Gender Differences in the Longitudinal Association Between Husbands' and Wives' Depressive Symptoms Among Korean Older Adults: The Moderating Effects of the Spousal Relationship

Purpose: The mutual effects of depressive symptoms between couples have long been reported; however, it remains unknown whether the spousal concordance of depression differs depending on spousal relationships.Method: Data on 291 married couples from the Korean Social Life, Health, and Aging Project (KSHAP) were examined. The KSHAP collected global network data from the target population living in one Korean village over eight years and across five waves. A seemingly unrelated regression (SUR) model in the panel data was employed to address correlation and heterogeneity.Results: If one spouse (husband or wife) had depressive symptoms, the other spouse tended to have depressive symptoms. However, the effect of marital relations on spousal concordance for depression was different in husbands and wives. This study demonstrated both spousal support aspects and spousal network aspects of spousal relationships. Depression concordance was more substantial for couples with a more negative marital relationship. A supportive marital relationship mitigated the impact of a husband's depression on his wife's depression but did not work in the opposite case. Spousal network overlap decreased the effect of a wife's depression on her husband's depression, but rather directly increased a wife's depression and failed to mediate the impact of a husband's depression on his wife's depression. Conclusion: Our findings suggest that approaches to helping older adults deal with mental health disorders should proceed not only on an individual but on a couple-level. Also, gender-specific strategies need to be constructed to enhance the mental well-being of the older population.

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

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.

Spousal concordance in pathophysiological markers and risk factors for type 2 diabetes: a cross-sectional analysis of The Maastricht Study

IntroductionWe compared the degree of spousal concordance in a set of detailed pathophysiological markers and risk factors for type 2 diabetes to understand where in the causal cascade spousal similarities are most relevant.Research design and methodsThis is a cross-sectional analysis of couples who participated in The Maastricht Study (n=172). We used quantile regression models to assess spousal concordance in risk factors for type 2 diabetes, including four adiposity measures, two dimensions of physical activity, sedentary time and two diet indicators. We additionally assessed beta cell function and insulin sensitivity and glucose metabolism status with fasting and 2-hour plasma glucose and hemoglobin A1c.ResultsThe strongest spousal concordance (beta estimates) was observed for the Dutch Healthy Diet Index (DHDI) in men. A one-unit increase in wives’ DHDI was associated with a 0.53 (95% CI 0.22 to 0.67) unit difference in men’s DHDI. In women, the strongest concordance was for the time spent in high-intensity physical activity (HPA); thus, a one-unit increase in husbands’ time spent in HPA was associated with a 0.36 (95% CI 0.17 to 0.64) unit difference in women’s time spent in HPA. The weakest spousal concordance was observed in beta cell function indices.ConclusionsSpousal concordance was strongest in behavioral risk factors. Concordance weakened when moving downstream in the causal cascade leading to type 2 diabetes. Public health prevention strategies to mitigate diabetes risk may benefit from targeting spousal similarities in health-related behaviors and diabetes risk factors to design innovative and potentially more effective couple-based interventions.

Spousal Concordance in Dietary Behaviors and Metabolic Components, and Their Association: A Cross-Sectional Study

This study aims to investigate spousal concordance in dietary behaviors, spousal concordance in metabolic components (MCs), and their association. A cross-sectional survey was conducted in Taiwan from November 2014 to May 2015. Matched-pair analysis, McNemar’s test, logistic regression analysis, and stratified analysis were performed. A total of 901 pairs of spouses (1802 participants) were analyzed. Husbands were less likely to report intakes of high-fiber food (ORMP (matched pairs odds ratio) = 0.30, p < 0.0001), fish (ORMP = 0.74, p = 0.0128), biscuits or cakes (ORMP = 0.60, p < 0.0001), and fast food (ORMP = 0.65, p = 0.01) compared with their wives. Husbands had significantly higher odds of being overweight (ORMP = 2.34, p < 0.0001); and of having hypertension (ORMP = 2.14, p < 0.0001), hypercholesterolemia (ORMP = 1.75, p = 0.0007), hyperlipidemia (ORMP = 2.96, p < 0.0001), and one or more metabolic components (composite MCs) (ORMP = 2.50, p < 0.0001) compared with their wives. After adjusting for age and education, the spousal concordance in high-fiber food intake was inversely associated with the spousal concordance in composite MCs (aOR = 0.62, 95% CI = 0.44–0.88, p = 0.0074), whereas the spousal concordance in processed food intake was positively associated with the concordance in composite MCs (aOR (adjusted odds ratio) = 1.56, 95% CI (Confidence Interval) = 1.03–2.36, p = 0.034). An intervention study for couples with intakes of different fiber foods and/or processed foods is critical for future study, in order to test what kinds of fiber foods/processed foods are associated with the development of the spousal concordance of metabolic components.

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

Background This study aimed to explore the gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. Methods Data of 3420 couples (husbands: mean age, 57.5 years, SD = 8.5; wives: mean age, 55.6 years, SD = 8.0) 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 (pre-)obesity) all measured at baseline. Results The incidence of chronic diseases after 4 years of follow-up was 34.5% in the husbands (727/2110) and 37.2% in the wives (882/2371). Taking the couples’ baseline sociodemographic and lifestyle covariates into account, husbands whose wife had a chronic disease at baseline showed an increased risk of developing a chronic disease over 4 years (ORadjusted=1.37, 95% CI:1.14,1.63), but this risk was not statistically-significant for wives (ORadjusted=1.16, 95%CI:0.97,1.40). Conclusions 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.

Spousal Concordance of Physical Frailty in Older Korean Couples

Marital status is an important risk factor for physical frailty. However, there are limited data on spousal concordance of physical frailty among married couples. Here, we evaluate the spousal concordance of frailty as defined by the Fried frailty phenotype and specific phenotype components that contribute to this association. Data on 315 married couples (630 individuals) aged between 70 and 84 years were obtained from the Korean Frailty and Aging Cohort Study (KFACS). Multivariate logistic regressions were used for the analysis. After adjusting for covariates (age, body mass index, education, house ownership, comorbidity, cognition, depressive symptoms, cohabitation with adult children for both partners), a husband’s frailty was positively associated with his wife’s frailty (odds ratio (OR) 3.34, 95% confidence interval (CI) 1.04–10.73, p < 0.05), and a wife’s frailty was significantly associated with her husband’s frailty (OR 4.62, 95% CI 1.31–16.33, p < 0.05), indicating a greater effect of the frailty status of the spouse among women than among men. Among the five components of the Fried frailty phenotype, weight loss, slowness, and exhaustion were the main contributing factors to the spousal association for frailty. In conclusion, having a frail spouse is a strong and independent risk factor for frailty among community-living older adults.