The association between lifetime marital histories and later-life cognitive function: Evidence from the United States and China

Abstract Objectives We adopted a life course perspective to characterize lifetime marital history typologies and examined their associations with later-life cognitive function in two nationally representative cohorts of adults aged 65+ in the United States and China. We also explored whether the associations vary by gender. Methods We used data from the Harmonized Cognitive Assessment Protocol from the Health and Retirement Study (HRS-HCAP) (n=3,318) and the China Health and Retirement Longitudinal Study (CHARLS-HCAP) (n=5,766). Cognition was measured by general cognitive function, executive function, memory, language, and orientation. Country-specific marital histories from age 18 to 65 were constructed using sequence and cluster analysis. Population-weighted linear regression models examined the associations of marital histories with general and domain-specific cognitive outcomes. Results Marital histories in the United States are more heterogeneous than in China. Relative to lifelong marriage with a normative age at onset (mid- to late-20s and 30s in both the United States and China), lifelong marriage with an onset in early 20s and premature widowhood by age 50 were associated with worse cognitive function in both countries. American older adults divorced and remarried, or divorced by age 40 without remarrying, did not perform worse across all cognitive outcomes, compared to the normatively married. Lifelong singlehood was associated with worse general cognitive function in China, but not in the United States. Discussion Our findings demonstrate that marital histories, including timing, sequence, and transition, have enduring implications for later-life cognitive health, with patterns shaped by cultural norms and the timing of marital transition.