Marriage Decreases Likelihood of Dementia

Shortly after he created Adam, God pronounced that it was not good for man to be alone. This was in a perfect world, with no sin, death, or sorrow—but even in that setting, the created-perfect Adam needed someone comparable to and fit for him.1 While not specifically stated in this verse, the reverse must also hold true–it would not be good for the woman to be alone either. After all, just a few verses later when we read of the first marriage, God describes Adam and Eve’s marriage as “they shall become one flesh” (Genesis 2:24). What was not good in isolation now is declared good as a husband and wife unity.

Recently a new study was published in which 19,579 men and women aged 52 and older from the US (beginning in 2000) who exhibited no signs of dementia were interviewed. Then for 14 years (2000 –2014) follow-up surveys were done with the individual or his/her medical proxy (in cases where the individual was unable to respond due to health issues or demise). The purpose of the study was to determine if there was any correlation between the risk of dementia and marital status. After discarding some data due to factors such as incomplete or incorrectly filled-out surveys, the total number of people included in the study was reduced to 15,379 respondents (6,650 men and 8,729 women) ages between 52 and 100 with the average age of 65 as of the start of the survey in 2000.

Methodologies and Expectations

The researchers wanted to see what had a significant effect on dementia rates, and so tailored their survey questions to include the following categories for respondents to select from: “married,” “cohabiting,” “divorced/separated . . . ,” “widowed,”2 and “never married.” They also included several other social, health, and economic categories in their survey questions—either/or categories like “male or female”, chronic health condition or not, and race (black or other), then several sliding scale questions such as levels of smoking, drinking, exercise, socializing, level of education, and household income.3

The researchers expected that the data would support their four hypotheses (although the first one was divided into 1a and 1b), which they detailed in their paper.

Hypothesis 1: Married adults have a lower risk of dementia than unmarried adults, including the divorced, widowed, and, to a lesser extent, cohabiting and never married in the United States (H1a). Among the unmarried, the widowed have the highest risk of dementia, followed by the divorced, never married, and cohabitors (H1b). Hypothesis 2: Marital status differences in dementia are at least partially explained by economic resources. Hypothesis 3: Marital status differences in dementia are at least partially explained by health-related factors such as health behaviors and chronic conditions. Hypothesis 4: Marital status differences in dementia are generally greater for men than for women.4

Not surprisingly, the researchers found that married respondents showed a significantly reduced rate of dementia across all models.

Not surprisingly, the researchers found that married respondents showed a significantly reduced rate of dementia across all models (with one minor exception, noted below). Age, chronic health conditions, and at-risk health behaviors added strong to moderate influence on dementia, social activity and economic status added moderate to little influence, and education added little to almost no influence on dementia. The only slightly surprising result was that “cohabiting” respondents had a slightly lower proportion (.02% average) of dementia during the subsequent surveys than married respondents (surveys were conducted every two years after 2000). But there were some mitigating factors— primarily that cohabiting respondents averaged three years younger than married respondents and age was the most significant factor (after marriage) in determining dementia.5 Additionally, the sample size for cohabiting was only 3% of the married sample size in the survey, and this could have skewed the results.

Marriage Leads to an Overall Healthier Life and Less Risk for Dementia

According to the raw data comparing the baseline survey in 2000 with all surveys through 2014: “The results show that widowed respondents had the highest proportion of dementia during the subsequent waves (6.02%), followed by never-married respondents (2.46%), and divorced respondents (2.41%). All these groups were significantly more likely to develop dementia than married respondents (1.67%).”6

In comparison to married respondents, all unmarried groups tended to have, on average, lower education levels, lower income, less wealth, and higher proportions of current smokers and they were also less likely to exercise. Divorced and widowed respondents had a greater number of chronic conditions than married respondents. Cohabiting respondents had a higher proportion of current drinkers (both heavy and light) than married respondents. Both cohabiting and divorced respondents had a lower proportion of participating in social activities than married respondents.7

The researchers used several different models in running the data. Some included gender, while others did not. Some used three or four variables instead of all. Some added additional categories (more on this below). But when all the surveys from 2000 to 2014 were statistically analyzed and all the covariables were controlled for or weighted for age, the results were robust and showed that all unmarried categories still had significantly higher odds of dementia than married respondents.8

Then the researchers decided they wanted to see if there was a difference between those who had been remarried versus those who were married to their original spouse. In all the other models, they had been grouped as one category: married. The results showed extremely slight increased odds of dementia for the remarried, but it was not statistically significant enough between these two married groups to predict odds of dementia.9

Non-married Men Fare Worse Than Non-married Women

The breakdown of those results showed some interesting patterns.

Finally, the researchers looked at gender differences. They wanted to know if non-marriage categories affected men vs. women differently. Again, these results were not too surprising, given that women are longer-lived than men on average. But the breakdown of those results showed some interesting patterns. They also decided to look at divorced vs. widowed to see if there was a significant difference. The authors commented on the overall finding of the study.

These results indicate that when all covariates were controlled, the estimated odds ratios of dementia between the married group and two of the unmarried groups—the divorced and the widowed—were significantly smaller for women than for men. Specifically, the odds of having dementia for divorced men were 2.601 times of those for married men, while the odds of having dementia for divorced women were only 1.306 times of those for married women. Further, the odds of having dementia were 53.1% higher for widowed men than for married men, while the odds of having dementia were 20.6% higher for widowed women than for married women.10

God Said, “I Hate Divorce”—So Do the Elderly

The researchers summed up their findings across all models and variables at the end of the paper and then attempted to reconcile the reasoning behind the sharp difference between men and women who had been divorced or widowed during the study.

First, we found that all unmarried groups including cohabiting, divorced, widowed, and never-married respondents had significantly higher odds of developing dementia during the 14-year study period than their married counterparts. These results are consistent with our hypothesis (Hypothesis 1a) as well as the general literature suggesting that married people enjoy better health than unmarried people. . . . Yet, inconsistent with our expectation (Hypothesis 1b), it was the divorced rather than the widowed who experienced the highest risk of dementia. This finding of the highest dementia risk among divorced older adults is consistent with a recent Swedish population study (Sundström et al., 2016). Divorce is one of the most stressful life events during adulthood. It leads to changes in individuals’ social environment, usually in negative ways, and in turn hurts both mental and physical health. Future research should investigate the specific pathways through which divorce damages cognitive function and leads to dementia.11

The highest risk factor for dementia is divorce.

It may seem odd (and contradictory to the raw data mentioned earlier, which showed that widowed respondents had the highest proportion of dementia) that divorcees experienced the highest risk of dementia. But keeping in mind that widowhood is much more prevalent among those (on average) 65 and older than divorce is, the raw numbers are skewed towards widowhood, but the highest risk factor for dementia is divorce. The researchers then postulated on the “whys” of older women better navigating divorce and widowhood.

Women are usually the kin-keepers in the family. Therefore, although divorce or widowhood may reduce women’s social networks to a certain extent, divorced/widowed women may still have advantages in social support relative to their male counterparts. Previous research has suggested that married men usually rely on their spouses to be their confidants while married women have wider networks of friends and relatives as confidants. Therefore, the loss of a spouse may hurt men’s social support networks more than those of women which in turn make divorced or widowed men relatively more isolated and increasing their risk of dementia.12

Does This Study Corroborate What Scripture Says About Widows?

Scripture relates historical snapshots that deal with the topic of marriage, widowhood, divorce, remarriage, and never being married among both men and women. And though there are some biblical people who do not “match the results” in a few cases (like Abraham and Isaac who outlived their wives by several years), generally this study corroborates what Scripture says. Most older widows in Scripture are women, not men. Both Elijah (1 Kings 17:9–16) and Elisha (2 Kings 4:1–7) ministered to widows. Ruth 1:1–5 relates how Ruth and her mother-in-law, Naomi, were widowed. Mark 12:42–44 records the account of the widow and her small yet completely sacrificial gift. Luke 2:36 tells of the aged widow Anna, and Luke 7:12–15, records Jesus’ raising of a widow’s son. The mother of Jesus, Mary, was apparently widowed when Jesus (while on the cross) told John to care for her (John 19:26–27). 1 Timothy 5:3–10 gives instructions on how the church is to care for older female widows. A quick word search for “widow” in the Bible reveals that a majority of them in both the Old and New Testaments were women. And in some cases where the widow is a man, it’s often because his wife died in childbirth, which was much more common at that time than now.

On Widows Remarrying?

The study revealed that the remarried showed little to no difference in positive effects than those who remained married to their first spouse. Again, it must be stressed that in this study of older adults, the number of divorces during the 14-year length of this survey was small (48), and the number of adults who remarried during the time of the study was small too (70). Total numbers were not given on how many of the “remarried” were divorcees but given the preponderance of widows to divorcees in the study, it seems fairly certain that the majority were widows. And does the Bible address this topic and does it do so in a positive light for widows? Absolutely! Levirate marriages were ordained by God to allow a widow to have posterity (Deuteronomy 25:5). Ruth was a widow who remarried (Ruth 4:9–13), and her children with Boaz were in the line of Christ. Paul gave instruction to the churches that younger widows should remarry (1 Timothy 5:14). We can see that even though “remarried” was a small subset in this study the findings are in line with details found in Scripture about widows remarrying.

Does Scripture Concur with the Health Benefits this Study Found Among Married Vs. Non-married?

In several places, Scripture speaks about benefits to both husband and wife over and over again, referring to happiness, blessing, health, graciousness, nourishment, and sweetness.

Overall, this study showed a strong correlation between the non-married and a greater risk and occurrence of dementia. In several places, Scripture speaks about benefits to both husband and wife over and over again, referring to happiness, blessing, health, graciousness, nourishment, and sweetness (see the “Bible’s Discussion of Marriage and Health” section below). Is it any wonder then that those who have been married for many years and are “one flesh” are generally healthier, happier, and less likely to succumb to mental illnesses and chronic physical and mental conditions? And part of the explanation lies in the companionship, trust, love, mental stimulation, and physical care and concern between spouses, which would all be occurring in a stable marriage setting. Of course, this is only a general rule, there are married couples which have one or both spouses dealing with chronic conditions (like diabetes or congestive heart failure) and mental illnesses (for example dementia, depression or anxiety issues), but in a general population the percentages are much lower.

“But I Am Single”

But what about the never married, especially those addressed in Scripture who have chosen not to be married in order to better serve the Lord? In Matthew 19:10–12, Jesus mentions those who have been born or made eunuchs (mainly due to physical inability, but also inborn mental or emotional ability) and will never marry. Jesus also mentions those who have made themselves eunuchs for the kingdom of God. He is not endorsing a physical act of castration or sterilization, but rather a resolve to celibacy in order to devote all of one’s focus to serving God. The Apostle Paul also mentions this in 1 Corinthians 7:7–9 and 7:32–40. He writes that those who never marry but resolve to serve God are better able to serve without distraction or concern.

It should be pointed out that the “never married” in this study of 15,379 respondents was a rather small subset of only 415 people (or 3.35%).13 This small percentage accords well with the statements made by both Jesus and Paul, that only those with physical incapability (Matthew 19:12) or to those it has been given as a “gift of dedication” (Matthew 19:11) and who can exercise self-control over sexual desire (1 Corinthians 7:9). Paul mentions his own resolve and then wishes that others could be like him, noting that God gives different gifts to different people (1 Corinthians 7:7). This then is Paul admitting that he (and others) had been or would be given the “gift” of celibacy, in order to serve God more single-mindedly.

In this light, how should we view the results of this section of the study, showing that the never-married had higher levels of dementia than the married individuals: specifically being among the top two or three categories?14 At first the data results do appear to be contradictory to what we read in Scripture, because Paul states that he wishes all men were unmarried as he was (1 Corinthians 7:7) and that unmarried women should remain single (1 Corinthians 7:8) and that “he who refrains from marriage will do even better” than those who marry (1 Corinthians 7:38). We might expect that for those “doing better” the statistics for dementia would be lower. But we need to remember that in 1 Corinthians 7 Paul is addressing and giving instruction to Christians, that only a small percentage of people have been “given celibacy as a gift,” and that if one is unable to suppress their sexual desires, it is actually better to marry than remain single (1 Corinthians 7:9). Since this survey is not one done exclusively for never-married Christians who have dedicated their lives to full-time Christian service and ministry, we would expect that the number of true Christian celibates actually surveyed for this study is extremely low, and that most of the never marrieds in this survey do not fit the category of single-mindedly dedicated to serving Christ. Thus, the survey data on this point is not necessarily at odds with Scripture.

It Is Not Good That Man Should Be Alone

While obviously not an exhaustive study, its main conclusion was that marriages (and in this study, all were one man-one woman marriages) lead to less stress. Stress is a known contributor to many physical and mental ailments. Although not detailed in the paper, most of the marriages lasted until “death do us part” or if both survived, for a minimum of the 14 years (2000–2014) of the study. But it is highly likely that most of those married at the commencement of the study had been married for several years prior to that date. So the data was almost inclusive of stable, long-term married couples. This accords well with what we see in Scripture—one man-one woman, committed (and probably for many, lifelong) marriages, and obvious care and concern for each other, as most during this 14-year study remained married or were separated only by the death of their spouse.

The authors of the study would probably be surprised at how closely their findings match the Word of God written thousands of years ago. There was an obvious benefit (percentage-wise) to health and mental well-being for the married couples. And interestingly, there was a definite negative effect on mental and physical health for those who had dealt with divorce before the study started. And when divorce is mentioned in connection with health and mental well-being in Scripture (for example, in Malachi 2), we see weeping, faithlessness, and violence mentioned. And we find that we end up where we began in Genesis 2—it is not good health-wise that man (and woman) should be alone.