The Association Between Marriage Status and Mild Cognitive Impairment among Chinese Older Adults: A Prospective Cohort Study

It is common and inevitable for older adults to undergo changes in marital status, one of which is widowhood that is likely to increase the risk of mild cognitive impairment (MCI) in later life. Till today, this association between widowhood, remarriage after widowhood and characteristics of widowed life and MCI risk among Chinese older adults remains poorly investigated. Data was derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018 and participants aged 65 years or above, without cognitive impairment at the baseline survey and without missing values in key variables were included. MCI status was measured MCI by the Mini-Mental State Examination. Cox Proportional Hazard models were used to estimate the association between marital status and MCI onset. This study used restrict cubic spline models to explore and plot how age at widowhood and living alone duration after widowhood were related to MCI incidence. In comparison to those never widowed, those who had spouse loss and did not remarry were more likely to get MCI, whether they were widowed later than the baseline year or always widowed throughout the survey. Widowed women, compared with their counterparts, have a significantly higher risk of MCI. When compared with those always widowed, those widowed but remarried did not have a significantly higher or lower risk of MCI. Among widowed participants, this MCI risk increased with the age of widowhood, and the association of living alone duration after widowhood and MCI onset displayed an inverse U-shape, with a peak risk at the 10th year. Widowhood is confirmed as a risk factor for MCI while remarriage could not alleviate this risk. Women, older adults, and those living alone after widowhood are the most vulnerable groups to MCI. Our findings have political implications.