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性别、婚姻史与晚年认知障碍:再婚是否对女性不利?

Gender, Marital Histories, and Cognitive Impairment in Later Life: Does Remarriage Disadvantage Women?

作者信息

Kang Hyunwook, Lee Haena, Choi Kyung Won, Kim Juyeon

机构信息

Department of Urban Sociology, University of Seoul, Seoul, South Korea.

Department of Sociology, Sungkyunkwan University, Seoul, South Korea.

出版信息

Innov Aging. 2025 May 6;9(6):igaf043. doi: 10.1093/geroni/igaf043. eCollection 2025.

Abstract

BACKGROUND AND OBJECTIVES

Although marital status influences cognitive health, limited research has examined the effects of diverse marital histories, particularly regarding remarriage. This study investigates the relationship between remarriage, marital histories, and cognitive impairment with a focus on gender differences. Building on the stress and marital resource models, we examine whether this relationship operates through economic and health-related factors.

RESEARCH DESIGN AND METHODS

Using the Health and Retirement Study (2004-2020;  = 11,406), we constructed 8 mutually exclusive categories based on current marital status and previous transitions, including divorce, widowhood, and multiple disruptions. We fit discrete-time hazard models to assess cognitive impairment risk across these marital trajectories. The bootstrap resampling method was used to conduct a formal mediation test.

RESULTS

Remarriage was associated with higher risks of cognitive impairment for women, but not for men, even after controlling for economic and health-related factors. Specifically, remarried women following widowhood or multiple disruptions had 39% and 32% higher risks of cognitive impairment, respectively, compared to continuously married women. The formal mediation test revealed that remarriage after multiple disruptions has adverse impacts on cognitive impairment, in part, through unhealthy behaviors and poor health status. However, when comparing remarried and unmarried groups, remarriage was associated with lower risks of cognitive impairment for men, whereas remarried women continued to show higher risks of cognitive impairment compared to their unmarried counterparts.

DISCUSSION AND IMPLICATIONS

This study is among the first to examine gender differences in how lifetime marital histories affect cognitive impairment risk. Remarriage, particularly following widowhood or multiple disruptions may put women at higher risks of cognitive impairment compared to those in their first marriage or those who remain single. These findings underscore the importance of considering detailed marital histories, beyond simple married/unmarried classification, when evaluating the role of social conditions in shaping cognitive impairment risk in practice settings.

摘要

背景与目的

尽管婚姻状况会影响认知健康,但针对不同婚姻经历影响的研究有限,尤其是再婚方面。本研究聚焦性别差异,调查再婚、婚姻经历与认知障碍之间的关系。基于压力和婚姻资源模型,我们探讨这种关系是否通过经济和健康相关因素起作用。

研究设计与方法

利用健康与退休研究(2004 - 2020年;样本量 = 11406),我们根据当前婚姻状况和先前的婚姻转变构建了8个相互排斥的类别,包括离婚、丧偶和多次婚姻变故。我们采用离散时间风险模型评估这些婚姻轨迹上的认知障碍风险。使用自助重抽样方法进行正式的中介检验。

结果

即使在控制了经济和健康相关因素之后,再婚对女性的认知障碍风险有影响,但对男性没有影响。具体而言,丧偶或经历多次婚姻变故后再婚的女性,与持续婚姻的女性相比,认知障碍风险分别高出39%和32%。正式的中介检验表明,多次婚姻变故后的再婚对认知障碍有不利影响,部分是通过不健康行为和健康状况不佳导致的。然而,在比较再婚和未婚群体时,再婚对男性的认知障碍风险有降低作用,而再婚女性与未婚女性相比,认知障碍风险仍然较高。

讨论与启示

本研究是首批考察终身婚姻经历如何影响认知障碍风险的性别差异的研究之一。与初婚或单身女性相比,再婚,尤其是丧偶或经历多次婚姻变故后的再婚,可能使女性面临更高的认知障碍风险。这些发现强调了在实际环境中评估社会状况对认知障碍风险影响时,除了简单的已婚/未婚分类外,考虑详细婚姻经历的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/addf/12242379/0628cd5fba37/igaf043_fig1.jpg

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