Many believe the prescription for a long, healthy life is marriage. Studies have shown married men and women reap certain health benefits, including a reduced risk of functional impairment as they age. But a new study published in the Journal of Women’s Health challenges this idea, suggesting it's the unmarried who have a lower risk of becoming frail compared to others. It also suggests these benefits depend upon a person's sex.

Frailty, a common condition associated with old age in, is the gradual loss of physiologic and cognitive ability, which raises the risk of health issues and functional impairments, as well as the rates of disability, hospitalization, and institutionalization. In the study, researchers classified a man or woman as frail if they experienced unintentional weight loss, low energy, slow walking speed, weakness, and exhaustion. Although marital status has been associated with risk of disability and death, it’s role in influencing frailty has not been thoroughly examined.

"This study adds to our understanding of how marital status influences the onset of frailty in older people, but reveals surprising gender-specific differences," Dr. Susan G. Kornstein, executive director of the Virginia Commonwealth University Institute for Women's Health, said in a statement.

Researchers from the University of Padova and the National Research Council’s Institute of Neuroscience evaluated a group of 1,887 men and women ages 65 and older for more than four years. The participants were enrolled in the Progetto Veneto Anziani study, a separate look into the rates of metabolic syndrome and cardiovascular disease among elderly people. None of the participants showed evidence of frailty at the start of the present study.

Researchers analyzed information on their formal education, physical activity, monthly income, smoking and drinking habits, number of cohabitants, and living status. They found the main determinants of frailty most influenced by marital status were unintentional weight loss, daily energy expenditure, and exhaustion.

After the follow-up period, nearly 22 percent of participants were considered frail. The data showed that unmarried men had a higher risk of developing frailty than married men. The same was true among married women when compared to their unmarried counterparts. However, when comparing the rates of frailty between widowed and married people, they found gender-related differences. For example, elderly men who were widowed had a higher risk for developing frailty compared to married men. However, unlike men, widowed women had significantly lower odds of becoming frail than married women, with a lower incidence of unintentional weight loss or low daily physical activity levels.

“Many studies have shown that women are less vulnerable to depression than men in widowhood, probably because they have greater coping resources and are better able to express their emotions,” researchers wrote. “These aspects may help to explain the lower risk of exhaustion seen in single women, who are likewise more socially integrated than single men, and consequently less exposed to frailty.”

The study also showed that unmarried women fared better than married women when it came to exhaustion and unintentional weight loss. Researchers believe the benefits widowed and unmarried women have over married women may be due to the fact that they don’t have to look after or care for a partner.

“Since women generally have a longer lifespan than men, married women may also suffer from the effects of caregiver burden, since they often devote themselves to caring for their husband in later life,” they wrote.

Limitations in the study include failing to consider whether or not an unmarried person had a partner, and the failure to assess the length of the study participant’s widowhood, “since it has been demonstrated that the acute and long-term effects of conjugal bereavement differ considerably.”

Researchers said more studies are needed to determine whether changes in social structure influence the impact of marital status on the onset of frailty.

Source: Caterina T, Nicola V, Stefania M, et al. Marital Status and Frailty in Older People: Gender Differences in the Progetto Veneto Anziani Longitudinal Study. Journal of Women’s Health. 2016.