Marital Status and Personal Well-being a Literature Review

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J Marriage Fam. Writer manuscript; available in PMC 2015 Oct 1.

Published in final edited form as:

J Marriage Fam. 2014 October 1; 76(v): 930–948.

Published online 2014 Sep 2. doi:10.1111/jomf.12133

PMCID: PMC4158846

NIHMSID: NIHMS608453

Happy Marriage, Happy Life? Marital Quality and Subjective Well-Being in Later Life

Vicki A. Freedman

*Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104

Jennifer C. Cornman

**Jennifer Cornman Consulting, 113 Chapin Pl., Granville, OH 43023

Norbert Schwarz

***Section of Psychology, Academy of Southern California, 3620 South. McClintock Ave., Los Angeles, CA 90089-1061

Abstract

The authors examined associations between marital quality and both general life satisfaction and experienced (momentary) well-being among older husbands and wives, the relative importance of own versus spouse's marital appraisals for well-beingness, and the extent to which the clan between own marital appraisals and well-being is chastened past spouse's appraisals. Data are from the 2009 Disability and Employ of Time daily diary supplement to the Panel Written report of Income Dynamics (N = 722). 1's own marital satisfaction is a sizable and significant correlate of life satisfaction and momentary happiness; associations practice not differ significantly by gender. The authors did not find a significant association between spouse's marital appraisals and ain well-beingness. Withal, the association between husband's marital quality and life satisfaction is buoyed when his wife also reports a happy marriage, yet flattened when his wife reports low marital quality. Implications for agreement marital dynamics and well-being in later life are discussed.

Keywords: role player–partner independence models, daily diary methods, experienced well-existence, gender differences, happiness, life satisfaction, marital quality, older adults

The protective effects of marriage for concrete and emotional well-being are widely documented (Carr & Springer, 2010). However, recent enquiry shows that these effects are conditional upon the quality of the matrimony; problematic marriages take an emotional cost, whereas high-quality marriages provide benefits, especially for women (Proulx, Helms, & Buehler, 2007) and older adults (Umberson, Williams, Powers, Liu, & Needham, 2006). Although the positive association between marital quality and well-being is well established, several important issues remain unexplored. Starting time, most such studies take focused on negative aspects of psychological performance, particularly depressive symptoms (Bookwala, 2012). Studies that have focused on positive aspects of well-being typically have used decontextualized and full general life satisfaction measures (Whisman, Uebelacker, Tolejko, Chatav, & Meckelvie, 2006) rather than momentary measures of positive mood that may be less susceptible to response bias.

2nd, most studies have focused on only one spouse's marital appraisals and have non considered that both own and spouse's appraisals may contribute independently to well-being (i.e., actor vs. partner effects; Cook & Kenney, 2005). Although mounting research suggests that one spouse'due south marital (dis)satisfaction may affect the other partner's well-being, such studies typically have focused on immature or midlife persons (Beach, Katz, Kim, & Brody, 2003; Whisman, Uebelacker, & Weinstock, 2004). Tertiary, we know of no studies that have explored the combined influences of both partners' marital appraisals on well-being. Older spouses' marital appraisals are correlated simply modestly (r < .l in the present written report; encounter too Bulanda, 2011; Carr & Boerner, 2009; Cohen, Geron, & Farchi, 2009); thus, it is plausible that spouses' appraisals as well as convergences (or divergences) therein may have independent associations with well-being. The protective effects of marital satisfaction on emotional well-being may be amplified when one's spouse also is satisfied with the marriage, whereas the association may exist dampened or fifty-fifty reversed when one's partner is dissatisfied. An exploration of the multiplicative influences of "his" and "her" marital assessments on 1's well-being will shed lite on complex associations between marital dynamics and emotional well-being in afterward life.

Thus, in this study nosotros explored the distinctive ways that both own and spouse'south marital quality appraisals are associated with two aspects of older adults' subjective well-being: (a) evaluations of one'south life in full general (i.e., global life satisfaction) and (b) how one experiences life moment to moment (i.e., happiness during randomly sampled activities on the day prior to interview). Data were from the 2009 Disability and Use of Fourth dimension (Dust) supplement to the Console Study of Income Dynamics, which includes 24-hr fourth dimension diaries capturing activities and emotions experienced on the previous twenty-four hour period. Using these data obtained from older married couples, we explored the following four areas: (a) associations between marital quality and well-beingness for husbands and wives; (b) differences in how own ("actor") and spouse'south ("partner") marital appraisals are associated with well-being; (c) the extent to which associations between marital quality appraisals and well-existence persist net of demographic, health, socioeconomic status, and characteristics of the target solar day (e.g., day of week, activeness); and (d) the extent to which the associations betwixt one's ain marital appraisals and well-being are moderated by a spouse'south appraisals.

Understanding afterwards life marriage is an important pursuit given current demographic trends. The proportion of adults historic period 65 and older is projected to increment, from thirteen% in 2010 to nearly 20% in 2030 (Federal Interagency Forum on Crumbling-Related Statistics, 2012). Marital quality has far-reaching implications for the wellness and well-being of older adults; it is a well-documented buffer against the health-depleting furnishings of later life stressors such as caregiving (Bookwala, 2012), and is a disquisitional resource as couples manage difficult decisions regarding their stop-of-life health intendance (Carr, Boerner, & Moorman, 2013).

Background

Marital Quality and Subjective Well-Being Amid Older Adults

Marital quality is positively associated with subjective well-existence, and this clan is typically stronger among women than men (Bookwala, 2012; Jackson, Miller, Oka, & Henry, 2014; Proulx et al., 2007; Whisman, 2001). Withal, well-nigh studies have examined newlyweds, young couples, or those with children living in the home (Bookwala, 2012; Whisman, 2001). Therefore, the potent association between marital quality and well-being amidst women relative to men may reflect distinctive aspects of marital roles and relations in immature and mid-adulthood. Feminist writings dating dorsum to Jesse Bernard (1972) suggest that spousal relationship and intimate relationships are more central to women'southward identities, and more consequential for their overall well-being relative to men, because women typically "specialize" in emotion piece of work and nurturing roles such every bit that of spouse or parent, whereas their husbands specialize in paid employment exterior the home (Loscocco & Walzer, 2013). Women may feel responsible for resolving marital problems and ensuring that the couple maintains a adept marriage for the sake of the children (Embankment et al., 2003; Davila, Karney, Hall, & Bradbury, 2003; Dehle & Weiss, 1998). Some scholars contend further that women traditionally have had less ability and status in marriage than men and thus have a greater emotional investment in maintaining a good for you relationship (Bulanda, 2011).

Amidst older adults, the gendered roles and relations established earlier in the life form may shift or converge, creating a context in which the association between marital satisfaction and well-being is similar for husbands and wives. First, as spouses historic period, their social networks beyond the marital dyad may modify such that marriage becomes an equally salient source of well-being for both men and women. As they age, older men (and women, to a lesser extent) exit full-time employment, reduce social contact with former colleagues, and increase interactions with their spouse (Kulik, 2002). Contact with friends and siblings also may decline equally some die, whereas others may experience health declines or caregiving duties that limit their social engagement (Dykstra & Gierveld, 2004). Social networks too may contract because of conscious efforts on the office of older adults. Equally older adults' time to come fourth dimension horizons become more limited, they may consciously limit their social networks and focus on a small subset of their closest relationships (Carstensen, 1991). As such, close ties with a spouse may be particularly salient to both older husbands' and wives' overall well-existence (Lang, 2001).

Second, developmental and role changes over the life course may contribute to a convergence in the salience of marital quality for husbands' and wives' well-being. Theoretical writings propose that a gendered "role crossover" occurs at midlife and later, whereby men get more oriented toward family and affiliation and less oriented toward power and agency, especially after retiring and leaving full-time employment. Older women, by contrast, may place an increased emphasis on agency and self-fulfillment, and their identities and well-being get less closely tied to their relationships with others (Loscocco & Walzer, 2013). Thus, the relative importance of bureau versus affiliation for men and women may converge in after life.

These psychological shifts are closely tied to shifts in social roles; when older men are retired and women's daily care of dependent children has subsided, spouses typically experience greater role disinterestedness (Hagedoorn et al., 2006; Kulik, 2002). Whereas in younger couples wives may take responsibility for and solve marital bug, as long-term marriages persist men may "catch up" and may feel as responsible for and go every bit invested in the marital relationship, especially as paid piece of work obligations absorb less of their time (Beach et al., 2003). Consequent with the assumption that the importance of marriage to husbands' and wives' overall well-being may converge in later on life, several minor, nonrepresentative studies of married older adults in the Usa have found no gender differences in the clan between marital quality and well-beingness (Quirouette & Pushkar-Gold, 1992; Whisman et al., 2006). Our first aim was to assess gender-specific associations between marital quality and well-being amidst a nationally representative sample of older spouses; nosotros expected that the magnitude and direction of these associations will be like for men and women.

Marital Quality and Global Versus Experienced Subjective Well-Being

Most research on the association between marital quality and subjective well-being has focused on negative outcomes, typically, depressive symptoms (Bookwala, 2012; Fincham, Embankment, Harold, & Osborne, 1997; Whisman et al., 2004). Ryff and Singer (1998) argued for the value of focusing on positive outcomes as well. Older persons who score very low on indicators of positive psychological functioning, such as life satisfaction or happiness, may be at an elevated risk of major depression if confronted with additional life stressors. By dissimilarity, emotional well-being is a resource on which older adults may depict every bit they cope with aging-related stressors, including concrete declines, sensory impairment, and caregiving challenges (Bookwala, 2012). Finally, older adults are believed to have a cognitive bias whereby they attend to positive and avoid or understate negative experiences, sentiments, and recollections (Charles, Mather & Carstensen, 2003). Therefore, indicators of positive aspects of well-being may offering a more than accurate portrayal of older adults' overall psychological health.

An increasing corporeality of inquiry is exploring associations betwixt marital quality and positive psychological outcomes, yet most studies thus far have focused on general indicators such equally global life satisfaction (Cohen et al., 2009; Glenn & Weaver, 1981). Scholars of subjective well-being have called for heightened attention to an alternative measure: experienced well-being, or the moment-to-moment reports of how ane is feeling (Kahneman, Krueger, Schkade, Schwarz, & Stone, 2006). Some researchers consider these measures an improvement over global, decontextualized measures such as life satisfaction, which may be influenced by errors in recollection, call back bias, and other cognitive processing bias errors (Schwarz & Strack, 1999).

Thus, we focused on both global and momentary measures of well-being. Global life satisfaction is a relatively stable orientation and is not afflicted by transient mood. It captures how people evaluate their lives relative to some standard, such as their expectation for how life should be (Schwarz & Strack, 1999). By contrast, momentary measures of experienced well-being are assessments of lives as individuals alive them. The 2 measures are highly correlated, nevertheless life satisfaction is more responsive to enduring markers of success (e.g., instruction), whereas experienced well-being is more responsive to contemporaneous activities and firsthand circumstances (Kahneman et al., 2006). Information technology is plausible that each could relate differently to marital quality (George, 2010); for example, frequent arguments with ane'southward spouse, or a spouse's urgings to have 1's medications, might cause a momentary spike in unhappiness only may too provide a feeling of being cared for, which may enhance one's overall satisfaction. We evaluated the associations between men's and women's marital quality and two aspects of well-being: (a) life satisfaction and (b) momentary happiness.

His and Hers Marital Quality Appraisals: Evaluating Player and Partner Furnishings

To appointment, most studies of the implications of later life marriage have focused on one individual within the marital dyad, "despite the importance of relationship interdependencies … to the study of aging" (Windsor, Ryan, & Smith, 2009, p. 586). This limitation is due in office to traditional models of data collection in which one person answers survey questions on his or her perceived human relationship quality and well-beingness (Carr & Springer, 2010). Nevertheless, husbands and wives practice not necessarily view their marriages in similar ways; marital quality assessments are typically correlated only modestly (r < .50), even in long-term relationships (Bulanda, 2011; Carr & Boerner, 2009; Cohen et al., 2009). As a event, few studies take investigated whether older adults' subjective well-being is a role of one'south own marital appraisals, i'southward spouse'due south appraisal, or a product of the 2.

Over the past decade, studies have begun to explore actor–partner effects, or the extent to which one individual'south experiences or traits affect other members of 1'due south social network (Cook & Kenny, 2005). For example, if i partner is dissatisfied with the matrimony, he or she could human action negatively toward the spouse past criticizing or withdrawing affection. Conversely, happily married persons may be motivated to provide support and encouragement to their partner, thereby enhancing their partner's happiness and well-beingness. Thus, ane partner'south marital (dis)satisfaction may be linked to the emotional well-existence of the other.

To date, studies of the marital dyad have yielded inconclusive findings. Several take found that a spouse's physical and emotional health are strongly associated with one's own well-beingness (see Bookwala, 2012, for a review), yet comparable patterns have not been detected with regard to marital quality and well-being. A report of married parents of teenage children constitute that one partner'south marital appraisals affected the other spouse'south depressive symptoms (Beach et al., 2003), and a report of newlywed couples found no prove of partner effects (Fincham et al., 1997). These results advise that partner furnishings may become evident only in longer term marriages, in which the partners are knowledgeable well-nigh and sensitive to fluctuations in one another's attitudes and feelings. To evaluate whether partner effects are evident in long-term marriages among older adults, we took reward of the couple-based pattern of the Disability and Use of Time (Dust) daily diary supplement (Freedman & Cornman, 2012) to the Panel Study of Income Dynamics (PSID; Loma, 1992) and evaluated whether spousal marital appraisals are associated with one's subjective well-being, independent of one's own marital appraisals.

The Multiplicative Effects of His and Her Appraisals

Although subjective well-being may respond directly and independently to a spouse's marital happiness, a straightforward cess of histrion and partner furnishings does not necessarily capture the complex interactions between the two. A mounting body of research, typically laboratory based studies, documents the processes through which husbands and wives independently respond to conflicts or joys in union and the reactions that one partner's response elicits from the other. These dynamic processes of action and reaction may have powerful implications for overall well-beingness. For example, studies of dyadic coping and communication reveal the varied means that couples, especially older couples managing wellness problems, might navigate such challenges (Holley, Haase, & Levenson, 2013; Revenson, Kayser, & Bodenmann, 2005). Such examples provide a foundation for investigating statistical interactions betwixt ain and spouse's marital appraisals and their associations with married persons' overall well-being.

We know of no studies that accept explored interactive furnishings of own and spouse's marital appraisals on one's ain well-being. Nonetheless, we speculate that the protective furnishings of one'due south own marital satisfaction may be buoyed past a spouse'due south positive marital appraisal, whereas the harmful effects of 1's own negative appraisal may be amplified when one's spouse also offers a negative appraisal. Nosotros expected to find stronger evidence of moderation effects amid husbands than wives, given well-documented gender differences in marital interactions, whereby women play a more active role in communicating, instigating change in a partner'south behavior, and conveying concerns most the marital human relationship (Bloch, Haase, & Levenson, 2014). Past contrast, men tend to take a more passive or silent arroyo to addressing marital issues, and therefore their feelings toward the marriage may not necessarily exist transmitted to their spouse and may not interact with their wives' marital assessments to bear on wives' overall well-existence (Heavey, Layne, & Christensen, 1993). Given this, women's marital interactions may elicit a stronger reaction from their husbands than vice versa, carrying consequences for husbands' well-being. To address these questions, nosotros evaluated two-style interaction terms of each partner's appraisal on one'south subjective well-being.

Other Influences on Marital Quality and Well-Existence

Nosotros evaluated the extent to which associations between marital quality and well-beingness persist when nosotros controlled for potential demographic and socioeconomic confounds, including historic period (Mroczek & Spiro, 2005; Proulx et al., 2007), race (Broman, 2005; Krause, 1993), own and spouse's physical health (Butterworth & Rodgers, 2006; Kaufman & Taniguchi, 2006), socioeconomic status (White & Rogers, 2000), marital duration (Umberson et al., 2006), whether 1 is in a starting time or higher guild marriage (Barrett, 2000; Mirecki, Chou, Elliott, & Schneider, 2013), and parental status (Umberson, Pudrovska, & Reczek, 2010). We also controlled for characteristics of the specific activities to which 1 was referring when describing one's mood on the study day.

Method

Data

Our analyses are based on data from the Dust supplement to the 2009 PSID, a national console written report of a representative sample of families in the U.s.a.. The original 1968 PSID sample included 18,000 individuals in approximately 5,000 families. All respondents from the original sample and anyone born to or adopted by one of these families have been followed in the written report. The PSID sample is a self-sustaining one; information technology increases as children leave their parents' households and form new households. Adult children are so tracked past the written report investigators; the blueprint produces a nationally representative cross-section of families each year (McGonagle & Schoeni, 2006). Interviews were conducted annually between 1968 and 1997 and biennially thereafter. Reinterview rates for original sample members have been consistently 98% per year (96% over 2 years), and the sample of families now exceeds 8,000. In 2009, the response rate for the PSID (including new dissever-off households) was 94.3%.

DUST sampled couples in the 2009 PSID in which both spouses were at to the lowest degree l years old and at to the lowest degree 1 spouse was at least 60 years former every bit of December 31, 2008. The vast majority of married persons in the PSID age threescore and older take spouses who are age 50 and older; however, the sample does not stand for the pocket-size fraction (~five%) of couples in which one spouse is 60 or older and the other under 50. To heighten opportunities for studying inability, couples in which one or both spouses reported a health limitation during the 2009 core interview were oversampled, and strata were farther divided by the husband'south historic period (<70, 70+).

The DUST musical instrument, which was administered past telephone within a few months later on the 2009 core PSID interview, was designed every bit a thirty- to xl-minute diary. Dust was paired during the first of two interviews with a 15- to 20-minute supplemental questionnaire that included global well-being, operation, marital quality, and stylized time use questions. To obtain a balanced sample of days, couples were systematically assigned interview days that would yield one weekday and one weekend twenty-four hour period diary; thus, up to 4 daily diaries could be completed per couple. Husbands and wives were interviewed separately but on the same appointment. The diary asked about all activities on the previous day, beginning at four:00 a.m. and continuing until four:00 a.k. the day of interview. Respondents also were asked detailed questions well-nigh how they felt while doing up to 3 randomly selected activities (for details, see Freedman & Cornman, 2012); this arroyo is based on the validated Twenty-four hours Reconstruction Method adult to measure momentary well-being (Kahneman et al., 2006). Grit assessed momentary well-beingness for upwards to three activities to minimize subject area fatigue and colorlessness; this sampling procedure is consistent with those of other national daily diary studies (Iida, Shrout, Laurenceau, & Bolger, 2012). Comparisons of momentary measures nerveless through 24-hr diary format with real-time feel sampling methods suggest very good agreement (Dockray et al., 2010).

Of the 543 eligible couples sampled for DUST, at to the lowest degree one diary was completed for 394 couples, yielding a response rate of 73%. About iv% of respondents (northward = 33) had a spouse who could not participate because of a permanent health condition (e.yard., retentivity loss). For these couples, diaries were collected from the spouse without a health condition. Because analyses focus on ain and spouse'due south reports of marital quality, our analytic sample was limited to couples for whom we had both spouses' reports of marital quality (n = 361). For analyses assessing momentary mood, we had 720 paired husband–wife diary days and 1,920 paired activities.

Dependent Variables

Subjective well-being

Global satisfaction is assessed with the question, "Taking all things together, how satisfied are you lot with your life these days?" Response categories range from 0 (non at all) to six (very). This single item was administered at the kickoff and cease of the interview, yielding a correlation of .65. This is consistent with other studies detecting one-60 minutes examination–retest reliabilities of.forty to .66 and same 24-hour interval test–retest reliabilities of .50 to .55 (Krueger & Schkade, 2008). In the analyses presented here, nosotros used the evaluation provided at the beginning of the interview, in order to avoid potential priming effects as a effect of the interview content (Strack, 1992). Momentary well-beingness refers to how happy a respondent was while doing reported activities on the study solar day. For the randomly selected activities from each diary, respondents reported how happy they were on a scale that ranged from 0 (not at all happy) to 6 (very happy).

Independent Variables

Marital quality

Marital quality is derived from a subset of six items drawn from a standardized musical instrument reflecting both marital strain and support (Whalen & Lachman, 2000). Respondents indicate how much: yous can open to your spouse if you lot need talk well-nigh your worries; your spouse appreciates you lot; your spouse argues with you (reverse coded); your spouse understands the way you feel about things; your spouse makes you experience tense (opposite coded); and your spouse gets on your nerves (reverse coded). Response categories range from 1 (not at all) to 4 (a lot). Responses are averaged and then that higher values reverberate more than positive assessments. A confirmatory factor analysis showed that the six items course a single cistron, with all loadings 0.53 or higher and a Cronbach'southward alpha of .78. We too calculated two 3-item scales capturing positive (α = .71) and negative interactions (α = .71). Preliminary regression analyses revealed similar associations betwixt own marital quality and well-existence, regardless of the scale used, and models using the six-item scale had superior model fit. Thus, we utilise the single half-dozen-item scale in all analyses.

Command variables

All models were adjusted for selected respondent, spouse, and couple characteristics that may potentially confound the statistical association between marital quality and well-being. Respondent and spouse characteristics include historic period, self-rated wellness, and disability. Age categories are fifty–69 (reference category), 70–79, and 80+ for men, and 50–59 (reference category), lx–69, and lxx+ for women. The unlike cutpoints for husbands and wives reflect the fact that at to the lowest degree 1 member of the dyad had to exist age 60 or older for study inclusion, and men tend to ally women younger than themselves. These categories also reflect the low number of men under age 60 and women over age 80 in the sample. We use chiselled rather than continuous measures because the association between historic period and well-being is not linear; the clan is positive betwixt ages threescore and 75 and reverses thereafter (Frijters & Beatton, 2012).

Gild of matrimony refers to whether i is in a remarriage; outset wedlock is the reference group. We as well controlled for whether a respondent has whatsoever children (1 = yeah, 0 = no). Self-rated health refers to whether one rates his or her own health as "fantabulous," "very adept," "practiced," "fair," or "poor"; higher scores reflect poorer wellness. The v-level ordinal mensurate is preferable to a dichotomous indicator (e.g., poor/off-white vs. other) because the latter conceals important gradations in later life health (Finnas, Nyqvist, & Saarela, 2008). Disability refers to whether 1 has "serious difficulty" with hearing; seeing when wearing glasses; concentrating, remembering or making decisions considering of a concrete, mental or emotional condition; walking or climbing stairs; difficulty dressing or bathing; or doing errands alone, such as visiting a doctor'due south function or shopping because of a physical, mental, or emotional condition. This mensurate was adult for the American Customs Survey (Weathers, 2005). Couple characteristics are total household income for 2008 (in quartiles), total wealth for 2008 (in quartiles), and marital duration (in years).

For analyses predicting momentary happiness during daily activities, nosotros also controlled for whether the activeness was performed on a weekend (vs. weekday), at home (vs. elsewhere), with the spouse (vs. alone or with someone else), and which of 17 different activity categories best captures the nature of the randomly selected action. Considering the action categories are mutually exclusive, we used traveling as the comparison group. A major strength of diary data is their detailed data on what people are doing when their momentary mood is assessed. In preliminary analyses, nosotros contrasted regression models using the full set of 17 activities indicators versus aggregated categories to predict well-being. The distinctive effects of the 17 categories in our sexual practice-specific models suggested that nosotros would need to create different aggregated categories for each gender, and we wanted to keep the sexual practice-specific models identical.

PSID has very low levels of missing data; across all the variables in the life satisfaction models, 21 (2.nine%) or fewer cases were missing data on any one variable. For the boosted variables that appear only in the happiness models, at most 24 (0.6%) activities have missing data on any one variable. All variables except one (instruction) have less than 1.five% missing data; nosotros recoded the missing data to the modal category of the variable. Education had missing information for two.ix% of cases, thus we imputed the historic period-sex specific way. Given the extremely low level of missing data (and hence likely trivial impact on variance estimates), we opted for hateful imputation rather than more complex multiple-imputation techniques.

Analytic Plan

We first present weighted descriptive statistics for husbands and wives (encounter Table i; see below for description of sampling weights). Next, we examine the unadjusted associations between both ain and spouse's marital quality appraisals and well-existence (see Table ii). We then evaluate the extent to which these unadjusted associations persist net of all control variables (encounter Table 3). Finally, we estimate models that include an interaction term between married man and married woman marital assessments (encounter Tabular array four). All analyses were performed in Stata 11.one.

Table 1

Weighted Ways (and Standard Deviations, in Parentheses) or Percentages for All Variables Used in the Assay for Husbands and Wives in the Disability and Use of Time Supplement to the Panel Study of Income Dynamics

Variables Husbands (northward = 361) Wives (northward = 361) p
Life satisfaction (range: 0–6) 5.0 (1.00) 5.0 (ane.07) .718
Momentary happiness during activities yesterday (range: 0–6) 5.one (1.xix) 4.nine (i.18) .090
Marital quality (range: one–iv) three.3 (0.53) 3.i (0.57) < .001
Player/partner characteristics
 Age < .001
  50–69 58.6
  50–59 17.9
  threescore–69 52.seven
  70–79 27.3
  70+ 29.4
  fourscore+ 14.1
 Completed education (in years) 13.9 (2.72) thirteen.3 (ii.35) < .001
 Race (one = Black, 0 = non-Black) 2.9 2.vi .325
 Second or college order marriage (ane = yes) 27.9 28.5 .628
 Has whatsoever children (one = aye) 85.v 88.vii .145
 Has a inability (1 = yeah) 44.three 36.1 .087
 Self-rated health (1 = excellent to 5 = poor) two.half-dozen (1.13) 2.seven (1.08) .069
Couple characteristics (northward = 361 couples)
 Income quartile, 2008
  0 to 25th percentile 21.3
  25th to 50th percentile 21.0
  50th to 75th percentile 25.8
  75th to 100th percentile 31.ix
 Wealth/avails quartile, 2009
  0 to 25th percentile 19.one
  25th to 50th percentile 22.8
  50th to 75th percentile 27.8
  75th to 100th percentile 30.iv
Marital duration (in years) 38.5 (14.57)
Characteristics of activities
 On the weekend (1 = yes) 31.6 34.iv .105
 At home (i = yes) 46.three 59.1 < .001
 With spouse (1 = yep) 32.5 xxx.8 .488
Randomly selected activities yesterday (percentage participating)
 Cocky-maintenance eight.ii vii.v .630
 Eating 11.7 ten.9 .658
 Working for pay 8.2 4.7 .012
 Shopping for food ane.8 i.nine .899
 Shopping for other goods three.2 2.7 .578
 Preparing food two.half-dozen 12.6 < .001
 Doing household chores 1.3 5.4 < .001
 Doing household maintenance 7.9 half dozen.1 .220
 Managing finances 2.6 one.half dozen .177
 Caring for others 1.iii one.seven .549
 Socializing 5.5 8.2 .047
 Watching Goggle box/movies 9.ix 7.6 .070
 Doing other non-active leisure activities vi.viii vii.0 .821
 Doing active leisure activities 3.2 2.6 .510
 Doing organizational activities 1.7 i.1 .153
 Using the computer 4.5 3.iv .320
 Traveling 19.eight xiv.7 .037

Table 2

Weighted Seemingly Unrelated Regression Models Predicting Life Satisfaction and Momentary Happiness, by Ain and Spouse's Marital Quality Appraisals, Among Husbands and Wives in the Disability and Use of Fourth dimension Supplement to the Panel Study of Income Dynamics

Predictor Life satisfaction (northward = 361) Momentary happy mood (n = ane,920)
Husbands Wives Husbands Wives
Marital quality
 Player 0.52** 0.72*** 0.49*** 0.40***
(0.17) (0.11) (0.10) (0.11)
 Partner 0.22 0.22 −0.xi −0.01
(0.11) (0.13) (0.12) (0.13)
Actor-specific intercept 2.64*** 2.04*** 3.71*** three.72***
(0.53) (0.37) (0.42) (0.40)
ρ .20 (.07) .10 (.04)

Table 3

Weighted Seemingly Unrelated Regression Models Predicting Life Satisfaction and Momentary Happiness, by Own and Spouse's Marital Quality Appraisals and Command Variables, Among Husbands and Wives in the Disability and Use of Fourth dimension Supplement to the Console Study of Income Dynamics

Predictor Life satisfaction (due north = 361) Momentary happy mood (n = one,920)
Husbands Wives Husbands Wives
Marital quality
 Actor 0.45** 0.67*** 0.42*** 0.40***
(0.16) (0.11) (0.09) (0.10)
 Partner 0.xix 0.19 −0.11 −0.00
Actor characteristics
 Age
  70–79 husbands/threescore–69 wives 0.07 −0.fifteen 0.22 0.nineteen
(0.15) (0.15) (0.sixteen) (0.xviii)
  80+ husbands /70+ wives −0.02 0.xviii 0.20 0.22
(0.22) (0.19) (0.23) (0.22)
 Completed education (in years) −0.06* −0.06* −0.05* −0.04
(0.03) (0.02) (0.02) (0.02)
 Race: Black vs. non-Black 0.49 0.31 0.49** 0.13
(0.30) (0.24) (0.19) (0.24)
 2nd or higher order wedlock −0.11 0.43* 0.07 0.27
(0.fifteen) (0.xviii) (0.14) (0.18)
 Has any children −0.10 0.15 0.01 0.21
(0.21) (0.14) (0.15) (0.16)
 Has a disability −0.21** −0.31 −0.18 −0.21
(0.07) (0.sixteen) (0.ten) (0.12)
 Cocky-rated ill health −0.16* −0.19** −0.14** −0.02
(0.06) (0.06) (0.05) (0.05)
Partner characteristics
 Age
  60–69 wives/70–79 husbands −0.06 −0.05 0.10 0.40**
(0.xiv) (0.16) (0.thirteen) (0.12)
  80+ husbands /lxx+ wives −0.18 −0.x −0.16 0.30
(0.20) (0.22) (0.19) (0.eighteen)
 Has a disability 0.00 0.02 −0.02 −0.26*
(0.xi) (0.xi) (0.ten) (0.12)
 Self-rated ill health −0.04 −0.16** 0.01 0.04
(0.05) (0.04) (0.06) (0.05)
Couple characteristics
 Income 2008
  25th to 50th percentile 0.34* 0.06 0.05 −0.10
(0.15) (0.16) (0.xiv) (0.15)
  50th to 75th percentile −0.02 0.08 −0.08 −0.01
(0.19) (0.xvi) (0.xvi) (0.16)
  75th to 100th percentile 0.15 0.10 −0.17 −0.29
(0.16) (0.17) (0.18) (0.17)
 Wealth 2009
  2nd quartile 0.84*** 0.08 0.44* −0.15
(0.14) (0.xviii) (0.17) (0.xvi)
  third quartile 0.92*** 0.sixteen 0.31 −0.08
(0.12) (0.13) (0.xviii) (0.17)
  4th quartile 0.lxxx*** −0.04 0.23 0.07
(0.13) (0.14) (0.20) (0.17)
 Marital duration (years ) −0.00 0.01 0.00 −0.00
(0.01) (0.01) (0.01) (0.01)
Activity characteristics
 Activity done…
  On the weekend (vs. weekday) 0.05 0.07
(0.07) (0.07)
  With the spouse (vs. alone or with someone else) 0.22* 0.09
(0.x) (0.09)
  At home (vs. away from home) −0.21* −0.08
(0.09) (0.11)
 Type of activity (/this activity)
  Self-maintenance 0.17 −0.09
(0.19) (0.18)
  Eating 0.eleven 0.21
(0.17) (0.14)
  Working for pay −0.32 −0.37*
(0.xix) (0.19)
  Shopping for food −0.59* −0.48
(0.29) (0.31)
  Shopping for other goods −0.48* −0.31
(0.23) (0.22)
  Preparing food 0.35 −0.23
(0.20) (0.23)
  Doing household chores −0.08 −0.37
(0.24) (0.19)
  Doing household maintenance −0.07 −0.83**
(0.16) (0.31)
  Managing finances −0.48* −0.30
(0.21) (0.24)
  Caring for others 0.02 −0.01
(0.21) (0.20)
  Socializing 0.thirteen 0.06
(0.16) (0.17)
  Watching Tv/movies 0.00 −0.32
(0.16) (0.17)
  Doing other non-agile leisure activities 0.08 −0.thirteen
(0.19) (0.15)
  Doing active leisure activities 0.09 0.15
(0.18) (0.19)
  Doing religious organization activities 0.27 0.13
(0.xv) (0.20)
  Doing other system activities −0.86** −0.75
(0.22) (0.46)
  Using the computer 0.03 −0.44
(0.xviii) (0.24)
  Traveling Omitted Omitted
Thespian-specific intercept 3.81*** 3.37*** 4.66*** 4.09***
(0.62) (0.68) (0.55) (0.67)
ρ .15 (.07) .06 (.04)

Table 4

Weighted Seemingly Unrelated Regression Models Predicting Life Satisfaction and Momentary Happiness, past Interaction Terms of Own and Spouse's Marital Quality, Amongst Husbands and Wives in the Disability and Utilize of Fourth dimension Supplement to the Console Study of Income Dynamics

Predictor Life satisfaction (n = 361) Momentary happy mood (n = 1,920)
Husbands Wives Husbands Wives
Marital quality
 Thespian 1.75* i.sixteen** 0.73* −0.eighteen
(0.65) (0.36) (0.36) (0.48)
 Partner ane.65* 0.63* 0.25 −0.52
(0.64) (0.28) (0.43) (0.43)
 Actor × Partner appraisement −0.45* −0.xv −0.11 0.18
(0.nineteen) (0.10) (0.13) (0.fifteen)
ρ .14 (.07) .06 (.04)

Associations were assessed using actor–partner interdependence models (APIM; Cook & Kenny, 2005), estimated using seemingly unrelated regression. In actor–partner interdependence models the event of the respondent's ain characteristics are referred to as player furnishings and the effect of the spouse's characteristics are labeled partner effects. This approach accounts for the nonindependence of husbands' and wives' evaluations of well-being (Cook & Kenny, 2005). The zero-society correlations betwixt husbands' and wives' life satisfaction and momentary happiness scores were .27 and .17, respectively. We used an adjusted Wald test to exam the equality of coefficients for husbands and wives.

Respondent-level descriptive statistics and regression models for life satisfaction are weighted to take into business relationship differential subsampling of eligible PSID couples across strata and differential nonresponse by strata. Weights for activity-level descriptive statistics and models assessing experienced happiness are further adjusted for the overrepresentation of weekend days in the original sample, differential response rates past day of the week, and the fact that activities of longer duration take a greater take a chance of being randomly selected for the sample of activities for which momentary happiness is assessed. Standard errors in the regression models are adapted for both survey design and the fact that multiple observations (east.g., activities) come from one respondent.

Results

Descriptive Analyses

The information in Tabular array 1 evidence that life satisfaction and experienced happiness practise not differ significantly by gender. Both husbands and wives, on boilerplate, rated their general life satisfaction as v.0 (out of 6). Men reported slightly more momentary happiness, but the gender divergence only approached statistical significance (five.1 vs. 4.ix, p = .09). Consequent with prior studies of marital quality, husbands rated their marriages slightly more positively than wives (3.3 vs. 3.i, p < .001). Wives were younger than husbands and less likely to report a disability (36.1 vs. 44.3%) even so also reported slightly poorer health; the latter two differences were non statistically meaning. The average marital duration was 38.5 years (SD = 14.half dozen), and 28% of respondents were in a remarriage.

Characteristics of diary activities are presented at the lesser of Table ane. Roughly one third of the randomly selected activities occurred on the weekend or were washed with a spouse. Wives' activities were more than probable than husbands' to accept place at domicile (59 vs. 46%, p < .001). Consequent with literature on the gender typing of social roles, we found that husbands were more probable than wives to have been working for pay and traveling on the report twenty-four hours, whereas women were more likely to have prepared food, done household chores, or socialized.

Multivariate Analyses

Marital quality and well-beingness: Unadjusted models

The unadjusted coefficients of husbands' and wives' own (actor) and spouse's (partner) marital quality appraisals on both own and spouse'due south well-being are displayed in Table ii. The left-manus console of the tabular array shows that each 1-signal increase in one'south ain marital quality appraisal was associated with a 0.52- and 0.72-point increase in husbands' and wives' life satisfaction scores, respectively (p < .01). Like patterns emerged for momentary happiness: Each 1-betoken increment in one'southward own marital quality cess was associated with a 0.49- and 0.40-point increment in one'due south ain happiness among husbands and wives, respectively (p < .001). Coefficients did not differ significantly by gender. We constitute no show that partner appraisals were associated with own well-being. These weak associations are non likely due to multicollinearity; the cypher-order correlation betwixt spouses' marital appraisals was modest (r = .38).

Marital quality and well-being: Fully adjusted models

Table 3 presents coefficients for husbands' and wives' life satisfaction (left-manus panel) and momentary happiness (right-paw panel), adapted for own and spouse's marital quality assessment, and all command variables. Associations between own (thespian) and spouse's (partner) marital quality assessments with well-being alter footling when all command variables were adjusted. Husbands' and wives' own reports of marital quality were significantly associated with their own life satisfaction reports (bs = 0.45 and 0.67, respectively, p < 0.01). Like patterns hold for happy mood (bs = 0.42 and 0.40 respectively, p < .001). These associations are big relative to other independent variables in the models; however, they practise not differ significantly by gender.

Once again, we did not find significant associations between partner appraisals and ain well-being. However, we found evidence of another potential partner influence: Spouse's self-rated health was inversely and significantly associated with wives' (but not husbands') life satisfaction (b = –0.16, p < .01). Wives' cocky-rated health was also associated with own life satisfaction (b = –0.19, p < .01). By contrast, husbands' self-assessed health (just not that of their wives) was associated with own life satisfaction (b = –0.16, p < .05, for poor wellness) and experienced happiness (b = –0.xiv, p < .01), and men with a disability reported lower life satisfaction (b = –0.21, p < .01).

Moderation analysis: Interactive furnishings of husbands' and wives' marital appraisals

Our final aim was to assess whether the associations between i'southward ain marital appraisals and well-being are contingent on spouse's marital appraisals. Coefficients for primary and interaction effects for husbands' and wives' marital quality assessments, adapted for controls, are presented in Tabular array 4. Nosotros institute statistically significant interaction terms for husbands just; the association betwixt men's ain marital quality and life satisfaction was conditional on the married woman's marital happiness.

For ease of interpretation, we accept plotted illustrative results in Figure 1. The left panel of the figure shows that, after controlling all other covariates, husbands who rated their marital quality equally very poor (Yard = 1.0) and whose wives also rated their marital quality every bit very poor (One thousand = 1.0) reported a life satisfaction score of merely 1.8 (out of half dozen) compared to v.4(a three.six-betoken improvement) if their wives' marital quality score was a 4. In other words, even an unhappily married man may take his life satisfaction buoyed when his wife experiences loftier marital satisfaction. Past contrast, among wives who rated their marriage very poorly (M = ane.0), their life satisfaction score was only modestly college when husbands' scores were iv rather than 1 (iv.0 vs. ii.v, or a 1.5-indicate improvement). An unhappily married woman may feel slightly elevated levels of life satisfaction when her husband is satisfied with the marriage, yet the increase is much flatter than among husbands.

An external file that holds a picture, illustration, etc.  Object name is nihms608453f1.jpg

Plotted Interaction Effects: Husband past Wife Marital Appraisal on Subjective Well-Being.

Stated otherwise, amidst persons with very low marital quality (M = 1.0), husbands experienced life satisfaction increases of roughly ane.3 points with each 1-bespeak increment in his wife's marital appraisals, whereas wives experienced comparable increases of just 0.five points per each 1-point increment in their husbands' marital appraisals. We did not find show of statistically significant interaction terms for experienced happiness (meet Table 4).

Give-and-take

Our analysis is the first we know of to explore associations among own, spouse's, and combined marital quality appraisals and both general and momentary assessments of subjective well-being among a nationally representative sample of married older adults. The findings, based on a unique daily diary data fix, offering several new insights into the complex associations between marital quality and two distinct aspects of emotional well-beingness in later life.

Marital Quality Similarly Associated With Husbands' and Wives' Well-Being

Nosotros found that marital quality was strongly associated with evaluations of one's life as a whole (every bit reflected in judgments of life satisfaction) and moment-to-moment experiences of happiness while performing daily activities. These associations were substantial in magnitude and persisted internet of controls. To put these coefficient sizes into perspective, note that each one-point increment on a iv-point marital quality scale was associated with a 0.45-point increment in husbands' global satisfaction and a 0.42-point increase in momentary happiness, whereas being disability gratuitous was associated with a 0.21-point boost in life satisfaction and a 0.23-bespeak increase in momentary happy mood. The unadjusted models explained roughly 5 times equally much of the variance in life satisfaction versus momentary happiness, whereas the fully adapted models explained roughly twice every bit much of the variance in satisfaction versus daily happiness. The fully adjusted models included controls for daily activities, which may account for a sizable proportion of the variance in daily mood. Life satisfaction appears to be more than responsive to traditional and indelible markers of life quality, such every bit marital quality, whereas measures of experienced well-being are more than responsive to contemporaneous activities and circumstances (Kahneman et al., 2006).

The magnitude of the associations betwixt marital quality and well-being did not differ significantly by gender; neither was model fit appreciably different for men and women in our fully adjusted models. These patterns are consistent with prior studies based on small nonrepresentative samples of older couples (Quirouette & Pushkar-Gold, 1992; Whisman et al., 2006) and the decision drawn from a recent meta-analysis (Jackson et al., 2014). Although studies based on younger samples have consistently shown stronger linkages between marital quality and global well-existence for women than men (Proulx et al., 2007; Whisman et al., 2006), these analyses do not reflect distinctive aspects of older adults' social roles, relations, and psychological development.

Matrimony may be equally salient to the well-being of older men and women. Both older men's and women's hereafter time horizons become more express, and individuals consciously peel down their social networks to include only those to whom one is closest and those relationships deemed most important to i'southward overall well-existence (Carstensen, 1991). Men's piece of work-related social ties and women's rich friendship networks may diminish in number, whether by one'southward own choice or the structural realities of retirement; decease; and the onset of significant others' aging-related challenges, including disease and caregiving (Dykstra & Gierveld, 2004; Kulik, 2002). As such, spouses may grow increasingly and equally reliant on ane another for both their overall and daily well-being (Lang, 2001).

Second, as gender roles and relations shift over the life course the daily nature of union and its implications for men'south and women'south well-being may converge. When men retire and older women's responsibility for pocket-size children subside, spouses typically experience and report greater function disinterestedness (Hagedoorn et al., 2006; Kulik, 2002). Older men may go more than oriented toward family and amalgamation and less oriented toward power and agency. Older women, by contrast, may place an increased emphasis on bureau and self-fulfillment, and their identities and overall well-beingness become less closely tied to their relationships with others (James, Lewkowicz, Libhaber, & Lachman, 1995). The relative importance of matrimony to women's well-existence may decline, whereas its importance to men's well-being may increase, leading to a convergence by later life.

Express Evidence for Partner Effects

Nosotros did non detect significant associations betwixt older adults' well-being and their spouses' marital quality assessment. This pattern does not announced to reflect multicollinearity, considering the zero-guild correlation betwixt the two spouses' marital assessments was just .38. Nosotros expected to find bear witness of partner furnishings, given prior writings suggesting that spouses who are dissatisfied with their wedlock may treat their partner poorly by either instigating conflict or withdrawing emotional back up (Whisman et al., 2004). These acts may in turn take direct implications for the partner's well-being. However, older adults may not act on their negative feelings toward their spouse, thus weakening the potential linkage betwixt ane spouse's marital satisfaction and the other spouse'south emotional well-existence. Older adults are more likely than younger adults to forgive their social partners or overlook their transgressions (Allemand, 2008), or they may ignore bug with their pregnant others because the relationship is an important (or even sole) source of emotional closeness and intimacy (Luong, Charles, & Fingerman, 2011).

Although nosotros did not find testify of partner effects related to marital appraisals, we did find that spouse's health affected the life satisfaction of women just. This finding is consequent with a vast literature documenting that women are more probable than men to act every bit a caregiver to their spouse. Women help maintain their married man's health by providing healthy meals and encouraging healthy behaviors, including compliance with physicians' recommendations (Umberson et al., 2006). Wives also tend to provide direct physical care to their unhealthy husbands; married woman caregivers perform a greater number and range of tasks and provide more hours of caregiving than practice husband caregivers (Pinquart & Sorensen, 2006). This caregiving may in turn tax women's emotional well-being (Kaufman & Taniguchi, 2006). Our results contribute to a mounting literature showing that husband's health contributes to a range of wife outcomes, including her perceptions of marital conflict (Iveniuk, Waite, Laumann, McClintock, & Tiedt, 2014), although wives' wellness does not have comparable furnishings on husband well-existence.

Men'southward Satisfaction and Multiplicative Marital Quality Effects

Finally, we found that the force of clan between a man's marital quality assessment and his life satisfaction is contingent on his wife'due south marital appraisals. A human who views his marriage very unfavorably may still enjoy relatively high levels of life satisfaction if his wife views the marriage favorably. However, a similarly pronounced blueprint did non sally among women. These patterns may reflect gendered interactions and communication inside wedlock. Women typically provide more than health-enhancing back up to husbands than vice versa, and women's provision of constructive emotional and practical spousal back up is linked to their own levels of marital happiness (Williamson & Schaffer, 2001). A happily married woman may be highly motivated to provide care and practical support to her spouse, such that even an unhappily married man may receive practical benefits that heighten his overall well-existence. Moreover, women are more probable to try to engage partners in marital problems, whether a happily wife praising positive aspects, or an unhappily wife criticizing her married man. By contrast, men tend to take a more than passive or silent approach, whereby their feelings toward the spousal relationship may non be conveyed to their spouse. Given men's more passive manner of marital interaction, their marital unhappiness may non chemical compound their wives' marital dissatisfaction to affect her overall well-being (Heavey et al., 1993).

Our results may also reflect gender differences in the bases of one's marital quality appraisals. Recent inquiry shows that older husbands' marital appraisals depend heavily on what men feel their wives do for them (eastward.grand., "She makes me experience loved and supported"), whereas older wives' marital satisfaction is based largely on what she feels she does for her husband (e.1000., "I make him feel loved and supported"; Boerner, Jopp, Carr, Sosinsky, & Kim, 2014). In other words, both men's and women'due south evaluations of marital quality are shaped past the perceived benefits for the husband. Thus, a couple in which both report high satisfaction may be one in which the married woman gives a lot and the husband feels he receives a lot, thus enhancing his life satisfaction.

Limitations

The Grit provides a unique opportunity to assess how assessments of marital quality matter for both partners' subjective well-existence, including both general and momentary measures. Nonetheless, our study has several limitations. First, although DUST is embedded in a longitudinal panel, it is cantankerous-sectional, and we therefore cannot ascertain causal ordering. Information technology is plausible that one'due south psychological well-existence may bias both own and spouse's marital appraisals. People evaluate their circumstances more positively when they are in a happy rather than sad mood. Similarly, persons with high levels of negative affect tend to offering more than negative accounts of their marriages and are more likely to recall negative information most past experiences (Teasdale, Taylor, & Fogarty, 1980). Unhappy persons also are less capable of providing their spouses the love and support they desire, or they may instigate frequent marital conflicts (Iveniuk et al., 2014). Our concerns are partly allayed by a recent meta-analysis showing that the association between marital quality and well-being was stronger when well-being was the dependent variable (Proulx et al., 2007). Furthermore, the associations we detected between marital quality and well-existence were comparable for both well-existence measures despite their distinctive properties: Life satisfaction is evaluative, whereas momentary well-being may change often and in response to one's immediate social context (George, 2010; Kahneman et al., 2006). To further explore these bug, we conducted supplementary analyses in which we reestimated all models using measures of negative aspects of momentary mood, including feeling deplorable, worried, and frustrated. The results were about identical to those presented here, in which negative moods were inversely related to own but not spouse's marital quality reports.

Second, the DUST does not measure personality traits, such every bit neuroticism or agreeableness (Whisman et al., 2006). Such measures are potentially important contributors to both marital quality and subjective well-beingness (Iveniuk et al., 2014) and would enable a fuller assessment of whether individuals have a "set betoken," or relatively stable level of happiness as a function of enduring traits (Diener, Lucas, & Scollon, 2006). Although we could not directly explore personality's influence on life satisfaction, momentary well-being models were estimated with a parameter to capture unmeasured attributes of respondents, suggesting that personality alone is unlikely to account for the marital quality–experienced happiness human relationship.

Third, we focused on marital quality equally a predictor of well-being just did not consider the extent to which marital quality (his, hers, or both) buffer against the upshot of other belatedly-life stressors, such every bit caregiving or functional impairment. Finally, given the cross-sectional design of the DUST, we could not assess the role of social selection. If marriages that are appraised highly are more likely to remain intact and are more than probable to enhance subjective well-being, selectivity into long-term marriages may enlarge these relationships. Future waves of the Grit may let fuller exploration of these bug.

Despite these limitations, our study reveals the important and complex role that marital appraisals play in the lives of older adults. Marital quality is an of import gene shaping both global well-beingness (happy lives) and experienced well-being (happy days). For husbands, in particular, life satisfaction is enhanced by wives' marital happiness, even among men who view their marriages unfavorably. Taken together, our results suggest that future research on marriage and well-being in later life should consider both spouses' perspectives on marital quality and should explore how these perspectives are linked to specific behaviors, such as spousal caregiving, that may enhance the other partner's well-being.

Acknowledgments

This work was supported by the National Institute on Aging (Grant P01 AG029409-04). The views expressed are those of the authors alone and do not represent their employers or the funding agency.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158846/

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