Marriage links couples in sickness and in health

BMJ Group News

What do we know already?

After decades together, older couples have much in common, including shared memories, friends, family, and daily routines. Such a close relationship can provide wonderful support and companionship later in life, but it also ties a person's emotional health and wellbeing closely to another's.

Some research suggests that this closeness can contribute to shared ailments, including depression. Depression in older people can trigger a decline in physical health, through people becoming more isolated and less active.

But how closely related are these problems in elderly couples? And if one spouse has symptoms of depression and declining physical abilities, how likely is it that their partner will have these problems, too?

To find out, researchers gathered data from a 15-year US study that followed more than 1,700 older married couples. Every few years, the participants were interviewed about their symptoms of depression and their ability to do everyday tasks, such as climbing stairs, picking up objects, cooking, and shopping. The participants were aged 70 or older at the start of the study, and had been married for an average of 40 years.

What does the new study say?

The researchers found that a spouse's symptoms of depression were closely tied to their partner's, waxing and waning throughout the study. And a spouse's physical limitations were strongly linked to these depressive symptoms, not only in themselves but also in their husband or wife.

These links remained strong even after researchers took into account people's ages, their mental sharpness and other factors that might have affected their risk of depression and physical decline.

These complex interactions make sense, say the researchers, when you consider how closely tied the spouses' routines and lives are. For example, if one spouse has depression, they may go out less frequently. This, in turn, may mean that their husband or wife also is less active, so they both decline physically. This decline could then trigger or worsen depression in both spouses.

How reliable is the research?

This is the first large study of its kind, and its findings should be fairly reliable. However, it leaves several questions unanswered. For example, it can't tell us if a person's symptoms of depression led to their physical decline (or their spouse's), or possibly vice versa. It can only show us that these problems often occurred together in these couples.

We also can't be certain that these findings apply to aging baby boomers, who are entering their later years with more diverse relationship histories, including divorces and remarriages. In contrast, all the people in the study had been married to their spouse for decades.

Where does the study come from?

The study was done by researchers with the University of British Columbia in Canada and Pennsylvania State University in the US. It was published in Health Psychology, a journal owned by the American Psychological Association.

What does this mean for me?

This study shows how important it is that signs of depression do not go unnoticed and untreated in older adults. Symptoms of this illness are closely linked to signs of physical decline, and this often affects both older individuals and their spouses.

If you are older, you and your spouse can help one another look out for signs of depression - such as feeling sad most of the time, losing interest in things you used to enjoy, and feeling restless - and seek help. Adult children of older parents, or other close family members and friends, can also help.