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Marriage effects bone health in men

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Men married after age 25 have better bone health than those who marry at an earlier age

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Adult bone mass may be influenced by stressors over the life course. Researchers from UCLA examined the association between marital life history and bone mineral density (BMD) net socioeconomic and behavioral factors known to influence bone mass.

Dr. Carolyn Crandall, MD, FACP, professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and senior study author along with colleagues used data from 632 adult participants in the Midlife in the United States Study, (MIDUS), 1995 to 1996, to examine associations between marital history and BMD, stratified by gender, and adjusted for age, weight, menopausal stage, medication use, childhood socioeconomic advantage, adult financial status, education, physical activity, smoking, and alcohol consumption.

Participants were re-interviewed in 2004-2005, (MIDUS II). The authors used hip and spine measurements obtained by standard bone-density scanners during participants' MIDUS II visits at UCLA, Georgetown University and the University of Wisconsin–Madison and other data to examine the relationship between bone health and marriage in 294 men and 338 women from around the country. Researchers also took into consideration other factors such as medicines, health behaviors and menopause.

The associations between marriage and bone health were evident in the spine but not the hip, possibly due to differences in bone composition, the researchers said.

The results showed compared to stably married men, men who were currently divorced, widowed, or separated, men who were currently married but previously divorced, widowed, or separated, and never married men had 0.33, 0.36 and 0.53s standard deviations lower lumbar spine BMD, respectively.

Among men married at least once, every year decrease in age at first marriage (under age 25) was associated with 0.07 SD decrement in lumbar spine BMD.

In women, greater support from the spouse was associated with higher lumbar spine BMD.

These findings suggest several significant associations between marriage and bone health but only in men.

Dr. Arun Karlamangla, MD, assistant professor of medicine in the geriatrics division at the Geffen School and researcher and co-author of study commented “Very early marriage was detrimental in men, likely because of the stresses of having to provide for a family,

Such as those who marry young are likely to be less educated, leading to lower pay and more difficulty in making ends meet, said the authors.

In their conclusion the researchers write “Our findings suggest that marriage before age 25 and marital disruptions are deleterious to bone health in men, and that marital quality is associated with better bone health in women.”

The team does not know the biological pathways connecting bone health and marriage; this will be the next stage of their research.

These findings suggest an association and not a cause and effect due to the fact there were no longitudinal assessments of bone density.

Despite these limitations, the findings "provide additional new evidence of the association between psychosocial life histories and adult bone health," the authors write. "The gender differences observed in the association between marital history and [bone strength] are consistent with gender differences seen in previous studies of marital status and other aspects of health, and imply that we should not assume that marriage has the same health rewards for men and women.

"Specifically, never marrying, and experiencing a divorce, widowhood, or separation are associated with poor bone health in men, whereas poor marital quality is associated with poor bone health in women."

This study is published online in the peer-reviewed journal Osteoporosis International.



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