A LARGE Taiwanese cohort study has revealed that spouses of individuals with dementia face a significantly higher risk of developing dementia themselves, with the increased risk most pronounced among women and varying by household socioeconomic factors.
Previous studies have suggested that spouses of individuals with dementia may be at increased risk of developing dementia themselves, but evidence regarding subgroup variation and absolute risk has remained limited. Understanding whether this risk extends across demographic, socioeconomic, and family contexts has remained important for developing household-level approaches to dementia risk assessment.
Researchers conducted a nationwide population-based cohort study using Taiwan’s National Health Insurance Research Database from 1998 to 2022, with follow-up through 2022. Spouses of individuals with incident dementia were identified and matched 1 to 4 with unexposed controls by birth year, sex, income, and urbanicity. Main outcomes included incident all-cause dementia, Alzheimer disease, and vascular dementia, with hazard ratios and 5-year absolute risk differences estimated using Cox regression and g-computation.
The matched cohort included 955,105 individuals, comprising 118,904 exposed and 475,616 unexposed women, and 72,117 exposed and 288,468 unexposed men. Spouses of individuals with dementia had a higher risk of all-cause dementia than unexposed spouses. For women, the hazard ratio was 1.74, with a 5-year adjusted risk difference of 2.75 percentage points. For men, the hazard ratio was 1.69, with a 5-year adjusted risk difference of 3.49 percentage points. Similar patterns were observed for Alzheimer disease and vascular dementia. Relative risks were more pronounced at younger ages, while absolute risk differences increased with age, and the association was attenuated among individuals with higher income or more children.
These findings have shown that spouses of individuals with dementia face a higher risk of developing dementia themselves, with the association varying across family and socioeconomic contexts. As this was an observational cohort study, causality cannot be established. The authors have highlighted the relevance of household context in dementia risk assessment.
Wang S et al. Spousal dementia exposure and risk of dementia. JAMA Netw Open. 2026;9(7):e2624175.
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