Marital dissatisfaction and adverse health and psychosocial outcomes among community-dwelling persons 45 years and older in Thailand

Abstract

Background: Only a small number of research have evaluated marital dissatisfaction and adverse health and psychosocial outcomes in lower-resourced countries. The aim of the study was to estimate the long-term associations of marital dissatisfaction with adverse health outcomes using four waves (7 years) of the national community-dwelling Health, Aging, and Retirement in Thailand (HART) study in people 45 years and older (also stratified by sex) from 2015 to 2022. Methods: HART data from the 2015, 2017, 2020, and 2022 waves were analysed, including community-dwelling individuals aged 45 and above (average age 65.1 years) who indicated marital dissatisfaction (analytic pooled sample: n = 10790 observations). Marital dissatisfaction was measured using validated scales. The time-variant causes and outcomes were evaluated using linear fixed effects regression. To determine the hazard ratios (HRs) and evaluate the associations between marital discontent and 7-year mortality in the entire sample, a Cox proportional hazards regression model was applied. Results: The average marital dissatisfaction score (0−10) was 1.8 (SD = 2.3). Fixed effects regressions showed that marital dissatisfaction was associated with low self-reported mental health, depressive symptoms, low quality of life, loneliness, functional limitations, poor self-rated physical health, low mastication, low exercise frequency, low meal skipping, and high subjective life expectancy. In addition, marital dissatisfaction was associated with all-cause mortality. Conclusions: Our knowledge of the connection between marital discontent and negative health outcomes—four markers of physical and mental health, including mortality—is improved by this longitudinal study. Measures of marriage happiness and the health advantages of marital education programs for couples should be part of health promotion initiatives for the aging population as a whole.