Skip to main content Accessibility help

The relationship between marital and parental status and the risk of dementia

  • Anna Sundström (a1) (a2), Olle Westerlund (a3) (a4), Hossein Mousavi-Nasab (a5), Rolf Adolfsson (a6) and Lars-Göran Nilsson (a7)...



This study examines the association between marital and parental status and their individual and combined effect on risk of dementia diseases in a population-based longitudinal study while controlling for a range of potential confounders, including social networks and exposure to stressful negative life events.


A total of 1,609 participants without dementia, aged 65 years and over, were followed for an average period of 8.6 years (SD = 4.8). During follow-up, 354 participants were diagnosed with dementia. Cox regression was used to investigate the effect of marital and parental status on risk of dementia.


In univariate Cox regression models (adjusted for age as time scale), widowed (hazard ratio (HR) 1.42, 95% confidence interval (CI) = 1.13–1.78), and not having children (HR 1.54, 95% CI = 1.15–2.06) were significantly associated with incident dementia. In multivariate analyses that included simultaneously marital and parental status and covariates that were found to be significant in univariate models (p < 0.10), the HR was 1.30 (95% CI = 1.01–1.66) for widowed, and 1.51 (95% CI = 1.08–2.10) for those not having children. Finally, a group of four combined factors was constructed: married parents (reference), married without children, widowed parents, and widowed without children. The combined effect revealed a 1.3 times higher risk (95% CI = 1.03–1.76) of dementia in widow parents, and a 2.2 times higher risk (95% CI = 1.36–3.60) in widowed persons without children, in relation to married parents. No significant difference was observed for those being married and without children.


Our findings suggest that marital- and parental status are important risk factors for developing dementia, with especially increased risk in those being both widowed and without children.


Corresponding author

Correspondence should be addressed to: Dr Anna Sundström, Centre for Population Studies/Ageing and Living Conditions and Department of Psychology, Umeå University, S-90187 Umeå, Sweden. Phone: +46 90 786 61 39, Fax: +46 90 786 66 95. E-mail:


Hide All
Becker, J. T. et al. (2009). Depressed mood is not a risk factor for incident dementia in a community-based cohort. The American Journal of Geriatric Psychiatry, 17, 653663. doi:10.1097/JGP.0b013e3181aad1fe.
Cohen, S. and Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310357. doi:10.1037/0033-2909.98.2.310.
Coombs, R. H. (1991). Marital status and personal well-being: a literature review. Family Relations, 40, 97102. doi:10.2307/585665.
Dykstra, P. (2006). Off the beaten track: childlessness and social integration in late life. Research on Aging, 28, 749767. doi:10.1177/0164027506291745.
Fabrigoule, C., Letenneur, L., Dartigues, J. F., Zarrouk, M., Commenges, D. and Barberger-Gateau, P. (1995). Social and leisure activities and risk of dementia: a prospective longitudinal study. Journal of the American Geriatric Society, 43, 583584.
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198. doi:10.1016/0022-3956(75)90026-6.
Fratiglioni, L., Paillard-Borg, S. and Winblad, B. (2004). An active and socially integrated lifestyle in late life might protect against dementia. The Lancet Neurology, 3, 343353. doi:10.1016/S1474-4422(04)00767-7.
Fratiglioni, L., Wang, H. X., Ericsson, K., Maytan, M. and Winblad, B. (2000). Influence of social network on occurrence of dementia: a community-based longitudinal study. The Lancet, 355, 13151319. doi:10.1016/S0140-6736(00)02113-9.
Håkansson, K. et al. (2009). Association between mid-life marital status and cognitive function in later life: population based cohort study. British Medical Journal, 2, 339, b2462. doi:
Helmer, C. et al. (1999). Marital status and risk of Alzheimer's disease: a French population-based cohort study. Neurology, 53, 19531958. doi:10.1212/WNL.53.9.1953.
Holmes, T. H. and Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213218. doi:10.1016/0022-3999(67)90010-4.
Hughes, M. E. and Waite, L. J. (2009). Marital biography and health at mid-life. Journal of Health and Social Behavior, 50, 344358. doi:10.1177/002214650905000307.
Jankowsky, J. L. et al. (2005). Environmental enrichment mitigates cognitive deficits in a mouse model of Alzheimer's disease. The Journal of Neuroscience, 25, 52175224. doi:10.1523/jneurosci.5080-04.2005.
Jorm, A. F. (2001). History of depression as a risk factor for dementia: an updated review. Australian & New Zealand Journal of Psychiatry, 35, 776781. doi:10.1046/j.1440-1614.2001.00967.x.
Karp, A. et al. (2004). Relation of education and occupation-based socioeconomic status to incident Alzheimer's disease. American Journal of Epidemiology, 159, 175183.
Kendig, H., Dykstra, P. A., van Gaalen, R. and Melkas, T. (2007). Health of aging parents and childless individuals. Journal of Family Issues, 28, 14571486. doi:10.1177/0192513X07303896.
Koropeckyj-Cox, T. (2007). Loneliness and depression in middle and old age: are the childless more vulnerable? Journal of Gerontology: Social Sciences, 6, S303312. doi:10.1093/geronb/53B.6.S303
Lupien, S. J., Maheu, F, Tu, M. and Schramek, T. E. (2007). The effects of stress and stress hormones on human cognition: implications for the field of brain and cognition. Brain and Cognition, 65, 209237. doi:10.1016/j.bandc.2007.02.007.
Mousavi-Nasab, S. M., Kormi-Nouri, R., Sundström, A. and Nilsson, L. G. (2012). The effects of marital status on episodic and semantic memory in healthy middle-aged and old individuals. Scandinavian Journal of Psychology, 53, 18. doi:10.1111/j.1467-9450.2011.00926.x.
Murphy, M., Grundy, E. and Kalogirou, S. (2007). The increase in marital status differences in mortality up to the oldest age in seven European countries, 1990-99. Population Studies: A Journal of Demography, 61, 287298.
Nakosteen, R., Westerlund, O. and Zimmer, M. (2004). Marital matching and earnings. Evidence from the unmarried population in Sweden. Journal of Human Resources, 39, 10331044. doi:10.2307/3559037.
Nilsson, L.-G. et al. (1997). The Betula prospective cohort study: memory, health and aging. Aging, Neuropsychology, and Cognition, 4, 132. doi:org/10.1080/13825589708256633.
Nilsson, L.-G., Adolfsson, R., Bäckman, L., de Frias, C. M., Molander, B. and Nyberg, L. (2004). Betula: a prospective cohort study on memory, health and aging. Aging, Neuropsychology, and Cognition, 11, 134148. doi:org/10.1080/13825580490511026.
Perris, H. (1984). Life events and depression. Part1. Effect of sex, age and civil status. Journal of Affective Disorders, 7, 1124. doi:org/10.1016/0165-0327(84)90060-0.
Ptok, U., Barkow, K and Heun, R. (2002). Fertility and number of children in patients with Alzheimer's disease. Archives of Women's Mental Health, 5, 8386. doi:10.1007/s00737-002-0142-6.
R Core Team. (2013). R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing. ISBN 3-900051-07-0. URL:
Saczynski, J. S. et al. (2006). The effect of social engagement on incident dementia: the Honolulu-Asia aging study. American Journal of Epidemiology, 163, 433440. doi:10.1212/WNL.0b013e3181e62138.
Scarmeas, N. and Stern, Y. (2003). Cognitive reserve and lifestyle. Journal of Clinical and Experimental Neuropsychology, 25, 625633. doi:10.1076/jcen.25.5.625.14576.
Seeman, T. E., Lusignolo, T. M., Albert, M. and Berkman, L. (2001). Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging. Health Psychology, 20, 243255. doi:10.1037/0278-6133.20.4.243.
Sullivan, A. R. and Fenelon, A. (2013). Patterns of widowhood mortality. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, first published online September 27, 2013. doi:10.1093/geronb/gbt079.
Van Gelder, B. M., Tijhuis, M., Kalmijn, S., Giampaoli, S., Nissinen, A. and Krombout, D. (2006). Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: the FINE study. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 4, 213219.
van Praag, H., Kempermann, G. and Gage, F. H. (1999). Running increases cell proliferation and neurogenesis in the adult mouse dentate gyrus. Nature Neuroscience, 2, 266270. doi:10.1038/6368.
Vikström, J., Bladh, M., Hammar, M., Marcusson, J., Wressle, E. and Sydsjö, G. (2011). The influences of childlessness on the psychological well-being and social network of the oldest old. BMC Geriatrics, 11, 78. doi:10.1186/1471-2318-11-78.
Wang, H. X., Karp, A., Winblad, B. and Fratiglioni, L. (2002). Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. American Journal of Epidemiology, 155, 10811087. doi:10.1093/aje/155.12.1081.


The relationship between marital and parental status and the risk of dementia

  • Anna Sundström (a1) (a2), Olle Westerlund (a3) (a4), Hossein Mousavi-Nasab (a5), Rolf Adolfsson (a6) and Lars-Göran Nilsson (a7)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed