Does Marriage Lead to Better Health Outcomes?

A new study suggests that dementia risk is considerably higher for singles as opposed to married folks. Jess and Jeff delved into the research this morning on The Morning Show.

For years we’ve been hearing that married folks fare better than their single counterparts when it comes to health outcomes, but then last year another study found that some of these claims have been overstated. So what’s the new verdict according to this study?

• In this study, published in the Journal of Neurology, Neurosurgery and Psychiatry, researchers analyzed the results from 15 previously published studies with a total of 812,047 participants from Europe, Asia, the US and Brazil. This is a considerable sample size of which 29,610 has a form of dementia (but see below for limitations).
• They found that people who had never been married and those who were widowed were more likely to develop dementia despite their age and sex. They conclude that the risk is 42% higher for singles and 20% higher for those who are widowed even when they accounted for physical health. Dementia rates in widowed people were attenuated when adjusted for education level.

So what is it about the wedding ring that leads to better health outcomes?

• The researchers emphasize that it’s not marriage itself, but some of the corollary benefits of marriage. You may recall a study last year which suggested that the quality of the marriage matters to associated health benefits — unhappy relationships cause cardiovascular distress (Kelly please look up the link to the old blog post to hyperlink - Global from 2016 perhaps?)
• In many cases, married people have more social interaction and support, healthier eating habits, higher self-esteem and greater financial support — all of which offer physical and mental health benefits.
• It’s also possible that people who are less likely to marry (due to other cognitive or personality traits) are more likely to develop dementia, as the relationship is correlational — not causal.

We know that marriage rates are falling and fewer Millenials say they have plans to marry, but life expectancy continues to increase, so how do you explain this discrepancy? On one hand, married folks are supposed to be healthier and live longer and on the other as marriage declines, life expectancy increase?

• First, we have to acknowledge that the number of singles in the study was much lower than those who were married.
• And they didn’t find a difference between dementia rates for the married versus those who were divorced.
• And we have to look at one other interesting finding in this study: the positive correlation between marriage and lowered risk of dementia has declined with time and is more pronounced for older study participants with dementia. For example, the risk of dementia for single people was 15% lower for every ten years later they were born.

What if you’re not married and don’t want to get married - how can you reap some of the health benefits and stay single?

• Seek social interaction and maintain social ties.
• Look out for your own health: exercise, diet, sleep, and stress — keep the company of friends who are supportive in these areas.

What can we learn from this study?

• We need more social supports for older people — especially singles and those who are widowed.
• We should look at preventative programming for singles (e.g. a new study finds that singing is beneficial to memory and mood in early dementia).
• From the researchers: We need to look for "ways of destigmatizing dementia and producing dementia-friendly communities more accepting and embracing of the kinds of disruptions that dementia can produce should progress alongside biomedical and public health programs."

Other notes:

• Globally, it is estimated that 47 million people are living with dementia. It’s a global term that describes a range of symptoms associated with a decline in memory or other cognitive skills that reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 percent of cases according to the Alzheimer’s Association.
• "Meta-regression analysis suggested that the relative risk of dementia in divorced people increased by 24% (95% CI 1% to 47%) for studies of participants born 10 years later (table 2), although risk remained non-significant when comparing the newer and older studies. There was some evidence that time period modified the effect of being lifelong single on risk of dementia: the risk of dementia in single people was 15% lower (9% CI 33% lower to 2% higher) for every 10 years later that participants were born. In the oldest studies (participants born on average before 1927), the risk of dementia in lifelong single versus married people was 1.40 (1.06 to 1.85) and for the most recent studies (of people born after 1927), the risk was 1.24 (0.94 to 1.62). No significant modifying effect of time period was found for the risk of dementia in widowed people."