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Objective This study aimed to investigate the association between positive marital quality and cognitive health over time and to examine gender differences in this association.Methods Drawing on 2006–2018 Korean Longitudinal Study of Aging data (n=7,427 respondents, 35,066 person-year observations), a series of hybrid mixed-effects models were used to estimate the effects of time-invariant (gender) and time-variant (marital quality) variables on within-person changes and on between-person differences in cognitive decline over the observation period.Results The results showed that individuals’ likelihood of having higher cognitive health grew when their spousal relationship became more positive and that, compared with those with lower levels of marital quality, people with higher levels of marital quality were more likely to have higher cognitive health. Interestingly, improvements in marital quality were more beneficial for men than for women, whereas level of marital quality had similar effects on men’s and women’s cognitive health.Conclusion Couple-based intervention programs aiming to improve marital quality should be encouraged, especially among older adults.

Gender Differences in the Link Between Marital Quality and Cognitive Decline Among Older Adults in Korea