Objectives: We investigated the relationship between the cognitive status of participants’ spouses and participants’ own cognitive outcomes, controlling for mid-life factors. Methods: Participants (n = 1845; baseline age 66–90 years) from the prospective Atherosclerosis Risk in Communities Study were followed from 2011 to 2019. We used linear regression and Cox proportional hazard models to estimate whether spouses of people with MCI/dementia had lower cognitive functioning and elevated risk of incident dementia. Results: Having a spouse with MCI/dementia was associated with a deficit in cognitive function (b = −0.09 standard deviations; 95% CI = −0.18, 0.00). Adjustment for mid-life risk factors attenuated this association (b = −0.02 standard deviations; 95% CI = −0.10, 0.06). We observed no significant relationship between spousal MCI/dementia status and incident dementia (hazard ratio = 0.97; 95% CI = 0.69, 1.38). Discussion: Spousal cognitive status is not associated with poor cognitive outcomes independent of mid-life factors.
Alzheimer’s Association. (2021). 2021 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 17(3), 327–406. https://doi.org/10.1002/alz.12328
2.
AppiahD.SchreinerP. J.SelvinE.DemerathE. W.PankowJ. S. (2019). Spousal diabetes status as a risk factor for incident type 2 diabetes: A prospective cohort study and meta-analysis. Acta Diabetologica, 56(6), 619–629. https://doi.org/10.1007/s00592-019-01311-y
3.
ArbelI.BinghamK. S.DawsonD. R. (2019). A scoping review of literature on sex and gender differences among dementia spousal caregivers. The Gerontologist, 59(6), Article e802–e815. https://doi.org/10.1093/geront/gny177
4.
BaeckeJ. A.BuremaJ.FrijtersJ. E. (1982). A short questionnaire for the measurement of habitual physical activity in epidemiological studies. The American Journal of Clinical Nutrition, 36(5), 936–942. https://doi.org/10.1093/ajcn/36.5.936
5.
BrookmeyerR.CorradaM. M.CurrieroF. C.KawasC. (2002). Survival following a diagnosis of Alzheimer disease. Archives of Neurology, 59(11), 1764–1767. https://doi.org/10.1001/archneur.59.11.1764
6.
BrownJ.ChenS. L. (2008). Help-seeking patterns of older spousal caregivers of older adults with dementia. Issues in Mental Health Nursing, 29(8), 839–852. https://doi.org/10.1080/01612840802182854
7.
CallahanC. M.UnverzagtF. W.HuiS. L.PerkinsA. J.HendrieH. C. (2002). Six-item screener to identify cognitive impairment among potential subjects for clinical research. Medical Care, 40(9), 771–781. https://doi.org/10.1097/00005650-200209000-00007
8.
CobbL. K.GodinoJ. G.SelvinE.Kucharska-NewtonA.CoreshJ.KotonS. (2016a). Spousal influence on physical activity in middle-aged and older adults: The ARIC study. American Journal of Epidemiology, 183(5), 444–451. https://doi.org/10.1093/aje/kwv104
9.
CobbL. K.McAdams-DeMarcoM. A.GudzuneK. A.AndersonC. A. M.DemerathE.WoodwardM.SelvinE.CoreshJ. (2016b). Changes in body mass index and obesity risk in married couples over 25 Years: The ARIC cohort study. American Journal of Epidemiology, 183(5), 435–443. https://doi.org/10.1093/aje/kwv112
10.
DasselK. B.CarrD. C. (2016). Does dementia caregiving accelerate frailty? Findings from the health and retirement study. The Gerontologist, 56(3), 444–450. https://doi.org/10.1093/geront/gnu078
11.
DasselK. B.CarrD. C.VitalianoP. (2017). Does caring for a spouse with dementia accelerate cognitive decline? Findings from the health and retirement study. The Gerontologist, 57(2), 319–328. https://doi.org/10.1093/geront/gnv148
12.
de VugtM. E.JollesJ.van OschL.StevensF.AaltenP.LousbergR.VerheyF. R. J. (2006). Cognitive functioning in spousal caregivers of dementia patients: Findings from the prospective MAASBED study. Age and Ageing, 35(2), 160–166. https://doi.org/10.1093/ageing/afj044
13.
Di CastelnuovoA.QuacquaruccioG.DonatiM. B.de GaetanoG.IacovielloL. (2009). Spousal concordance for major coronary risk factors: A systematic review and meta-analysis. American Journal of Epidemiology, 169(1), 1–8. https://doi.org/10.1093/aje/kwn234
14.
FonarevaI.OkenB. S. (2014). Physiological and functional consequences of caregiving for relatives with dementia. International Psychogeriatrics/IPA, 26(5), 725–747. https://doi.org/10.1017/S1041610214000039
15.
GalvinJ. E.RoeC. M.PowlishtaK. K.CoatsM. A.MuichS. J.GrantE.MillerJ. P.StorandtM.MorrisJ. C. (2005). The AD8: A brief informant interview to detect dementia. Neurology, 65(4), 559–564. https://doi.org/10.1212/01.wnl.0000172958.95282.2a
16.
GibbonsC.CreeseJ.TranM.BrazilK.ChambersL.WeaverB.BédardM. (2014). The psychological and health consequences of caring for a spouse with dementia: A critical comparison of husbands and wives. Journal of Women & Aging, 26(1), 3–21. https://doi.org/10.1080/08952841.2014.854571
17.
GrossA. L.PowerM. C.AlbertM. S.DealJ. A.GottesmanR. F.GriswoldM.WruckL. M.MosleyT. H.CoreshJ.SharrettA. R.Bandeen-RocheK. (2015). Application of latent variable methods to the study of cognitive decline when tests change over time. Epidemiology (Cambridge, Mass.), 26(6), 878–887. https://doi.org/10.1097/EDE.0000000000000379
18.
HoxJ. J.MoerbeekM.van de SchootR. (2010). Multilevel analysis: Techniques and applications (2nd ed.). Routledge.
19.
KnopmanD. S.GottesmanR. F.SharrettA. R.WruckL. M.WindhamB. G.CokerL.SchneiderA. L. C.HengruiS.AlonsoA.CoreshJ.AlbertM. S.MosleyT. H. (2016). Mild cognitive impairment and dementia prevalence: The atherosclerosis risk in communities neurocognitive study. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, 2(1), 1–11. https://doi.org/10.1016/j.dadm.2015.12.002
20.
LangaK. M.LarsonE. B.CrimminsE. M.FaulJ. D.LevineD. A.KabetoM. U.WeirD. R. (2017). A comparison of the prevalence of dementia in the United States in 2000 and 2012. JAMA Internal Medicine, 177(1), 51–58. https://doi.org/10.1001/jamainternmed.2016.6807
21.
LivingstonG.HuntleyJ.SommerladA.AmesD.BallardC.BanerjeeS.BrayneC.BurnsA.Cohen-MansfieldJ.CooperC.CostafredaS. G.DiasA.FoxN.GitlinL. N.HowardR.KalesH. C.KivimäkiM.LarsonE. B.OgunniyiA.MukadamN. (2020). Dementia prevention, intervention, and care: 2020 report of the lancet commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6
22.
ManningW. D.BrownS. L. (2011). The demography of unions among older Americans, 1980–present: A family change approach. In SetterstenR. A.AngelJ. L. (Eds.), Handbook of sociology of aging (pp. 193–210). Springer. https://doi.org/10.1007/978-1-4419-7374-0_13
23.
McAdams DeMarcoM.CoreshJ.WoodwardM.ButlerK. R.KaoW. H. L.MosleyT. H.HindinM.AndersonC. A. M. (2011). Hypertension status, treatment, and control among spousal pairs in a middle-aged adult cohort. American Journal of Epidemiology, 174(7), 790–796. https://doi.org/10.1093/aje/kwr167
24.
NortonM. C.SmithK. R.ØstbyeT.TschanzJ. T.CorcoranC.SchwartzS.PiercyK. W.RabinsP. V.SteffensD. C.SkoogI.BreitnerJ. C. S.Welsh-BohmerK. A.Cache County Investigators (2010). Greater risk of dementia when spouse has dementia? The cache county study. Journal of the American Geriatrics Society, 58(5), 895–900. https://doi.org/10.1111/j.1532-5415.2010.02806.x
25.
OryM. G.HoffmanR. R.IIIYeeJ. L.TennstedtS.SchulzR. (1999). Prevalence and impact of caregiving: A detailed comparison between dementia and nondementia caregivers. The Gerontologist, 39(2), 177–185. https://doi.org/10.1093/geront/39.2.177
26.
RothD. L.Dilworth-AndersonP.HuangJ.GrossA. L.GitlinL. N. (2015). Positive aspects of family caregiving for dementia: Differential Item functioning by race. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 70(6), 813–819. https://doi.org/10.1093/geronb/gbv034
SchneiderA. L. C.SharrettA. R.GottesmanR. F.CoreshJ.CokerL.WruckL.SelnesO. A.DealJ.KnopmanD.MosleyT. H. (2015). Normative data for 8 neuropsychological tests in older blacks and whites from the atherosclerosis risk in communities (ARIC) study. Alzheimer Disease and Associated Disorders, 29(1), 32–44. https://doi.org/10.1097/WAD.0000000000000042
29.
SmitsJ. (2003). Social closure among the higher educated: Trends in educational homogamy in 55 countries. Social Science Research, 32(2), 251–277. https://doi.org/10.1016/S0049-089X(02)00049-2
30.
SpearmanC. (1904). The proof and measurement of association between two things. The American Journal of Psychology, 15(1), 72–101. https://doi.org/10.2307/1412159
31.
VälimäkiT. H.MartikainenJ. A.HongistoK.VäätäinenS.SintonenH.KoivistoA. M. (2016). Impact of Alzheimer’s disease on the family caregiver’s long-term quality of life: Results from an ALSOVA follow-up study. Quality of Life Research: an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 25(3), 687–697. https://doi.org/10.1007/s11136-015-1100-x
32.
VitalianoP. P.MurphyM.YoungH. M.EcheverriaD.BorsonS. (2011). Does caring for a spouse with dementia promote cognitive decline? A hypothesis and proposed mechanisms. Journal of the American Geriatrics Society, 59(5), 900–908. https://doi.org/10.1111/j.1532-5415.2011.03368.x
33.
WilsonR. S.SegawaE.BoyleP. A.AnagnosS. E.HizelL. P.BennettD. A. (2012). The natural history of cognitive decline in Alzheimer’s disease. Psychology and Aging, 27(4), 1008–1017. https://doi.org/10.1037/a0029857
34.
Wu-ChungE. L.LealS. L.DennyB. T.ChengS. L.FagundesC. P. (2022). Spousal caregiving, widowhood, and cognition: A systematic review and a biopsychosocial framework for understanding the relationship between interpersonal losses and dementia risk in older adulthood. Neuroscience and Biobehavioral Reviews, 134, 104487. https://doi.org/10.1016/j.neubiorev.2021.12.010
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