Brain blog showcase: Say “I do” to a healthier mind

All this week we’re showcasing the work of students who have been “researching the headlines” as part of their undergraduate studies. Their task was to describe an original research report exploring how lifestyle affects brain health in a manner accessible to non-experts, as well as evaluating the media coverage of the research. If you’re interested in using this approach in your own teaching, you can contact Alan Gow (A.J.Gow@hw.ac.uk) for more information and materials.

Next up in the “brain blog” showcase, we have…

Say “I do” to a healthier mind

by Aaron Irving

George Bernard Shaw once quipped: “Marriage is an alliance entered into by a man who can’t sleep with the window shut, and a woman who can’t sleep with the window open”.

This might ring true with many couples, especially nowadays when marriage has become progressively less prevalent. However, a recent study suggests that sticking to a more traditional way of life could have benefits to mental health.

A review paper published in the Journal of Neurology, Neurosurgery & Psychiatry details that those living the single life have an increased risk of developing dementia compared to their settled down peers.

The paper compiles evidence from 15 studies and concludes that those who have tied the knot are 42% less likely to develop the syndrome than those who have never married.

The research, titled ‘Marriage and risk of dementia: systematic review and meta-analysis of observational studies’, was lead by Dr Andrew Sommerlad of University College London. The team searched through various medical databases and consulted experts to find studies reporting a relationship between marital status and dementia. It was a vast review, including 812,047 participants, of which 29,610 were diagnosed with the condition.

Importantly, the researchers adjusted for age and sex, and analysed data to summarise the “relative risks” of marital status; finding that being lifelong single or widowed increased risk by 42% and 20%, respectively, with no difference being found for divorce.

The authors argued that marriage allows better social interaction throughout life which “builds cognitive reserve”, while bereavement might put stress on the hippocampal nerves.

Emphasis was placed on the “robustness” of the findings on single-life risk, but noted, was that the increased risk for widowed people can be attenuated by adjusting for education, among other variables.

Because this was a review study with no true new findings, the selection and inclusion of previous studies was important. Care was taken by the authors to choose appropriate literature. Both, cross-sectional and cohort studies were included, with diagnosis coming from clinical assessment and registers – all of which allowed a broad approach to examining the relationship.

However, this selection process, and the resultant data, raises questions about the thoroughness of the study. There are a few issues:

Firstly, “marriage” has certain implications aside from a signature on paper and the adoption of a surname – living together, having similar friends’ groups and shared hobbies, to name but a few. These however, are not exclusive to marriage, but are common in long-term cohabitation. This argument can be stretched out further. At what age does one have to be widowed at for risk to increase to 20%? Do multiple remarriages provide the same cognitive shelter as one lifelong union? The list continues…

While some of these limitations are acknowledged by the authors, they are reflective of the overall issue with the link – it is not so much marriage that ‘prevents’, but the lifestyle it promotes and accompanies.

Media coverage in the UK was led by the Guardian, who opted for a sensible and cautious title: “Marriage could help reduce risk of dementia, study says”.

The article continues in a similar understated, but accurate fashion, including details about methods, participants and publication.

However, the article does lack the “Why?” factor, giving no context by explaining the prevalence of dementia, despite this being both present in the study, and common knowledge.

Additionally, there are a few points left unexplained. For example, the article writes that “dementia could be related to other underlying cognitive or personality traits”. The study itself clarifies that pre-existing traits could make marriage less likely, therefore increasing the single/dementia population, however, as it’s written, it’s difficult to see what the reader is supposed to understand from that statement.

The article includes a quote from Dr Laura Phillips of Alzheimer’s Research UK. While supporting the findings of the study, the quote contains more insight into the relationship between marriage and dementia (financial status, for example) than the Guardian have cared to report, making the article rather bare in comparison.

Contrastingly, the article omits any acknowledgement of the authors – neither a name, nor quote, is included – listing them only as “experts”.

How we age, be it normally or pathologically, is dependant on many factors, with marriage being but one. In fact, the study claims that similar degrees of risk are achieved with physical inactivity, smoking, and poor education.

While evidence from this study, and others, lies strongly in favour of marriage as a way of preventing dementia, this is not necessarily easily put into practice. For many, wedlock is not a quick and easy arrangement, therefore, getting married is not constructive advice for achieving better mental health in old age.

As Dr Phillips points out, what may be most useful is striving towards what married life should provide: social interaction, mental engagement and healthy life choices.

References

Marriage could help reduce risk of dementia, study says (2017, November 29), The Guardian. Retrieved from https://www.theguardian.com

Sommerlad, A., Ruegger, J., Singh-Manoux, A., Lewis, G., & Livingston, G. (2017). Marriage and risk of dementia: systematic review and meta-analysis of observational studies. Journal Of Neurology, Neurosurgery & Psychiatry, jnnp-2017-316274. http://dx.doi.org/10.1136/jnnp-2017-316274