Abstract Details

Title Marital Status and Cognitive Decline in a Prospective Northern Manhattan Cohort

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-014

Objective

To determine whether marital status is associated with cognitive decline in a population-based cohort.

Background

Being unmarried has been associated with clinical markers of cerebral vasculopathy and adverse neurovascular events. It remains unknown whether marital status is associated with cognitive decline.

Design/Methods In the Northern Manhattan Study, a prospective and diverse community-dwelling cohort, we evaluated cognition of the participants who received MRI, all of whom were > 55 years of age and stroke-free. The sample was divided into married and unmarried participants, and the latter were subdivided into divorced/separated, widowed, or single. During 2 to 3 visits over 9±4 years, we measured their memory, processing speed, language, and executive function, and computed a global score that averaged these four outcomes. We used longitudinal analyses to investigate associations between marital status and cognitive decline. Covariates included sociodemographic variables — age, ethnicity, and sex — and the following neurovascular risk factors: hypertension, diabetes, hypercholesterolemia, smoking, APOE-ε4 status, total cranial volume, presence of covert brain infarct, and body mass index.

Results Of 970 participants, 43% were married, 15% were single, 14% were widowed, and 27% were divorced/separated. Compared to married participants, unmarried participants had a greater decline in memory (β=-0.14; 95% CI [-0.26, -0.02]), processing speed (β =-0.24, 95% CI [-0.36, -0.12]), and global cognition (β=-0.13, 95% CI [-0.22, -0.04]). Decline in processing speed was most pronounced in single participants (β=-0.32, 95% CI [-0.49, -0.15]) and widowed participants (β= -0.29, 95% CI [-0.47, -0.11]). Marital status did not predict a decline in executive function.

Conclusions Processing speed, memory, and global cognition scores decreased more for unmarried participants compared to their married counterparts. These results link marital history with cognitive sequelae. Future studies should explore how health behaviors vary by partnership status, and whether supporting healthy relationships can improve neurocognitive outcomes.

Authors/Disclosures
Courtney Gao, MD PRESENTER	An immediate family member of Dr. Gao has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Kaiser Permanente. An immediate family member of Dr. Gao has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Kaiser Permanente. An immediate family member of Dr. Gao has or had stock in Kaiser Permanente. An immediate family member of Dr. Gao has or had stock in Pfizer. An immediate family member of Dr. Gao has or had stock in Roche. An immediate family member of Dr. Gao has or had stock in Exelixis.
Jackson A. Roberts, MD	Dr. Roberts has nothing to disclose.
Yan Ge, MD	Dr. Ge has nothing to disclose.
Hannah Gardener, ScD (University of Miami)	Ms. Gardener has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Intersocietal Accreditation Commission. Ms. Gardener has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ellipse Analytics. Ms. Gardener has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Baum Hedlund. Ms. Gardener has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant with A Green Slate Consulting.
Tatjana Rundek, MD, PhD	The institution of Dr. Rundek has received research support from NIH.
Mitchell S. Elkind, MD, MS, FAAN	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.
Sarah Tom, PhD	The institution of Dr. Tom has received research support from National Institutes of Health . Dr. Tom has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Alzheimer's Association .
Jose Gutierrez, MD (Columbia University)	Dr. Gutierrez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cardiovascular Research Foundation. Dr. Gutierrez has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for White and Rusell. Dr. Gutierrez has received research support from NIH. Dr. Gutierrez has received publishing royalties from a publication relating to health care. Dr. Gutierrez has received publishing royalties from a publication relating to health care.

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