BBC Claims Singles Are at Risk for Alzheimer's; I Think the BBC is Losing Its Mind

Say it ain't so, BBC! Did you really report the singles-bashing headline, "Singles face Alzheimer's risk"? I'd only call it singles-bashing if this turned out to be still another matrimanical scare story, with little basis in science. So let me explain, BBC, why even you have been mugged by the Marriage Mafia.

The people in the Alzheimer's study were 1,432 Finns who had been recruited into the study in mid-life, then evaluated for cognitive impairment about two decades later when they were between 65 and 79 years old. Alzheimer's made the headline, but the study was about a variety of cognitive impairments, most of them mild. Of the 1,432 people in the study, 139 had some sort of cognitive impairment; only 48 had Alzheimer's.

Those who were widowed had 6 times the rate of cognitive impairment (all kinds) as those who were married. The divorced had 3 times the rate, and those who had always been single had twice the rate.

I wondered how many people we were actually talking about here, so I scoured the web for other accounts of this study and found more information. (Ordinarily, I go to the original scientific report, but this research has been described only in a talk given at a conference. The work has not been peer-reviewed, which should have been another warning to the BBC.) The vast majority of the people in the study (1,147 of the 1,432) were married. There were 111 who were always single, 63 who were divorced, and 111 who were widowed.

Crunching the numbers (see the statistical note at the end), that means that of those people in the study who had always been single, the number who had some form of cognitive impairment was about 14. For the divorced, it was about 12, and for the widowed, about 41. The others (about 71) were married. So yes, people who had always been single had a higher rate of cognitive impairment than people who were married, but we are talking about 14 people.

The headline was not about all forms of cognitive impairment, though -- it was about Alzheimer's. Only 34.5% of all of the impairments were Alzheimer's. So of those people in the study who had always been single, how many had Alzheimer's? About 5, give or take. About 4 of the 63 divorced people had Alzheimer's and 14 of the 111 widowed people; the other 25 (approximately) were married.

Here's something I found in a different report of the findings that the BBC did not bother to mention at all:

"The association with an increased risk of Alzheimer's disease did not reach statistical significance."

Translation: the findings weren't really there. Scientifically speaking, any differences between the people of different marital statuses could have been due merely to chance.

With no reliable differences in the rate of Alzheimer's between the married and the single people, the BBC should not have heralded the "findings" in a headline. But it did that and more - inviting the author of the conference paper to speculate on why the married people were less at risk.

"This study points to the beneficial effects of a married life," said Krister Hakansson.
Anyone who has taken a beginner's course in research methodology knows that the study does no such thing. Even assuming that the author is referring to all cognitive impairments (for which there were differences) and not just Alzheimer's, he cannot know whether being married caused people to have lower rates of impairment, or whether the particular people who married would have had lower rates even if they had stayed single.

Still, with the BBC's encouragement, the author continued to explain why married people are less at risk: "Living in a couple relationship is normally one of the most intense forms of social and intellectual stimulation."

If you are a matrimaniac, you might accept that without question; after all, it sounds plausible, right? Personally, I'd bet on people (whether single or married) participating in collaborative work groups, on research teams, or in grassroots social movements as having more intense social and intellectual stimulation that a couple in their 70s who have been married for decades. I'd even go with pairs of close friends. But I'm just riffing here. In a poll of older couples in the UK, just under a third "felt challenged or stimulated in their relationship." Six percent said they did not talk to one another at all!

A different report of the dementia study was even worse than the BBC's in the lessons it drew from the research. The opening line was, "If you are single and in your 40s, it might be a healthy idea to get hitched."

Just to play along, I'm going to take this suggestion seriously. Let's say I've always been single. (It is true.) Let's also go with the author's undemonstrated assumption that marital status causes dementia. Let's also pretend that the differences in rates of dementia among the various marital status groups are statistically reliable (which, for Alzheimer's, they are not). That means that if I stay single, I have about double the chance of developing dementia in later life than someone who marries and stays that way. Some of those married people, though, will divorce after the study has ended and the researchers are no longer following them around. Those divorced people will now have a higher rate of dementia than I would by staying single.

Even those who marry and never divorce will not stay in their marital status forever. Half will become widowed. Then they will be way more likely to develop dementia than I will by staying single. But maybe you will be the partner who dies first - then you would keep your favored status as least likely to develop dementia throughout your life. Of course, unlike the spouse who outlived you and then became more at risk for dementia, you'd be dead.

Bella DePaulo is the author of Singled Out: How Singles Are Stereotyped, Stigmatized, and Ignored, and Still Live Happily Ever After.

[Statistical note: Because so little information was provided, I had to figure out the numbers myself. Here's how I did it. I started with the facts that were reported. There were 1,432 people in the study, and of those, 1,147 were married. Of all of the people in the study, 139 had some sort of cognitive impairment (most of it mild). Those who were always single had twice the impairment rate of the married, the divorced had 3 times the rate, and the widowed had 6 times the rate. Running those numbers, I found that if the rate of cognitive impairment among the married were 6.2%, then 71 of the 1,147 married people would be cognitively impaired. The rate is double for the always-single, so 12.4% of the 111 would be cognitively impaired, or 14 people. The rate for the divorced is 3 times that of the married, so 6.2% X 3 = 18.6% or 12 divorced people. For the widowed it was 6 times the rate for married, so 37.2% or 41 people. 71 married + 14 always-single + 12 divorced + 41 widowed adds up to 138, within rounding error of the 139 reported by the BBC and in other news reports. As for Alzheimer's, only 48 of the 139 cases of cognitive impairment, or 34.5%, were Alzheimer's. (The others were milder forms of impairment.) So, 34.5% of the 71 married people equals about 25 with Alzheimer's; 34.5% of the 14 always-single people equals 5 with Alzheimer's; 34.5% of the 12 divorced people equals 4 with Alzheimer's; and 34.5% of the 41 widowed people equals 14 with Alzheimer's. 25 married + 5 always-single + 4 divorced + 14 widowed equals the 48 total with Alzheimer's reported in the media.]

Comments

[Krister]

I am the lead author of this study and one clarification is the use of the term "single". The main results, highly significant (p

[RachelAB]

Something else that struck me about this article: Alzheimer's has a fairly low prevalence. Only about 3 people in every 100 people will develop it. About 11 out of 100 get heart disease; 7 out of 100 get cancer.

The Medical News article you found actually hints at the real culprits: APOE-e4 genotype (there's a genetic predisposition toward Alzheimer's) and stress (people who have undergone stress are more likely to be affected by the damaging action of this genotype - loosing a spouse/partner through divorce or death is stressful...). So, here's our headline: Stress and genes can kill you! I guess that's no longer newsworthy...

[LBAseminars]

I had similar concerns about Krister HÃ¥kansson"s study, particularly as it relates to the difference between women"s and men"s experience of being ever-singles. In a recent email conversation, HÃ¥kansson confirmed the substantial difference in women"s and men"s experience of singlehood; nevertheless, the small number of singles in his study, particularly single men, led him to focus largely on married vs. divorced populations. He also explained the uniqueness of post-WWII widowhood in the study"s eastern Finland population. In his defense, I"m not sure even he would agree with some of the media"s headlines this week about his research.
As a researcher on the science of reducing the risk of Alzheimer's disease, I have often suspected a "married" bias in studies suggesting that an active social life helps maintain cognitive fitness. In these studies, being married is often ~ and inexplicably ~ listed as a criterion for being socially active. For more details on the research for reducing the risk of Alzheimer"s, see www.LBAseminars.com.
Lucie Arbuthnot, Ph.D.
Keep Your Brain Fit for Life„¢
Sanford, Maine

[Alan71]

This has an interesting parallel to the experience the gay community has had with scientific research. Particularly in the first half of the century, many psychological/sociological studies were produced claiming that gays were unhappy, maladjusted, and possibly dangerous; studies largely influenced by researcher hostility towards homosexuality (which thankfully has changed a great deal in the last generation).

Robin may have a point about a lack of stimulus. However, I don't think that the people pushing these studies would do the logical follow-up and say "How can singles find more stimulation as they age so as to avoid Alzheimer's?" They'd probably just say, "Get married, stay married" and refuse to consider any pragmatic, problem-solving approaches. Because debates like this are rarely about the science; they're mostly about worldview.

[AngryAmish]

Best comment on marriage. Ever. :http://www.youtube.com/watch?v=Z9vk5vUzuXc&feature=related

P.S. As a perennial single, I am truly thankful that you've chosen to mine this particular vein in your social commentary.

[RobinSeattle]

Part Two:

Now here is why it could impact singles: people who are unattached and who spend a lot of time alone at home doing little more than watching tv are not getting much stimulus. They are in a stimulus dead environment. If there is a tendency toward Alzheimer's, then there is not enough stimulus to slow its effects.

Whereas, marrieds are at least getting social and perhaps even intellectual stimulus everyday from their partners and this is ramped up if they carry on busy social lives. They go out, they participate in the community, etc, and that could (this is all just bigtime conjecture on my part) by so doing impeding the expression of Alzheimer's.

However, there are obviously marrieds who suffer form Alzheimer's and here is perhaps why: if the marriage is a content dead relationship in a stimulus poor environment then, again, there is nothing to halt the progress of the disease once it begins expressing itself.

I also offer a couple fo examples in my own family: I had an aunt who suffered Alzheimer's beginning in her 80's. But it was only after her husband of several decades had passed away and she lived largely alone and had a sedentary lifestyle with no intellectual interests.

To be continued....

[RobinSeattle]

Given that you aren't a neurologist and neither am I, and that Alzheimer's would seem to be a non-behavior based malady, your only resort is to attack the methodology rather than the content in order to assure singles that they aren't headed for senility since the study as you understand it doesn't seem to offer the mechanics of how Alzheimer's would impact singles more than married folks.

Well, the study could be right, but its conclusions are perhaps too narrow and, in the name of playing devil's advocate here, I am going to offer a possible reason singles could be harder hit by that malady.

It was either on one of the PBS stations or the Science Channel that I saw a program about a hopeful therapy for Alzheimer's. Basically, it goes like this: put an Alzheimer's sufferer in a high stimulus environment and the brain seems to start rewiring itself with the effect that not only do memories recover at least somewhat, but the pace of the disease slows enough so that more cognitive thinking is also recovered.

To be continued....

[Faxus]

When I read the original article I too was suspicious, thanks for digging deeper.