Association of marital status with cognitive function in Chinese hypertensive patients: a cross-sectional study

Abstract Purpose The aim of this study was to evaluate the association of marital status with cognitive function, and to examine the potential effect modifiers in Chinese hypertensive populations. Methods A total of 9,525 adult Chinese hypertensive patients were enrolled in this cross-sectional study. Cognitive function as the dependent variable in our study was assessed by the version of the Mini-Mental State Examination (MMSE). We adjusted for potential confounding factors in multiple linear regression models to examine the relationship of marital status with cognitive function. In addition, we divided the population according to gender to explored whether there was a gender-specific differences. Results Among the 9,525 study participants, the mean (SD) age of males was 63.5 (10.3) years and mean MMSE was 24.9 ± 5.0, whereas in females the mean (SD) age was 63.8 (9.3) years and mean MMSE was 19.4 ± 6.4. Non-married person had lower score of MMSE, as well as lower subscore in each of the cognitive domains. A stronger correlation between marital status and lower MMSE score was statistically significant in men (non-married: β = -1.55; 95% CI: -1.89, -1.21) but not women (non-married: β = -0.22; 95% CI: -0.56, 0.12; p interaction = 0.006). Compared to participants in widowed and divorced status, never married men was more likely to have lower score of MMSE (β = -2.30, 95% CI -3.10 ,- 1.50; p < 0.001). Conclusions Our study demonstrated that non-married status as an extremely important but prone to be neglected social risk factor for cognitive function. Gender was a strong effect modifiers: Being non-married was correlated with a higher risk of cognitive decline compared to being married in Chinese hypertensive men, especially among older men, but not women. Moreover, never married men showed poorer cognitive function than those who were divorced or widowed.