Neuropsychiatric behavioral symptoms are associated with the ending of marriages

Older adults with more severe behavioral symptoms, including agitation, aggression, and disinhibition, are more likely to become divorced than those with less severe symptoms. However, increasing stages of dementia are associated with a low likelihood of divorce. These are some of the conclusions of a new study published August 16 in the open-access journal PLOS ONE by Joan Monin of the Yale School of Public Health and colleagues.

In recent years, divorce has been on the rise among older adults. Moreover, dementia can be difficult for married couples for many reasons, including the introduction of caregiving burden, loss of intimacy, and financial strain. In the new study, researchers analyzed data from 37 NIA/NIH Alzheimer’s Disease Research Centers (ADRCs) across the US. The final study included 263 married or living-as-married couples who were divorced or separated during their follow up period at an ADRC, as well as 1,238 age-matched controls.

The study found that the greater the score on the clinical dementia rating scale, the lower the likelihood of divorce or separation (AOR=0.68, 95%CI 0.50-0.93). However, the severity of behavioral symptoms, as measured by Neuro Psychiatric Inventory (NPI) scores, was positively associated with divorce and separation (AOR 1.08, 95% CI 1.03-1.12). Therefore, as older adults' behavioral symptoms increase so does the likelihood of divorce or separation, while those with the most severe dementia are the least likely to divorce or become separated.

The authors conclude that the treatment of behavioral symptoms in older adults may not only help individuals themselves, but also their spouses and families. They also suggest that clinicians and social network members may want to provide added relationship support for older adults in the early stages of dementia. 

The authors add: “This study shows that neuropsychiatric behavioral symptoms such as agitation/aggression, depression/dysphoria, disinhibition and elation/euphoria are risk factors for divorce or separation in older adult couples. It also shows that as dementia progresses the likelihood of divorce or separation greatly decreases.”

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In your coverage please use this URL to provide access to the freely available article in PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0289311

Citation: Monin JK, McAvay G, Zang E, Vander Wyk B, Carrión CI, Allore H (2023) Associations between dementia staging, neuropsychiatric behavioral symptoms, and divorce or separation in late life: A case control study. PLoS ONE 18(8): e0289311. https://doi.org/10.1371/journal.pone.0289311

Author Countries: USA

Funding: This work was supported by the National Institute on Aging at the National Institutes of Health [R01AG047891 to HGA]. HGA, BVW contributed from the Yale Claude D. Pepper Older Americans Independence Center [P30AG021342]. HGA, BVW and CC contributed from the Yale Alzheimer’s Disease Research Center [P30AG066508].