The Impact of Marital Quality as Older Couples Adjust to Dementia Onset

Abstract

Abstract Objectives A burgeoning literature links being married to better cognitive health, but less attention has been paid to how couples view their marital relationships. Couples do not always concur in their assessments, and such discrepancies affect both partners’ health. We present a dyadic study on whether and how overall and discrepant views of marital quality predicted (a) dementia onset and (b) changes in older adults’ depressive symptoms with spousal dementia. Methods A pooled sample of couples aged 50+ (dyad N = 3,936) from the Health and Retirement Study rated positive and negative marital quality at baseline (2006/2008). Each participant reported whether they had been told of having dementia and their depressive symptoms once every other year (2006/2008–2014/2016). Results Cox proportional hazards regression revealed that older adults who rated their marriages either more positively or more negatively than their spouses were more likely to develop dementia. We applied multiphase growth curve modeling to older adults whose spouses developed dementia, finding that those in marriages that were more negative overall reported more depressive symptoms but exhibited a smaller increase in these symptoms in response to spousal dementia. Discussion This study adds to the literature by showing how discrepant marital assessments shape cognitive aging and offers new insights into identifying older adults with greater dementia risk. Findings also revealed the impact of overall negative marital quality on older adults’ psychological adjustment to spousal dementia, which could inform interventions intended to help couples better cope with early-stage dementia from a relational perspective.