loss and dementia risk within each racial group. Results from discrete-time event history models suggested that widowhood is significantly associated with a higher risk of dementia for both Whites and Blacks, controlling for basic demographic characteristics. However, while divorce is significantly associated with a higher risk of dementia for Blacks, the association is marginally significant (p < 0.1) for Whites. There are few significant gender variations in these associations except for the effect of divorce among Whites. Even after controlling for economic and health-related factors, we found that divorce is associated with a higher risk of dementia among White men but not among White women. Economic resources explain a significant portion of the association between widowhood and dementia risk, more so for Whites than for Blacks. Our findings call for more research into the pathways through which marital loss shapes the risk of dementia across racial and ethnic groups.

摘要

最近的研究发现,离婚或丧偶导致的婚姻丧失与老年人痴呆症的风险增加有关。然而,这些关联是否因种族和性别而异尚不清楚。为了解决这一差距,我们利用健康与退休研究(2000-2016 年)的纵向数据,分别针对非西班牙裔白人和非西班牙裔黑人,调查了婚姻丧失与痴呆症风险之间的关联。我们进一步研究了每个种族群体中婚姻丧失与痴呆症风险之间联系的性别差异。离散时间事件历史模型的结果表明,在控制基本人口特征后,丧偶与白人和黑人的痴呆症风险增加显著相关。然而,虽然离婚与黑人的痴呆症风险增加显著相关,但对于白人来说,这种关联仅具有边缘显著性(p<0.1)。这些关联中几乎没有显著的性别差异,除了白人离婚的影响。即使控制了经济和健康相关因素,我们发现离婚与白人男性的痴呆症风险增加有关,但与白人女性无关。经济资源解释了丧偶与痴呆症风险之间关联的很大一部分,对于白人来说比对于黑人来说更为明显。我们的研究结果呼吁对婚姻丧失如何通过种族和族裔群体塑造痴呆症风险的途径进行更多研究。

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本文引用的文献

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Death of a Child Prior to Midlife, Dementia Risk, and Racial Disparities.中年前儿童死亡、痴呆风险与种族差异。
J Gerontol B Psychol Sci Soc Sci. 2020 Oct 16;75(9):1983-1995. doi: 10.1093/geronb/gbz154.
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Trajectories of cognitive decline by widowhood status among Korean older adults.韩国老年人丧偶状态下认知能力下降轨迹。
Int J Geriatr Psychiatry. 2019 Nov;34(11):1582-1589. doi: 10.1002/gps.5168. Epub 2019 Jul 15.
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Does widowhood affect cognitive function among Chinese older adults?丧偶会影响中国老年人的认知功能吗?
SSM Popul Health. 2018 Nov 27;7:100329. doi: 10.1016/j.ssmph.2018.100329. eCollection 2019 Apr.
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Sex differences in chronic stress responses and Alzheimer's disease.慢性应激反应与阿尔茨海默病中的性别差异。
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