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Gender differences in associations between spousal cognitive decline and marital strain: Evidence from the U.S. older couples

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  • Li, Meiyi
  • Li, Yiang
  • Engelman, Michal

Abstract

Despite extensive research demonstrating how marriage affects health, less is known about how health changes impact marriages, particularly when one spouse's health declines. This study extends the stress process model to dyadic contexts to ask whether and how one spouse's cognitive decline is associated with the other spouse's perceived marital strain, with attention to potential differences by gender. It also examines the influence of social support from family and friends, as well as social engagement and community participation on the dyadic dynamic. We estimated Actor-Partner Interdependence models with data (N = 620 couples) from Waves 2 and 3 of the National Social Life, Health, and Aging Project. Our results highlight gender asymmetries in dyadic stress processes. Wives reported higher marital strain when their husbands had dementia, while husbands reported lower marital strain when their wives experienced mild cognitive impairment and dementia. Friend support is associated with lower marital strain for wives whose husbands experience cognitive impairment, while socialization is related to higher marital strain for men whose wives experience cognitive impairment.

Suggested Citation

  • Li, Meiyi & Li, Yiang & Engelman, Michal, 2026. "Gender differences in associations between spousal cognitive decline and marital strain: Evidence from the U.S. older couples," Social Science & Medicine, Elsevier, vol. 388(C).
    • Handle: RePEc:eee:socmed:v:388:y:2026:i:c:s0277953625011037
    DOI: 10.1016/j.socscimed.2025.118772
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