It is generally well accepted that being married is linked to better health and lower risk of disability in older people, but a new study reveals a surprising exception to this view. It finds that among older women, those who are widowed have a lower risk of becoming frail than their married counterparts.
However, among men, it is the other way around - married older men appear to have a lower risk of frailty than their unmarried or widowed peers.
The study, by researchers from the University of Padova and the National Research Council's Institute of Neuroscience, also in Padova, Italy, is published in the Journal of Women's Health.
When they set out on their investigation, the researchers predicted that unmarried older people would have a higher risk of becoming frail than their widowed or single counterparts, since marital status is usually linked with reduced risk of disability and death.
For their study, the team analyzed data on 1,887 men and women over the age of 65 who had been followed for at least 4 years as part of the Progetto Veneto Anziani, a study of over 3,000 older citizens randomly selected from the general population of Northern Italy.
The researchers only included those participants for whom there was no evidence of frailty when they enrolled on the study.
The analysis showed that older men who had never married or were widowed had a higher risk of developing frailty than their married counterparts. This result was in line with what the researchers anticipated.
But they were surprised to find that among the older women in the group, it was the widowed women who had the lowest risk of developing frailty, compared with their married counterparts.
The researchers classified individuals as frail if they met at least three of the five "Fried criteria." These criteria take into account unintentioned weight loss in the previous 12 months, measures of exhaustion, physical activity, ability to walk a short distance and handgrip strength.
'Marriage protects the male gender more than the female one'
In discussing the results, the researchers make a number of points, of which two stand out as being of interest. First, they note that the married men in their sample were more likely to be smokers and drinkers and have chronic diseases like diabetes, COPD, cancer. They were also more likely to be less well educated than unmarried men. The authors write:
"This picture would appear to disagree with the theory according to which healthier people with a better psychological and socioeconomic status would be more likely to be selected for marriage."
The second interesting point the authors make is that the participants lived much of their early adult life in the mid-20th century, a social context where housekeeping, food shopping and food preparation were almost always done by women.
This means - as the study finds - unmarried and widowed men were therefore more likely to have a higher risk of unintentional weight loss than married peers, with negative consequences on health status, muscle strength and physical performance.
In contrast, the study finds that widowed women had a lower incidence of unintentional weight loss or low daily physical activity levels than married women. "Moreover," note the authors, "although women who had never married showed no significant association with frailty, after adjusting for potential confounders, they too had significantly lower odds of unintentional weight loss and exhaustion than married women."
The researchers note that this would confirm the findings of sociological studies that suggest being unmarried is "more disadvantageous for men than for women, and that marriage protects the male gender more than the female one." They add:
"In fact, the presence of a wife may bring material benefits for men in terms of household management and healthcare, whereas women are more likely to feel stressed and find their role restrictive and frustrating."
The researchers acknowledge that their study has several weaknesses, among which they note, the social context of the population they studied compared with the continuous changes the structure of society, means the results may not reflect the current situation, "particularly considering the very small number of divorcees and unmarried people in our sample."
Nevertheless, Susan G. Kornstein, editor-in-chief of the Journal of Women's Health, notes:
"This study adds to our understanding of how marital status influences the onset of frailty in older people, but reveals surprising gender-specific differences."
Meanwhile, Medical News Today recently learned of a study that found dog walking is linked to better physical health among seniors, and older adults who have strong bonds with their canine pets tend to exercise longer and more often.