Gender Specificity of Spousal Concordance in the Development of Chronic Disease among Middle-Aged and Older Chinese Couples: A Prospective Dyadic Analysis.

Jing Liao,Jinzhao Xie,Jing Zhang,Jing Gu

doi:10.3390/ijerph18062886

Abstract

This study aimed to explore the gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. Data of 3420 couples were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression was used to analyze the incidence of chronic disease development over 4 years, conditional on the spousal baseline chronic disease status; and stepwise adjusting for the couples’ sociodemographic characteristics (i.e., age, education, retirement status and household income), and their individual lifestyle (i.e., smoking, drinking, exercise, social participation and BMI) all measured at baseline. The incidence of chronic diseases after 4 years of follow-up was 22.95% in the husbands (605/2636) and 24.71% in the wives (623/2521). Taking the couples’ baseline sociodemographic and lifestyle covariates into account, husbands whose wife had chronic diseases at baseline showed an increased risk of developing chronic diseases over 4 years (ORadjusted = 1.24, 95%CI: 1.02, 1.51), but this risk was not statistically-significant for wives (ORadjusted = 0.88, 95%CI: 0.71, 1.08). Our study identified gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. This finding may contribute to the design of couple-based intervention for disease prevention and management for community-dwelling older adults.

Highlights

Published: 11 March 2021China has the world’s largest number of older adults, estimated at 248 million in 2020 and projected to rise to 482 million by 2053 [1,2]
Among the 3420 couples at baseline (Figure 1), both spouses were free of chronic disease in 50.79% couples, only the husband had a diagnosed chronic disease in 22.92%
We extended the evidence in a Chinese community-based setting, with lifestyle data directly collected from both couples, and health status defined by multiple chronic disease status that were more common in older adults [41]

Summary

Introduction

Published: 11 March 2021China has the world’s largest number of older adults, estimated at 248 million in 2020 and projected to rise to 482 million by 2053 [1,2]. It is estimated that the number of middle-aged and older patients with chronic diseases will triple to 300 million by 2050 [4]. A range of cross-sectional studies on spousal concordance in chronic disease has been conducted worldwide, with evidence primarily of lifestyle-related chronic diseases, such as hypertension [7,8], cardiovascular disease [9,10,11], cancer [12,13] and type 2 diabetes [14,15] This spousal concordance in chronic disease may be explained by assortative mating and the shared resources hypothesis. Assortative mating suggests that individuals tend to choose a spouse with a similar demographic profile, lifestyle, and life attitudes [16], whilst the shared resources hypothesis states that a Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations

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