Having a family life increases the risk of dementia in the elderly

Researchers from the University of Florida College of Medicine and the University of Montpelier found that older adults who were divorced or never married had a lower risk of developing dementia over 18 years of follow-up compared to their married peers. The findings suggest that unmarried people may not have an increased risk of developing cognitive impairment, contrary to a long-held opinion in public health and aging research.

Marriage is often considered to improve health and prolong life, but evidence reflecting the association of marital status with dementia risk remains conflicting.

The increasing number of older adults who are divorced, widowed, or never married has raised concerns about potential susceptibility to dementia in these groups. Previous studies have not consistently examined how marital status is associated with specific causes of dementia and how factors such as gender, depression, or genetic predisposition may influence these associations.

In an article published in the journal Alzheimer’s & Dementia, researchers presented the results of an 18-year cohort study of the association of marital status with the risk of dementia in older adults

More than 24,000 participants without dementia at baseline were enrolled at 42 Alzheimer’s disease research centers across the U.S. through the National Alzheimer’s Disease Coordination Center. Annual clinical examinations were performed by trained physicians using standardized protocols to assess cognitive function and determine a diagnosis of dementia or mild cognitive impairment.

To assess long-term risk, the researchers followed participants for 18.5 years, providing data for more than 122,000 person-years. Participants’ marital status at baseline was categorized as married, widowed, divorced, or never married.

The risk of dementia was analyzed using Cox proportional hazards regression, with married participants as the control group. The model took into account demographic characteristics, mental and physical health, behavioral history, genetic risk factors, and other variables.

Compared to married participants, divorced or never-married participants had a consistently lower risk of developing dementia throughout the study period. Dementia was diagnosed in 20.1% of the total sample. Among married participants, 21.9% developed dementia over the study period. The incidence among widows was similar at 21.9 %, but markedly lower among divorcees (12.8 %) and never married (12.4 %).

These correlations remained significant for the divorced and never married groups after accounting for factors related to health, behavior, genetics, and referrals. The relationship for widowed participants in the fully adjusted model weakened and was no longer statistically significant.

Divorced and never-married people were also less likely to progress from mild cognitive impairment to dementia.

The risk was slightly higher among men, younger people, and participants referred to clinics by health care providers. However, stratified analyses showed minimal differences, suggesting that associations persisted across a wide range of demographic and clinical subgroups.

The researchers concluded that unmarried people, especially those who were divorced or never married, had a lower risk of developing dementia than those who remained married.

The patterns were broadly similar across sex, age, education, and genetic risk categories.

Older unmarried people in this study were less likely to be diagnosed with dementia than their married peers.

The findings contrast with previous studies linking unmarried status to increased risk of dementia and provide new evidence that relationship status may be associated with cognitive outcomes when diagnosed under standardized conditions.

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Published: 08.04.2025

Updated: 07.04.2025

Medical expert:

PhD. Olexandr Voznyak

Medical author, Medical editor:

Stepan Yuk