- Studies found that enjoyment of time with a spouse positively correlates with better cognitive function.
- Marital strain is consistently linked to poorer cognitive function, suggesting that unresolved conflicts and stress within a marriage can adversely affect cognitive health.
- These effects encompass multiple domains of cognitive functioning, including memory, executive function, and perceptual speed.
Introduction
Forget crossword puzzles—your spouse might be the key to keeping your mind sharp well into your golden years.
This is the implication of a systematic literature review conducted by Paniz Haghighi, Emma A.L. Littler, Dane Mauer-Vakil, Michaella Miller, and Mark Oremus of the University of Waterloo. Their study, published in Social Science & Medicine, synthesizes the outcomes of 15 studies that investigated the link between marital quality and cognitive function.
Read on to learn more about their research into the (mostly) positive correlations between marital quality and cognitive function.
Background
Systematic literature reviews aren’t published in scholarly journals as often as you might think–but when they are, they’re often very valuable. In this article, published in Social Science & Medicine, Paniz Haghighi and her colleagues consider the existing research on the link between marital quality and cognitive function.
Unsurprisingly, for most married people, their closest and most emotionally significant relationship is with their spouse. And research consistently shows that married individuals enjoy better physical and psychological health compared to their unmarried peers. Past research, for instance, has shown:
- Spouses often act as informal caregivers during illness, positively influencing recovery.
- The economic benefits of marriage, such as pooled resources, can enhance access to quality nutrition, health insurance, and transportation for medical appointments.
- Spousal support also improves health-seeking behaviors and treatment adherence, particularly among older men.
- Conversely, being unmarried is linked to more severe chronic conditions, higher blood pressure, greater depressive symptoms, higher mortality rates, and cognitive impairment.
The benefits of marriage are not limited to health. Other findings include:
- As social networks shrink with age, individuals increasingly rely on their spouses for emotional and practical support.
- Spouses are more likely than other family members or friends to provide instrumental support, such as help with household chores.
- Older adults generally prefer to live independently, and spousal relationships are vital in supporting this independence.
But, of course, the mere fact of being married does not automatically confer these benefits. We know that, in some cases, single individuals may experience better health outcomes than those in unhappy marriages. For example, divorce from a stressful or abusive marriage can lead to improved health.
Cognitive function, marital quality, and stress buffering
Cognitive function encompasses a range of mental processes essential for everyday tasks, including thinking, reasoning, learning, remembering, and problem-solving. The DSM-5 outlines six key domains of cognitive function:
- Executive function
- Complex attention
- Learning and memory
- Language
- Perceptual-motor function
- Social cognition
Together, these domains are known as ‘global’ cognitive function, which plays a critical role in healthy aging by supporting independence, job performance, decision-making, and overall quality of life.
Marital quality refers to the satisfaction and positive attitudes one has towards their spouse. It encompasses both positive aspects (e.g., love, support, satisfaction) and negative aspects (e.g., conflict, demands, strains).
The stress-buffering hypothesis suggests that high-quality support from loved ones, such as spouses, can mitigate the impact of stress by providing stability, positive emotions, self-worth, and resources to reframe stressors. Effective stress buffering can reduce physiological stress reactions and support cognitive health by fostering effective coping strategies.
This is important because we know chronic stress is a significant risk factor for cognitive decline as it impairs the brain’s ability to acquire, consolidate, and retrieve information. This is because stress activates the hypothalamic-pituitary-adrenal axis, leading to the release of cortisol, a stress hormone that negatively affects cognitive functioning.
Therefore, less stressed individuals due to their marriage may have better cognitive functioning. Conversely, poor marital quality can be a significant source of stress, negatively impacting cognitive performance through various physiological pathways.
There is already some evidence supporting this hypothesis:
- One systematic review previously found that single and widowed individuals have a higher risk of dementia compared to married individuals.
- Another review by indicated that marital status might influence the relationship between social support and memory in middle-aged and older adults, with spousal support showing some positive associations with memory, although the effects were modest.
- To date, however, no reviews have specifically examined the link between marital quality and cognitive function.
Therefore, Haghighi and her colleagues are aiming to fill this gap in the literature.
Methods
To be included in the review, articles had to explore the impact of marital quality or similar variables (like marital adjustment or satisfaction) on cognitive function. Specific criteria were:
- Study Designs: Only cohort, case-control, and cross-sectional studies were considered, regardless of publication date or setting, provided they were published in English in scholarly journals. Randomized controlled trials were excluded due to the inability to randomize the exposure variable, which is marital quality.
- Participants: Studies must include adults aged 18 or older who were married or in common-law relationships. The definitions of “common law” used in the studies were accepted as they were.
- Exposure: The primary exposure variable was marital quality. This includes measures of positive marital experiences (such as satisfaction and adjustment) and negative experiences (like strain and conflict). Various validated instruments and single-question measures were accepted.
- Outcome: The main outcome variable was cognitive function, measured globally or by specific domains (e.g., memory, executive function) using any tools. Studies focusing only on clinical diagnoses of cognitive disorders like Alzheimer’s disease were excluded.
Databases searched included PubMed, PsycINFO, and Scopus from inception to January 9, 2024. Additionally, reference lists of included articles were manually reviewed to identify any missed relevant studies.
The screening process involved two steps:
- Title and Abstract Screening: Initial screening based on titles and abstracts. Articles were included for full-text screening if both reviewers answered “yes” to all inclusion questions or lacked information but did not answer “no”.
- Full-text Screening: Articles that passed the initial screening were reviewed in full text. Both reviewers had to agree on inclusion for the article to be accepted. Disagreements were resolved by consensus or by a third reviewer.
A data extraction form was created, including details such as authors, publication year, country of data collection, study design, sample size, proportion of female participants, types and measures of marital quality and cognitive function, covariates, and main findings. Two reviewers independently extracted data, compared their results, and resolved discrepancies by consensus or a third reviewer.
Due to significant methodological differences across studies, a meta-analysis was not feasible. Results were summarized using the regression coefficient (β) or other effect measures (e.g., correlation coefficient), and findings were discussed separately for each cognitive outcome.
The risk of bias in each study was evaluated using the Joanna Briggs Institute Critical Appraisal Checklists. Two reviewers independently assessed each study, and any disagreements were resolved by consensus. The review found that 13 articles had a low risk of bias, while two had a moderate risk.
The review process identified 649 articles, with 455 screened by title and abstract and 36 proceeding to full-text screening. Ultimately, only 15 articles qualified for inclusion in the narrative synthesis.
Findings
Research has consistently highlighted the significant impact of marital quality on global cognitive function. Nine studies reviewed demonstrated a clear association between marital interactions and cognitive performance:
- For instance, Gallagher and Stokes (2021) found that marital strain was negatively correlated with cognitive function in both husbands (r = −0.07) and wives (r = −0.06), while enjoyment of time with a spouse had a positive correlation (r = 0.07 for husbands and r = 0.06 for wives).
- Similarly, Liu et al. (2021) reported that baseline positive marital quality was associated with better baseline cognitive function (β = 0.22, 95% CI = 0.09, 0.35), whereas negative marital quality was linked to worse cognitive function (β = −0.27, 95% CI = −0.41, −0.14).
However, the relationship between marital quality and cognitive function is complex and multifaceted:
- Ko et al. (2007) noted negative but non-significant correlations between marital satisfaction and cognitive function, suggesting that the strength of these associations might vary.
- Moreover, Wuttke-Linnemann et al. (2020) observed a positive correlation between marital quality and cognitive function in individuals with dementia (r = 0.16), although this was not statistically significant, indicating that the effects might differ depending on the cognitive status of individuals.
- Ge et al. (2017) provided a contrasting view by reporting a positive association between spousal strain and global cognitive function (β = 0.10, 95% CI = 0.04, 0.16), which complicates the understanding of whether all forms of marital quality uniformly impact cognitive health.
- Xu et al. (2016) further added that negative marital experiences could inversely relate to cognitive limitations over time (β = −0.00, 95% CI = −0.01, −0.00), suggesting that some negative experiences might unexpectedly benefit cognitive function.
Memory
Memory, both episodic and working, is another domain where marital quality exerts a significant influence.
- For example, Ge et al. (2017) reported positive associations between spousal strain and both episodic (β = 0.11, 95% CI = 0.03, 0.19) and working memory (β = 0.19, 95% CI = −0.01, 0.39), though the latter was not statistically significant.
- Lindert et al. (2022) found that marital strain was linked to greater declines in episodic memory over time among men (β = 0.13, 95% CI = 0.01, 0.25), but this was not significant for women (β = 0.04, 95% CI = −0.10, 0.18).
- Sillars et al. (1990) highlighted that negative marital satisfaction was associated with poorer recall of negative and confrontational statements (r = −0.32 and r = −0.35, respectively).
- Whisman and Delinsky (2002) showed that higher marital satisfaction was positively correlated with the recall of positive adjectives in both husbands (r = 0.09) and wives (r = 0.19). Conversely, negative marital satisfaction was significantly correlated with the recall of negative adjectives (r = −0.43 for husbands and r = −0.60 for wives), reinforcing the idea that negative aspects of marital quality could detrimentally affect memory.
Executive Function
Executive function, encompassing skills such as planning, problem-solving, and attentional control, also appears to be influenced by marital quality.
- Ge et al. (2017) found a significant positive association between spousal strain and executive function (β = 1.28, 95% CI = 0.32, 2.24).
- Lindert et al. (2022) observed positive, albeit non-significant, correlations between marital strain and declines in executive functioning over time among both men (β = 0.01, 95% CI = −0.07, 0.09) and women (β = 0.05, 95% CI = −0.01, 0.11).
- Min and Song (2023) noted that individuals in ambivalent (β = 0.10, 95% CI = −0.17, 0.38) or supportive relationships (β = 0.06, 95% CI = −0.14, 0.26) demonstrated better executive functioning compared to those in aversive relationships. On the other hand, indifferent relationships were associated with poorer executive function (β = −0.12, 95% CI = −0.39, 0.15).
These findings suggest that the nature of marital relationships—whether supportive, ambivalent, or indifferent—can significantly affect one’s executive functioning capabilities.
Perceptual Speed
Perceptual speed, the ability to quickly and accurately process visual information, showed limited associations with marital quality.
- Windsor et al. (2014), for example, reported no correlation between positive spouse exchanges and perceptual speed (r = 0.00).
- Negative spouse exchanges were inversely correlated with perceptual speed before adjusting for covariates (unadjusted r = −0.08), but this association weakened after full adjustment (r = −0.07), indicating that other factors might mitigate the impact of marital quality on perceptual speed.
Conclusions
This review underscores the complex relationship between marital quality and cognitive function:
- Overall, positive marital quality tends to be associated with better cognitive performance across various domains, although the results are not universally consistent.
- But several studies reported non-significant associations, which might be due to underpowered analyses or differences in study design, sample characteristics, and measures of marital quality and cognitive function.
The findings align with existing literature suggesting that supportive social relationships, particularly marital relationships, can positively influence cognitive health by providing emotional support, stability, and resources to manage stress. However, negative marital quality can act as a source of stress, potentially undermining cognitive health.
Sex differences in the impact of marital quality on cognitive function were evident, with men and women experiencing and reacting to marital quality differently.
- Men generally report higher satisfaction in marriages and rely more on their spouses for emotional support, making them more sensitive to marital strain.
- Women, on the other hand, tend to have larger social networks and receive support from various sources, which might buffer the impact of marital quality on their cognitive health.
The authors make several suggestions for future research:
- Future research should consider additional contextual factors such as the length of marriage and previous marital history.
- Future research should aim for consistency in defining and measuring marital quality and cognitive function.
- Finally, the reviewers encourage researchers to engage more directly with the difference between “sex” and “gender,” and the social construction of the latter, in future research.
What Can You Do?
Improving both marital quality and cognitive functioning in old age is not only beneficial but also achievable through intentional actions and lifestyle changes. Here are some concrete steps you can take to enhance your relationship with your spouse and support your cognitive health:
- Prioritize Open Communication: Regularly engage in meaningful conversations with your spouse. Discuss your feelings, thoughts, and experiences to maintain a deep emotional connection. Address conflicts constructively and seek resolution through calm and respectful dialogue.
- Invest in Quality Time Together: Schedule regular activities that you both enjoy, such as hobbies, outings, or even simple walks. Shared experiences can strengthen your bond and create positive memories.
- Support Each Other’s Goals: Encourage and support your spouse’s personal and professional aspirations. Acknowledging and celebrating each other’s achievements fosters a sense of partnership and mutual respect.
- Maintain Physical Affection: Physical touch, such as holding hands, hugging, and kissing, can enhance intimacy and emotional closeness. Regular physical affection can reduce stress and boost mood.
- Engage in Joint Physical Activities: Participate in physical exercises together, such as walking, dancing, or yoga. Physical activity benefits both physical and cognitive health and can be more enjoyable with a partner.
- Cultivate a Positive Attitude: Focus on the positive aspects of your relationship. Express gratitude and appreciation for your spouse, which can reinforce positive feelings and reduce stress.
- Seek Professional Help if Needed: If you encounter persistent marital issues, consider seeking counseling or therapy. Professional guidance can help you navigate challenges and improve relationship dynamics.
- Stay Socially Active: Maintain a strong social network beyond your marriage. Engage with friends, family, and community groups to ensure a balanced support system and diverse social interactions.
- Engage in Cognitive Stimulation: Challenge your brain with activities that stimulate cognitive function, such as puzzles, reading, learning new skills, or engaging in intellectually stimulating conversations with your spouse.
- Manage Stress Effectively: Practice stress-reducing techniques such as mindfulness, meditation, or relaxation exercises. Reducing stress can protect cognitive health and improve overall well-being.
By incorporating these actions into your daily life, you can foster a healthier, happier marriage and support your cognitive functioning well into old age. Prioritizing your relationship and mental health through these practical steps can lead to a more fulfilling and resilient life together.
Do you find these results surprising? What else can be done to improve either marital quality or cognitive functioning in old age? Discuss in the comments!
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