Gender Differences in the Association Between Marriage and Cognitive Decline: Evidence From the China Health and Retirement Longitudinal Study (CHARLS).

Abstract

This study aimed to investigate the relationship between marital status and the risk of cognitive decline in middle-aged and older adults, with a particular focus on gender differences. Data were derived from the China Health and Retirement Longitudinal Study (CHARLS), using Cox proportional hazards models to examine the association between marital status and cognitive decline. The analysis controlled for sociodemographic factors (age, education, smoking, alcohol consumption), lifestyle factors (physical activity, sleep), and gender. Gender-stratified analyses were conducted to explore potential differences in the protective effects of marriage on cognitive function. The overall association between marital status and cognitive decline risk did not reach statistical significance after controlling for confounders. However, gender-stratified analysis revealed that marriage was significantly negatively associated with cognitive decline risk in men. No significant association was observed in women. Age remained a significant predictor of cognitive impairment. Marriage may be associated with cognitive function, particularly among men, while no significant association was observed in women. These findings suggest that gender differences should be taken into account in cognitive health interventions. Future studies are warranted to explore the potential mediating roles of marital quality, social support, and emotional interactions in shaping cognitive outcomes.