Abstract：
UNASSIGNED: Marital factor has been associated with dementia and Alzheimer\'s disease, but there is limited evidence on the impact of holistic marital history over time.
UNASSIGNED: This study aimed to examine association of marital history with cognition.
UNASSIGNED: The study included 24,596 dementia-free participants from the Chinese Longitudinal Healthy Longevity Study (CLHLS). Holistic marital history was collected at baseline, categorizing participants into five groups: widow-single, widow-remarried, divorce-single, divorce-remarried and married based on the first two marriages. Dementia was collected at follow-up through self-report or from a delegate if the participant was deceased. For 15,355 participants, the Chinese Mini-Mental Status Examination (CMMSE) was administered at both baseline and follow-ups. Cognitive impairment was defined as a follow-up CMMSE score below 18, and rate of cognitive change was calculated as the change in CMMSE score between consecutive visits divided by the duration.
UNASSIGNED: Compared with married older adults, widow-single group had significantly higher risk of dementia (HR 1.28, 95% CI 1.05, 1.54), cognitive impairment (HR 1.31, 95% CI 1.17, 1.47) and significantly faster decline of MMSE score (β -0.09, 95% CI -0.17, -0.01). Meanwhile, widow-remarried group had significantly lower risk of dementia, cognitive impairment and slower MMSE score decline than widow-single group, although the differences were only significant among female but not male.
UNASSIGNED: In this prospective cohort, married older adults and those widowed but with a second marriage had significantly better cognition than widowed individuals who did not remarry.
UNASSIGNED: This study aimed to examine association of marital history with cognition.
UNASSIGNED: The study included 24,596 dementia-free participants from the Chinese Longitudinal Healthy Longevity Study (CLHLS). Holistic marital history was collected at baseline, categorizing participants into five groups: widow-single, widow-remarried, divorce-single, divorce-remarried and married based on the first two marriages. Dementia was collected at follow-up through self-report or from a delegate if the participant was deceased. For 15,355 participants, the Chinese Mini-Mental Status Examination (CMMSE) was administered at both baseline and follow-ups. Cognitive impairment was defined as a follow-up CMMSE score below 18, and rate of cognitive change was calculated as the change in CMMSE score between consecutive visits divided by the duration.
UNASSIGNED: Compared with married older adults, widow-single group had significantly higher risk of dementia (HR 1.28, 95% CI 1.05, 1.54), cognitive impairment (HR 1.31, 95% CI 1.17, 1.47) and significantly faster decline of MMSE score (β -0.09, 95% CI -0.17, -0.01). Meanwhile, widow-remarried group had significantly lower risk of dementia, cognitive impairment and slower MMSE score decline than widow-single group, although the differences were only significant among female but not male.
UNASSIGNED: In this prospective cohort, married older adults and those widowed but with a second marriage had significantly better cognition than widowed individuals who did not remarry.
摘要：
■婚姻因素与痴呆症和阿尔茨海默病有关，但是随着时间的推移，关于整体婚姻史的影响的证据有限。
■本研究旨在探讨婚姻史与认知的关系。
■该研究包括来自中国纵向健康长寿研究（CLHLS）的24,596名无痴呆参与者。在基线时收集整体婚姻史，将参与者分为五组：寡妇单身，寡妇再婚,离婚-单身,离婚-根据前两次婚姻再婚和结婚。痴呆症在随访时通过自我报告收集，如果参与者死亡，则从代表那里收集。对于15,355名参与者，在基线和随访期间进行中国简易精神状态检查(CMMSE).认知障碍定义为随访CMMSE评分低于18，认知变化率计算为连续访问之间CMMSE评分的变化除以持续时间。
■与已婚老年人相比，寡妇-单身组痴呆的风险明显更高(HR1.28，95%CI1.05，1.54)，认知障碍（HR1.31，95％CI1.17，1.47）和MMSE评分明显更快的下降（β-0.09，95％CI-0.17，-0.01）。同时,寡妇再婚组患痴呆症的风险明显降低，认知障碍和MMSE评分下降速度低于寡妇-单身组，尽管差异仅在女性而非男性之间显着。
■在这个前瞻性队列中，已婚的老年人和丧偶但有第二次婚姻的人比没有再婚的丧偶者的认知能力明显更好。
■本研究旨在探讨婚姻史与认知的关系。
■该研究包括来自中国纵向健康长寿研究（CLHLS）的24,596名无痴呆参与者。在基线时收集整体婚姻史，将参与者分为五组：寡妇单身，寡妇再婚,离婚-单身,离婚-根据前两次婚姻再婚和结婚。痴呆症在随访时通过自我报告收集，如果参与者死亡，则从代表那里收集。对于15,355名参与者，在基线和随访期间进行中国简易精神状态检查(CMMSE).认知障碍定义为随访CMMSE评分低于18，认知变化率计算为连续访问之间CMMSE评分的变化除以持续时间。
■与已婚老年人相比，寡妇-单身组痴呆的风险明显更高(HR1.28，95%CI1.05，1.54)，认知障碍（HR1.31，95％CI1.17，1.47）和MMSE评分明显更快的下降（β-0.09，95％CI-0.17，-0.01）。同时,寡妇再婚组患痴呆症的风险明显降低，认知障碍和MMSE评分下降速度低于寡妇-单身组，尽管差异仅在女性而非男性之间显着。
■在这个前瞻性队列中，已婚的老年人和丧偶但有第二次婚姻的人比没有再婚的丧偶者的认知能力明显更好。
