The Association between Widowhood and Cognitive Function among Chinese Elderly People: Do Gender and Widowhood Duration Make a Difference?

Nan Xiang,Huwei Li,Erpeng Liu,Xigang Qin,Zhang Yue,Hang Liang

doi:10.3390/healthcare9080991

Abstract

Few studies have examined the effects of widowhood on cognitive function in Chinese elderly individuals. We conducted a longitudinal study to assess the association between widowhood and cognitive function and further explored gender differences in this association and the impact of widowhood duration. The analytical sample consisted of 5872 Chinese elderly people who participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and were followed up from 2005 to 2014. We used the Chinese version of the Mini-Mental State Examination (MMSE) to assess cognitive function. Widowhood duration was calculated from the self-reported year at which the spouse passed away. Multilevel growth models were employed to estimate the association between widowhood and cognitive function while adjusting for many demographic and socioeconomic characteristics. Widowhood status was associated with cognitive decline among Chinese elderly individuals after adjusting for covariates (B = −0.440, 95% CI −0.727 to −0.152), and this association was only statistically significant among men (B = −0.722, 95% CI −1.104 to −0.339). Being widowed for 5 years or less (B = −0.606, 95% CI −1.112 to −0.100), 16–20 years (B = −0.937, 95% CI −1.685 to −0.190), and 21+ years (B = −1.401, 95% CI −1.967 to −0.834) predicted worse cognitive function in men, while being widowed for more than 21+ years (B = −0.655, 95% CI −1.186 to −0.124) was associated with cognitive decline in women. More attention should be directed towards widowed men and long-term widowed elderly individuals.

Highlights

The trend of population ageing is developing rapidly in China, which raises great concern for public health
The results suggested that being widowed for 21+ years (B = −1.109, 95% CI −1.488 to −0.730) had a significant negative effect on cognitive function, and widowers and widows had different trajectories of cognitive decline with increases in time since spouse loss
We provided clear evidence that gender and widowhood duration really mattered in this association, which contributes to the existing literature by improving understanding of the complexity of the linkage between widowhood and cognitive function

Summary

Introduction

The trend of population ageing is developing rapidly in China, which raises great concern for public health. The data from the seventh national census bulletin show that by 2020, there were 190.64 million Chinese elderly people over the age of 65, accounting for 13.50% of the total population [1]. It is predicted that by 2050, the number of Chinese elderly people will reach a peak of 488 million, representing 35.6% of the total population [2]. Because of the life expectancy gap between men and women, numerous elderly people will experience widowhood in the coming decades [3]. Widowed elderly individuals in China are predicted to reach 118.4 million by 2050, which is 2.5 times larger than the number in 2010 [4]. The large number of elderly individuals suffering from cognitive decline will pose a heavy burden on medical costs without sufficient attention and policy interventions. It is crucial to identify risk and protective factors for cognitive function

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Discussion

Conclusion