Spousal Loneliness, Depression, and Closeness Among Older Adults Married to Persons with Dementia: A Nationally Representative Study (SA314B)

TitleSpousal Loneliness, Depression, and Closeness Among Older Adults Married to Persons with Dementia: A Nationally Representative Study (SA314B)
Publication TypeJournal Article
Year of Publication2023
AuthorsHsu, K, Cenzer, I, Harrison, K, Ritchie, C, Waite, L, Waite, L
JournalJournal of Pain and Symptom Management
Volume65
Paginatione304-e305
ISSN Number0885-3924
Keywordscloseness, depression, Loneliness, Older Adults
Abstract

Outcomes 1. Analyze the role of marriage in serious illness and dementia 2. Discuss interactive biopsychosocial model underlying marriage and health among older adults with serious illness, and key social measures 3. Describe the prevalence of loneliness, depression, or both among spouses married to persons with dementia 4. Discuss how one's partner's cognitive decline is associated with higher levels of loneliness and depression Background Older adults married to persons with dementia (PWD) may be at risk for loneliness and depression. However, it is unclear how often each occur and the extent to which they are distinct. Research objectives To determine the prevalence of loneliness and depression among older adults married to PWD or mild cognitive impairment (MCI) and the role of marital closeness in mediating these outcomes Methods We used a nationally representative sample of 3,666 married couples enrolled in the Health and Retirement Study (2014 and 2016). We included older adults married to PWD (N=201), married to persons with MCI (N=778), or married to persons with normal cognition (N=2,687). We determined the prevalence of loneliness using multivariable logistic regression adjusting for socio-demographic characteristics, then tested for interaction between marital closeness and degree of spousal cognitive impairment. We assessed the prevalence of depression, and both loneliness and depression, using the same method. Results The sample was 54% women and on average 67 years old (Range: 50–97). After adjustment, older adults married to PWD were more likely to be lonely (Normal: 20%, MCI: 21%, PWD: 30%; p=0.02), depressed (Normal: 7%, MCI: 14%, PWD: 16%; p< 0.01), and both (Normal: 4%, MCI: 8%, PWD: 9%; p< 0.01). The association between spousal cognition and loneliness differed by marital closeness (interaction p-value=0.01); among “close” couples, spousal cognitive impairment was associated with higher likelihood of loneliness (p=0.01). In contrast, no association existed between spousal cognitive impairment and loneliness among “not close” couples (p=0.24). Conclusion Nearly 1 in 3 spouses of PWD experienced loneliness and 1 in 6 experienced depression. The association between spousal cognition and loneliness was stronger among those with close marital bonds. Implications Findings highlight substantial opportunity to identify and address loneliness and depression among spouses of PWD with close relational bonds to improve quality of life.

DOI10.1016/j.jpainsymman.2022.12.132
Citation KeyHSU2023e304