The Separate and Joint Associations of Own and Spousal Depression with Mortality in Couples

Background

Depression causes a substantial burden on a person’s health and well-being. However, evidence is limited regarding whether depression of one person in a marital relationship may affect the other partner’s health. This study examined whether depression in one partner within a married couple is associated with the other partner’s mortality, also considering whether only one or both partners have depression.

Methods

To test the hypothesis that spousal depression is associated with higher mortality risk for their partner, we used a nationally representative sample of older US adults from the Health and Retirement Study. Depression was assessed in both partners using the Center for Epidemiologic Studies Depression Scale. With baseline measures in 2010, we characterized depression status for 8,442 married individuals within 4,225 couples as follows: i) no depression in either partner, ii) depression in respondent only, iii) depression in spouse only, and iv) depression in respondent and their spouse. Associations between couples’ depression status and individuals’ mortality over 11 years were estimated using Cox proportional hazards models adjusted for 22 covariates.

Results

Higher mortality hazard was observed when only the respondent had depression (hazard ratio (HR): 1.44 [95% confidence interval (CI): 1.26, 1.63]), but also when only their spouse exhibited depression (HR: 1.18 [95% CI: 1.00, 1.38]). When both partners had depression, a jointly elevated mortality hazard was observed (HR: 1.56 [95% CI: 1.30, 1.87]).

Conclusions

Results suggest the harmful effects of depression could extend beyond the individual to one’s partners’ physical health. Future studies on health effects of depression should incorporate familial contexts.

Highlights