are-the-severity-of-neuropsychiatric-behavioral-symptoms-and-advanced-dementia-staging-related-to-the-risk-of-divorce-or-separation-in-older-adults?

Older individuals are getting divorced more frequently. Divorce often has detrimental effects on people’s financial and psychological health, while it may be advantageous and necessary for safety if there has been abuse. According to a recent study, women’s living standards decrease by 45% after divorce. Men, on the other hand, saw a post-divorce 21% fall in their standard of living that persisted despite re-partnering.

In the meantime, there has been a rise in dementia frequency among older persons, and research points to a strain on intimate connections. Studies has shown that dementia caregiving has a harmful effect on spouses. It is yet uncertain whether dementia staging and neuropsychiatric behavioral symptoms are linked to divorce or separation in older couples.

Researchers looked into whether divorce and separation among older persons were related to advanced dementia staging and the severity of neuropsychiatric behavioral symptoms. They made use of information from 37 American Alzheimer’s Disease Research Centers. At the first visit, a few participants were already married or cohabitating.

During the follow-up, cases were identified based on the initial divorce or separation. Each control group received five married or legally married controls who were of similar age. The team evaluated each patient’s marital status, including whether they were married, widowed, divorced, separated, single, or living with a domestic partner.

Semi-structured interviews with the patient, dependable informants, or a family source provided the necessary data for the clinical dementia rating (CDR).The primary exposure was 12 symptoms from the Neuro-Psychiatric Inventory (NPI) – anxiety, agitation/aggression, appetite, apathy/indifference, depression/dysphoria, delusions, motor disturbance, hallucinations, euphoria/elation, nighttime behaviors, disinhibition, and irritability.

Symptoms present in the last month were rated as none, mild, moderate, or severe. Covariates included age, sex, ethnicity, years of education, the relationship between participant and informant, and whether the informant lived with the participant. Conditional logistic regression, adjusted for covariates, was applied to examine the association between CDR score, NPI score, and case/control status. Moreover, separate analyses were performed for each NPI symptom, adjusted for multiple comparisons.