Investigating Heterogeneity in the Relationship Between Marital Satisfaction and Cognitive Health by Gender and Across the Cognitive Function Distribution

Abstract

Background and Objectives Marital satisfaction has been established as an essential factor for promoting health and well-being in older adults. However, it is unclear whether marital satisfaction is also associated with cognitive health in this population. This study aimed to investigate the longitudinal association between marital satisfaction and cognitive function, while also exploring variations in this relationship by gender and across the cognitive function distribution. Research Design and Methods This study used six waves of the Korean Longitudinal Study of Ageing (KLoSA) and employed gender-stratified unconditional quantile regression (UQR) models with fixed effects (FE) to estimate the association between marital satisfaction and cognitive function across different quantiles of the cognitive function distribution. FE models controlled for unobserved individual-level confounders such as genetics, cognitive and non-cognitive skills, and early childhood social and cultural background. Results The results of this study revealed that marital satisfaction was positively associated with cognitive function (b = 0.305), and this association was stronger in older men than in older women (b = 0.392 for older men vs. b = 0.181 for older women). The UQR-FE models suggested that the stronger association between marital satisfaction and cognitive function was observed among older men with lower cognitive function (b = 0.817 for 10th percentile vs. b = 0.118 for 90th percentile). Among older women, no clear patterns of heterogeneity were found across the cognitive function distribution. Discussion and Implications The findings of this study highlight a significant degree of heterogeneity in the relationship between marital satisfaction and cognitive function among older men, with the stronger associations observed in the lower percentiles of the cognitive function distribution. Interventions aimed at improving marital quality could be an effective strategy for promoting cognitive health in older adults, with an approach tailored to the individual’s characteristics.

The relationship between marital status and cognitive impairment in Chinese older adults: the multiple mediating effects of social support and depression

“…Second, the use of cross-sectional data from 2018 to assess social support, depression, and cognitive impairment imposes constraints in deriving causal relationships. While the longitudinal association between marital status and cognitive impairment may vary according to gender and across different levels of cognitive function [ 10 ], other research has indicated cognitive impairment may be related to marital status [ 65 , 66 ], as well as to depression [ 67 ]. Furthermore, depression has been shown to diminish an individual’s social support [ 68 ].…”

“…A longitudinal qualitative study over 34 years indicated that the frequency of interaction with spouses increased from early adulthood onwards, with emotional closeness deepening throughout adulthood [ 9 ]. Spousal relationships and marital quality are influential in determining psychosocial and cognitive function, especially in older men [ 10 , 11 ]. The enduring nature of marital status represents a potentially important yet often disregarded social factor that either elevates the risk or serves as a protective element against cognitive impairment in the long term [ 7 ].…”

The asymmetric effects of improving and declining marital satisfaction on cognitive function

“…However, our results also indicate that improvements in marital satisfaction can enhance cognitive function, especially among middle‐aged adults. Most extant longitudinal studies examining the influence of marital satisfaction on cognitive function or mental health primarily focus on the detrimental effects of declines in marital satisfaction (J. Kim & Kwon, 2023). Some studies have attempted to measure positive and negative aspects of marital quality separately, using distinct question sets within the same model (Huo et al, 2022; Xu et al, 2016).…”

“…Consistent with this perspective, several studies have investigated the relationship between marital quality and cognitive outcomes (Huo et al, 2022; Liu et al, 2021; Xu et al, 2016). Moreover, recent advancements in quasi‐experimental design have enriched our understanding of this relationship by addressing potential selection biases (J. Kim & Kwon, 2023).…”

“…Traditionally, Korean men have been viewed as breadwinners, while women have been expected to manage household chores, nurture family ties, and care for family members (Lee et al, 2004). Given women's traditional caregiving roles, it is plausible that men's cognitive function is in part sustained by the support they receive from their spouses (J. Kim & Kwon, 2023). Hence, the heterogeneity in the association between marital satisfaction and cognitive function by age and gender might manifest more prominently in the Korean context.…”