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. Author manuscript; available in PMC: 2025 Feb 25.
Published in final edited form as: Appl Psychol Health Well Being. 2024 Nov 15;17(1):e12627. doi: 10.1111/aphw.12627

Daily relationship satisfaction and markers of health: Findings from a smartphone-based assessment

Selin Karakose 1, Martina Luchetti 1, Thomas Ledermann 2, Yannick Stephan 3, Antonio Terracciano 1, Angelina R Sutin 1
PMCID: PMC11806907  NIHMSID: NIHMS2049231  PMID: 39545372

Abstract

Relationship satisfaction is associated consistently with better physical and mental health. Less is known about these associations in daily life, particularly the association between relationship satisfaction and cognitive health. This study examined the daily, within-person association between relationship satisfaction and subjective health markers, including cognitive health. Participants from the United States (N = 303; Mage = 51.71, SD = 7.32) in the Couples Healthy Aging Project (CHAP) completed assessments of relationship satisfaction and health markers every night for eight days. Multilevel modeling was performed by accounting for personal (sex, age, race, education), relational (relationship duration), and contextual (day in the study, weekend day) factors. Within-person, on days when participants were more satisfied with their relationship, they felt healthier, younger, more satisfied with their life, and more purposeful. They also reported a sharper mind, better memory, and clearer thinking; relationship satisfaction was unrelated to whether participants were bothered and disrupted by forgetting. Results indicated that a satisfying romantic relationship is closely associated with better physical, psychological, and cognitive health markers in daily life.

Keywords: relationship satisfaction, health, cognitive health, daily diary, middle adulthood, subjective cognition

INTRODUCTION

Romantic relationships play a crucial role in many aspects of an individual’s life and are associated with long-term health outcomes, including morbidity and mortality (Lev-Ari et al., 2021; Whisman et al., 2018). Relationship satisfaction, defined as one’s overall feelings and attitudes toward their romantic relationship (Fincham & Rogge, 2010; Kamp Dush et al., 2008), has been associated consistently with better physical and mental health (Adamczyk et al., 2021; Braithwaite & Holt-Lunstad, 2017; Wilson & Novak, 2022). Individuals who are less satisfied with their relationships, for example, tend to have higher rates of depressive symptoms, more chronic diseases, and are at greater risk of premature mortality, whereas individuals with satisfying relationships tend to have better health and live longer (Adamczyk et al., 2021; Kiecolt-Glaser & Wilson, 2017; Lawrence et al., 2019; Wilson & Novak, 2022). Less is known about whether these effects extend to cognitive health. The present study examines the association between relationship satisfaction and health by using a daily approach and including markers of physical, psychological, and cognitive health.

LITERATURE REVIEW

Theoretical framework

Within the stress/social support hypothesis, there are two models that emphasize the importance of relationships for health: the main-effect model (Cohen, 2004; Cohen & Wills, 1985) and the stress-buffering model (Cohen & Wills, 1985). These models focus on the positive effect of social support with different processes: The main-effect model highlights the importance of structural aspects of a relationship (e.g., relationship status), while the stress-buffering model emphasizes functional aspects of relationships (e.g., relationship quality). In particular, the main-effect model posits that simply being in a committed relationship promotes better health because it is a major source of ongoing social support. Substantial evidence supports a direct positive association between relationship status and health outcomes: Individuals who are in committed relationships have better health outcomes than their non-partnered counterparts (Robles et al., 2014; Staehelin et al., 2012; Wang et al., 2020; Wong et al., 2018). A recent meta-analysis suggests a similar effect of partnership on life satisfaction (Stahnke & Cooley, 2021) that may extend to other health markers.

The stress-buffering model highlights the role of social support on health, indicating that it is protective against the detrimental effects of stress by providing psychological and material resources to manage the stress (Cohen & Wills, 1985). In the context of romantic relationships, this model predicts that satisfying relationships, typically associated with greater partner support, contribute to better health since they could buffer the negative effects of stress on health (Burman & Margolin, 1992). Stress-buffering studies provide evidence that positive aspects of relationships can modulate daily physiological stress responses (Saxbe et al., 2008) as well as future morbidity risk (Birditt & Antonucci, 2008). Both models emphasize that romantic relationships play a key role in providing social support (Burman & Margolin, 1992) and can co-occur in the context of relationships (Slatcher, 2010).

Relationship satisfaction and markers of health

Relationship satisfaction has been associated with markers of physical and mental health. Self-rated health, for example, is a subjective measure of an individual’s overall health and is one of the most common health markers that predict mortality (Lorem et al., 2020; Stenholm et al., 2014; Stephan, Sutin, Luchetti, et al., 2021). Numerous studies have documented a robust positive association between greater relationship satisfaction and self-rated health (Baucom et al., 2020; Lawrence et al., 2019; Robles et al., 2014). Longitudinal studies also revealed that greater relationship satisfaction predicts the maintenance of better self-rated physical health over time (Adamczyk et al., 2021; Lawrence et al., 2019; Miller et al., 2013; Robles et al., 2014).

Relationship satisfaction is also related to aspects of mental health, including life satisfaction and purpose in life. There is a positive relation, for example, between greater relationship satisfaction and both life satisfaction (Bouchard & McNair, 2016) and purpose in life (Pfund et al., 2020). Longitudinal research further supports the long-term benefits of a satisfying relationship for both life satisfaction (Be et al., 2013; Gustavson et al., 2016; Stanley et al., 2012; Whitton et al., 2014) and purpose in life (Pfund & Hill, 2022).

There is thus substantial evidence that satisfying romantic relationships contribute to better physical and mental health (Robles et al., 2014; Staehelin et al., 2012; Wang et al., 2020; Wong et al., 2018). There are also several opportunities to expand this literature. First, compared to physical and mental health, less is known about whether the association extends to cognitive health. Subjective cognition is a marker of cognitive health that refers to an individual’s evaluation of their cognitive functioning, such as their memory and thinking skills (McWhirter et al., 2020). A recent meta-analysis including >74,000 individuals indicates that subjective perception of cognition is associated with objective cognitive outcomes, including the risk of developing dementia (Pike et al., 2022). There has been a growing effort to identify potential risk and protective factors of subjective cognition, particularly in interpersonal relationships (Khondoker et al., 2017; Pai et al., 2023). While early work suggested the importance of network size as a protective factor for cognitive health (Giles et al., 2012; Holtzman et al., 2004), more recent research emphasizes the role of quality of relationships (Jang et al., 2024; Zhaoyang et al., 2021). For example, a 9-year longitudinal study found that satisfying family relationships were associated with reduced risk of dementia (Zhu et al., 2023), which is characterized by substantial impairment in cognitive domains (American Psychiatric Association, 2013). To our knowledge, the association between relationship satisfaction and subjective cognition has not yet been tested. There is evidence, however, that married participants are less likely to experience subjective cognitive decline compared to divorced participants (Weng et al., 2020). Although the mechanism between social relationships and cognitive functioning is unclear (Zhaoyang et al., 2021), greater relationship satisfaction may be related to better perceived cognitive function, in part, by buffering the detrimental effects of stress, which is key for better cognitive functioning (Leng et al., 2013). A better understanding of the association between relationship satisfaction and subjective cognition may guide future research and practice by providing broader insights into the role of romantic relationships in cognitive health. Given the importance of subjective cognition on adverse outcomes (e.g., dementia; Pike et al., 2022), such information may also be promising for protecting against neurodegenerative disorders in the long term.

Second, subjective age, which reflects how old or young a person feels relative to their chronological age, has been linked to various health outcomes (Alonso Debreczeni & Bailey, 2021; Stephan et al., 2018; Stephan et al., 2022), but, it has not been associated yet with relationship satisfaction. There is some promising support from related constructs: Individuals who feel less lonely and have more robust friendship networks tend to feel, on average, younger than their chronological age (Degges-White & Kepic, 2020; Vitman Schorr et al., 2020). Subjective age is unrelated to marital status (Henderson et al., 1995; Stephan et al., 2014), but a prospective study found that high-quality romantic relationships may strengthen the benefits of younger subjective age on health outcomes (Zee & Weiss, 2019).

Lastly, most of what is known about the longitudinal association between relationship satisfaction and health is from long-term longitudinal studies with measurement intervals that span years. Daily diary methodology (and similar intensive or micro longitudinal studies), compared to traditional longitudinal studies, provides an opportunity to capture the nuances in everyday experiences (Bolger et al., 2003) that may give insight into how processes unfold within individuals over days (Hamaker & Wichers, 2017). Examining daily changes can potentially identify patterns of associations across variables that could differ in strength or even direction compared to the patterns observed in long-term studies. Furthermore, as a repeated measurement in natural settings, the daily diary approach helps reduce recall bias and improve ecological validity (Bolger et al., 2003). There is a growing literature that uses intensive longitudinal approaches to cognition, which has uncovered dynamics of cognitive function in daily life that are not possible to measure with retrospective studies or laboratory settings (Kekäläinen et al., 2023; Sutin et al., 2024). Recent findings from daily diary studies have also provided evidence that some components typically conceptualized as the trait level, such as life satisfaction and purpose in life, are also state-level variables (Lutz et al., 2023; Pfund et al., 2024). Although relationship satisfaction is defined as relatively stable in longitudinal studies (Bühler et al., 2022), there is evidence of significant day-to-day fluctuations in relationship satisfaction (Totenhagen et al., 2018; Zhao et al., 2022). These fluctuations in relationship satisfaction may be associated with fluctuations in health markers. Indeed, previous studies that have used ecological momentary assessment (EMA) approaches indicate the importance of relationships for health outcomes: More pleasant interactions in daily life are beneficial for physical, psychological, and cognitive health (Bernstein et al., 2018; Zhaoyang et al., 2021). Given the dynamic nature of relationship satisfaction across days (Totenhagen et al., 2018; Zhao et al., 2022), an analysis of relationship satisfaction at the within-person level in daily life is important to understand whether being happier with the relationship than usual on a given day is associated with better subjective health on the same day. In addition to capturing subtle changes, investigating the associations in a daily timeframe could be informative for understanding whether certain health markers are more prone to short-term fluctuations of relationship satisfaction, even if small, and how these fluctuations could accumulate and impact health over time.

Much of the previous studies on between-person and within-person associations included younger or older adult populations (Adamczyk et al., 2021; Bernstein et al., 2018; Lawrence et al., 2019; Pfund et al., 2022; Stanley et al., 2012; Whitton et al., 2014). There has been less of a focus on midlife and the transition into older adulthood. There are many important reasons to focus on this period of adulthood: (1) relationship satisfaction is not stable across the lifespan, and middle and early older adulthood is recognized as a period of change in relationship satisfaction (Bühler et al., 2021), which may limit the generalizability of previous studies that did not include this age group; (2) romantic relationships tend to become increasingly important as individuals age (Thomas et al., 2017), which makes the contribution of relationships to health more crucial (Liu & Waite, 2014); (3) middle and early older adulthood is a significant period in the life course that is predictive of better physical and cognitive health later in life (Hagger-Johnson et al., 2017; Infurna et al., 2020); (4) this age group is often identified as a “sandwich generations” that face unique stressors taking care of both children and parents (Miller, 1981; Patterson, 2022). A better understanding of the association between relationship satisfaction and health in middle adulthood may help support more successful aging at older ages.

The present study

The current study builds upon prior work on relationship satisfaction and health and advances knowledge of the association between relationship satisfaction and multiple health markers in three specific ways. First, the present research addresses the association between relationship satisfaction and cognitive health, in addition to other markers of physical and mental health. Despite the substantial evidence that satisfying romantic relationships contribute to better physical and mental health (Kiecolt-Glaser & Wilson, 2017; Robles et al., 2014), less is known about whether the association extends to subjective cognitive health. Second, the current study shrinks the timescale that usually spans years to nightly assessments to examine daily within-person associations. To our knowledge, this is one of the first comprehensive studies to examine the association between relationship satisfaction with nine different health markers, which are strongly related to subsequent morbidity and mortality (Alonso Debreczeni & Bailey, 2020; Kotter-Grühn et al., 2015; Stephan et al., 2018; Stephan, Sutin, Wurm, & Terracciano, 2021; Sutin et al., 2023; Sutin et al., 2024; Zhu et al., 2022). Third, we examine these associations in midlife and the transition into older adulthood, which is a critical life period that is predictive of health in later life (Hagger-Johnson et al., 2017; Infurna et al., 2020). Specifically, this research uses a sample of adults aged 40–70 in a committed relationship who provided smartphone-based assessments every night over eight days to examine within-person associations between relationship satisfaction and self-rated health, life satisfaction, purpose in life, subjective age, and subjective cognition. We expect relationship satisfaction to fluctuate across days and that levels of relationship satisfaction covaries with markers of health.

METHOD

Participants and procedure

The sample included 303 participants (165 females and 138 males) from the Couples Healthy Aging Project (CHAP). CHAP aimed to better understand how interpersonal factors contribute to cognitive health within romantic relationships. Participants were recruited through social media advertisements, community events, and snowball sampling. The inclusion criteria for the study were both partners had to be between the ages of 40 and 70, be in a relationship for at least one year, live together, and both partners had to be willing to participate in the study as a couple.

CHAP was approved by the Institutional Review Board of Florida State University (ID: STUDY00000472). All participants provided written informed consent before participating and were compensated for their participation. The data were collected between February 2020 and October 2021. More information about the study can be found in (Kekäläinen et al., 2023; Sutin et al., 2024).

Participants ranged in age from 40 to 70 years, with an average age of 51.71 (SD = 7.32) [Mmales = 52.96, SD = 7.59 and Mfemales = 51.01, SD = 6.98) were white (75.9%) [73.2% for males and 78.2% for females) and reported an average education of 16.59 years (SD = 3.31) [Mmales = 16.33, SD = 3.59 and Mfemales = 16.81, SD = 3.05). The average duration of the relationship was 20.74 years (SD = 10.38), and most were married (95%). Of note, with 300 participants, we have 90% power to detect a within-person association of .10. The sample size also reflects the available grant funding.

Participants completed an initial interview and smartphone-based ecological momentary assessments (EMAs) that included a nightly survey. EMA is a specific form of daily diary study that allows researchers to investigate momentary experiences throughout the day at prompted times (e.g., morning, afternoon, and evening). Participants were provided with an Android smartphone that had a custom-built EMA app to collect data for eight consecutive days. The present research focused on data collected in the nightly survey that occurred between 6 pm and 11 pm each evening (depending on participants’ daily schedule; see Kekäläinen et al., 2023). Data were extracted from the smartphone at the end of the 8-day period.

Measures

All subjective markers of health used single-item measures that were adapted from other daily studies in the literature and measured each day in the nightly survey for eight consecutive days. Demographic and relationship covariates were based on the baseline survey, and contextual variables were based on the EMA data/period.

Relationship satisfaction

Participants rated their satisfaction with their relationship that day on a sliding scale from not at all (0) to extremely (100), with a higher value indicating higher relationship satisfaction. The single-item relationship satisfaction measure was used in previous daily studies (Gable et al., 2003; Gable & Poore, 2008; Girme et al., 2018). Similar end-of-day single-item assessments of relationship satisfaction have been found to correlate with long-term outcomes, such as relationship dissolutions (Gable & Poore, 2008).

Self-rated health

Participants rated how healthy they felt overall for the day on a sliding scale from not at all (0) to extremely (100), with a higher value indicating better health. The single-item self-rated health measure is widely used in health surveys (O’Leary et al., 2021; Stephan, Sutin, Luchetti, et al., 2021), including in daily contexts (Graf et al., 2017; Scholz et al., 2012) and is reliable and valid (DeSalvo et al., 2006).

Life satisfaction, purpose in life, and subjective age

Life satisfaction was measured with the item, “Overall, how satisfied with your life did you feel today?” and purpose in life was measured with the item, “I felt my life had purpose today.” These items were used in previous daily diary studies (Maher et al., 2013; Maher et al., 2015; Newman & Nezlek, 2019) and have good reliability and validity (Maher et al., 2015; Newman & Nezlek, 2019). Subjective age was measured with the item, “Overall, how old did you feel today relative to your chronological age?” as in previous daily studies (Kotter-Grühn et al., 2015). All three items were measured with a sliding scale from not at all (0) to extremely (100), with higher values indicating more satisfaction, more purpose, and older subjective age.

Subjective cognition

Participants rated their cognitive function with items from the Patient-Reported Outcomes Measurement Information System (PROMIS ®) Applied Cognition-Abilities Scales (Saffer et al., 2015) as in other daily studies of subjective cognition (Kratz et al., 2020). Specifically, participants indicated whether they felt their mind was as sharp as usual, whether their memory was as good as usual, and whether their thinking was as fast as usual, each day, on a sliding scale from not at all (0) to extremely (100); higher values indicated better cognitive functioning. Participants were also asked whether they forgot anything (e.g., someone’s name, to take a medication, etc.) that day and participants who forgot something during the day were asked to rate how much they were bothered by the forgetting and how much it disrupted their activities on a sliding scale from 0 to 100, with higher scores indicating more bothered and disrupted by the forgetting. Evidence suggests that smartphone-based cognitive tasks in natural settings are as valid and reliable as traditional lab-based measures of perceptual speed and working memory (Sliwinski et al., 2018).

Covariates

Demographic covariates included age in years, sex (0 = male, 1 = female), race (0 = white, 1 = person of color), and education in years. The relationship covariate was relationship duration in years. The contextual covariates were the days in the study (1 to 8) and the day of the week when each assessment was completed (0 = weekday, 1 = weekend day).

Data analysis

Out of the 308 enrolled in the study, data from five participants could not be retrieved from the phone due to technical issues. Of the 303 participants, 24 individuals were in a same-sex relationship. Although self-rated health and life satisfaction tend to be similar between same-sex and opposite-sex individuals (van der Star & Bränström, 2015), we examined whether results were the same excluding same-sex participants. We reported the results without excluding participants in a same-sex relationship because the results were the same.

To test the daily within-person associations between relationship satisfaction and subjective markers of health, Multilevel Modeling (MLM) was used (Iida et al., 2012). MLM accounts for the hierarchical data structure and allows the estimation of fixed and random effects. MLM has been used with daily diary data (Cole et al., 2020; Rothenberg et al., 2022). For each outcome, a series of models were estimated with full information maximum likelihood estimation (MLE).

First, a null model with a random intercept and no predictors was estimated to compute the intraclass correlation coefficients (ICC), reflecting the within-person correlation of the eight observations over time. Measurement occasions (at Level 1) were nested within individuals (at Level 2). The next model, Model 1 included a person-mean centered score for repeated daily assessments of relationship satisfaction as a Level 1 predictor of each outcome. The person-mean centered score represented participants’ deviations from their mean level of relationship satisfaction across daily assessments. The participant mean level of relationship satisfaction was taken across assessments and subtracted from each night score. Model 2 extended Model 1 to account for Level 2 personal factors (sex, age, race, education) and relational factors (relationship duration). Model 3 accounted for Level 1 contextual factors (day in the study, weekday versus weekend day) in addition to personal and relational factors. An example MLM equation is shown in Supplemental 1.

To evaluate sex as a potential moderator of the association between relationship satisfaction and health (Robles et al., 2014), additional analysis tested for a cross-level interaction between sex and daily relationship satisfaction. All models were run separately for each outcome and included a random intercept. All continuous variables at Level 2 were grand mean centered. Two-sided p < .05 was considered statistically significant.

RESULTS

Most participants completed 8 days of assessments (65% completed all eight nightly surveys; 86.5% completed at least 7 nightly surveys). The current analysis used 2,235 nightly surveys out of 2,424 possible assessments (92% completion rate). Descriptive statistics for the study variables and ICC estimates are in Table 1. There was significant within-person (57%) and between-person variance (43%) in relationship satisfaction across these assessments, indicating substantial variability that could be associated with other daily variables. The between-person correlations were similar to what has been reported in the literature (Table S1): on average, participants with higher relationship satisfaction had better subjective health, reported more satisfaction and purpose in their lives, felt younger, and had better subjective cognition (except for bothered and disrupted by the forgetting).

TABLE 1.

Descriptive statistics and ICC estimates for the study variables.

Variable M (SD) ICC
Relationship satisfaction 78.11 (20.45) .428
Self-rated health 68.36 (24.33) .587
Purpose in life 79.79 (19.50) .596
Life satisfaction 78.22 (20.32) .607
Subjective age 46.69 (20.25) .583
Thinking 71.97 (20.22) .586
Memory 71.82 (20.04) .590
Mind sharp 71.58 (20.45) .588
Forget bother 41.10 (28.40) .569
Forget disrupt 24.13 (24.17) .510
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Note: N = 303. Mean calculated across days. ICC = Intraclass correlation coefficient. ICC represents the proportion of variance in a measure attributed to between-person variability.

Table 2 shows the multilevel modeling results from the fully adjusted model, (Model 3), which accounted for personal, relational, and contextual variables. Positive and significant associations emerged between daily relationship satisfaction and the markers of health. Specifically, on days when participants were more satisfied with their relationship than on their average day, they felt generally healthier, more satisfied with their life, more purposeful, and younger than their age. These results were similar to those of Model 1(uncontrolled model) and Model 2 (controlling for sex, age, race, and education) (see Tables S3 and S4 for results of Models 1 and 2).

TABLE 2.

Associations between relationship satisfaction and self-rated health, life satisfaction, purpose of life, and subjective age analyzed by multilevel modeling.

Self-rated health Life satisfaction Purpose in life Subjective age
Variable B SE p B SE p B SE p B SE p
Intercept 69.218 1.901 <.001 75.711 1.545 <.001 77.434 1.547 <.001 46.737 1.615 <.001
Relationship satisfaction 0.327 0.029 <.001 0.538 0.022 <.001 0.269 0.023 <.001 −0.212 0.024 <.001
Relationship duration −3.863 2.210 0.082 2.374 1.810 0.191 2.941 1.807 0.105 2.384 1.881 0.206
Sex −0.031 0.107 0.768 −0.059 0.087 0.499 0.024 0.087 0.781 −0.080 0.091 0.377
Education −0.183 0.338 0.589 −0.468 0.276 0.092 −0.110 0.276 0.690 −0.381 0.287 0.185
Race 8.370 2.599 0.001 4.163 2.129 0.051 3.885 2.125 0.068 −3.329 2.212 0.133
Age 0.169 0.162 0.299 0.323 0.133 0.016 0.225 0.133 0.090 −0.057 0.138 0.679
Day in the study −0.203 0.149 0.172 −0.123 0.115 0.284 0.012 0.118 0.920 −0.083 0.125 0.506
Weekend day 1.241 0.763 0.104 2.452 0.590 <.001 −1.064 0.605 0.078 −0.752 0.643 0.243
Variance
Residual 237.593 7.682 <.001 145.869 4.692 <.001 149.037 4.819 <.001 168.598 5.451 <.001
Intercept 320.891 28.990 <.001 221.852 19.705 <.001 215.753 19.369 <.001 232.753 20.985 <.001
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Note: Relationship satisfaction was person-mean centered. Level 2 continuous variables were grand mean centered. Reference categories male (sex), white (Race/ethnicity), weekend (weekend).

Further, on days when participants were more satisfied with their relationship, they felt that their mind was sharper, their memory better, and they could think clearer (see Table 3 for Model 3 and Table S4 for Model 2). Daily relationship satisfaction was not related to whether participants were bothered or disrupted by forgetting (Table S5). None of the associations between relationship satisfaction and markers of health was moderated by sex, except the association with feeling one’s mind sharp was stronger among females than males (Table S6).

TABLE 3.

Associations between relationship satisfaction and mind sharp, memory, and thinking, analyzed by multilevel modeling.

Mind sharp Memory Thinking
Variable B SE p B SE p B SE p
Intercept 70.459 1.596 <.001 70.693 1.579 <.001 70.802 1.583 <.001
Relationship 0.242 0.024 <.001 0.213 0.024 <.001 0.216 0.024 <.001
satisfaction
Relationship duration −5.703 1.857 0.002 −4.326 1.840 0.019 −5.201 1.842 0.005
Sex −0.175 0.090 0.052 −0.156 0.089 0.079 −0.204 0.089 0.022
Education 0.240 0.284 0.398 0.133 0.281 0.635 0.139 0.281 0.621
Race 4.124 2.184 0.060 4.208 2.164 0.053 2.563 2.166 0.238
Age 0.244 0.136 0.075 0.229 0.135 0.090 0.213 0.135 0.117
Day in the study 0.684 0.125 <.001 0.482 0.122 <.001 0.735 0.123 <.001
Weekend day 1.187 0.636 0.076 1.571 0.627 0.012 0.627 0.632 0.321
Variance
Residual 166.244 5.376 <.001 160.965 5.179 <.001 162.920 5.270 <.001
Intercept 226.650 20.459 <.001 225.821 20.202 <.001 223.061 20.128 <.001
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Note: Relationship satisfaction was person-mean centered. Level 2 continuous variables were grand mean centered. Reference categories male (sex), white (Race/ethnicity), weekend (weekday).

DISCUSSION

The current study took a novel approach to examine the association between relationship satisfaction and multiple markers of health among romantic partners. Building on the substantial evidence that satisfying romantic relationships contribute to better physical and mental health (Adamczyk et al., 2021; Lawrence et al., 2019; Robles et al., 2014), the present research shrank the timescale that usually spanned years to examine nightly assessments and address the daily within-person associations between relationship satisfaction and health, including the associations with subjective markers of cognitive health. In our sample of middle-aged and early older adults (a group less studied in previous research), we found that on days when participants felt more satisfied with their relationship, they had better subjective health, reported more satisfaction and purpose in their lives, felt younger, and had better subjective cognition (except for bothered and disrupted by forgetting). These associations held controlling for personal (sex, age, race, education), relational (relationship duration), and contextual factors (day in the study, weekend day). With the exception of mind sharp, there was no evidence of moderation by sex, suggesting that most effects were similar across females and males.

Previous research examining the association between relationship satisfaction and health has mainly focused on between-person associations or long-term within-person associations. Thus, less is known about these associations in daily life. Our findings provide new evidence for such daily, within-person associations: Being more satisfied with the relationship than usual on a given day is associated with better health benefits.

These findings are consistent with both cross-sectional and long-term longitudinal studies that suggest that greater relationship satisfaction is associated with better self-rated physical health (Lawrence et al., 2019; Robles et al., 2014), life satisfaction (Bouchard & McNair, 2016; Gustavson et al., 2016), and purpose in life (Pfund & Hill, 2022). It is further consistent with prior research on the importance of social relationships (Degges-White & Kepic, 2020; Vitman Schorr et al., 2020) and the quality of relationships (Zee & Weiss, 2019) for feeling younger.

The current study also extended the positive association between relationship satisfaction and health markers to subjection cognition: On days when participants were more satisfied with their relationship than on an average day, they felt that their mind was sharper, their memory was better, and they could think clearer. Prior research has not examined the association between relationship satisfaction and subjective cognition. These results, however, are in line with the literature that highlights the importance of the quality of social relationships for subjective cognition in daily life (Jang et al., 2024; Zhaoyang et al., 2021). Such positive evaluations of subjective cognition predict a lower risk of dementia (Strand et al., 2018) and may be promising for protecting against such neurodegenerative disorders in the long term.

Relationship satisfaction was unrelated to whether participants were bothered or disrupted by forgetting. This pattern may be explained by the fact that our sample is relatively young, and only participants who forgot something during the day were asked to rate how much they were bothered by forgetting and how much it disrupted their activities, which was limited to between 21.2% (N = 52) and 32.6% (N = 93) of the sample on any given day. Future studies could address this relation with larger sample sizes as well as in samples of older adults. It is also important to note that we focused on the positive aspects of romantic relationships. (i.e., satisfaction with the relationship). A previous study suggested an association between negative aspects of close relationships (e.g., adverse interactions, lack of adequate support) and accelerated cognitive aging, particularly in executive function (Liao et al., 2014). Given the importance of relationship strain on health as one age (Umberson et al., 2006), it is recommended to investigate the potential role of negative aspects of couple relationships (e.g., strain, negative communication) on subjective cognition, particularly memory processes, in addition to positive aspects.

The positive associations between relationship satisfaction and the markers of health align with both the main-effect model and stress-buffer model (Cohen, 2004; Cohen & Wills, 1985), two theoretical models that postulate that committed romantic relationships contribute to health. Our daily findings support the assumption of the main effect model, which suggests that simply being in a committed relationship, as a major source of ongoing social support, predicts better health outcomes (Cohen, 2004; Cohen & Wills, 1985). In addition, there is evidence of a protective role for satisfying romantic relationships, typically associated with greater partner support, against stressors within the stress-buffering framework (Røsand et al., 2012; Uchino, 2009) that is associated with positive health outcomes (Birditt & Antonucci, 2008; Cohen & Wills, 1985). More specifically, greater relationship satisfaction in daily life may buffer the detrimental effects of stress, which is a risk factor for adverse health outcomes (Prior et al., 2016), as well as cognitive functioning (Marin et al., 2011). Indeed, there is evidence that relationship satisfaction can modulate daily physiological stress responses (e.g., cortisol) (Saxbe et al., 2008). Lower stress is also linked with daily healthy behaviors (e.g., smoking behavior, diet, physical activity) that could potentially contribute to better physical health as well as subjective cognition (Park & Iacocca, 2014). Future work should expand the stress-buffer model in the context of daily associations between relationship satisfaction and health by considering how it buffers against daily stress.

Greater relationship satisfaction in daily life may also contribute to these daily associations through additional pathways. For example, people in happy relationships want to spend time with each other (Genadek et al., 2016), and partners who spend time together reported greater meaning (Flood & Genadek, 2016), as well as satisfaction in their lives (Hudson et al., 2020). Also, individuals who are more satisfied with their relationships engage in healthier behaviors, such as joint exercise, that contribute to better health (Kiecolt-Glaser & Wilson, 2017; Wilson & Novak, 2022), feeling younger (Stephan et al., 2020), and better cognitive function (Wang et al., 2023). Future studies are needed to examine the mechanisms between greater relationship satisfaction and better health in daily life.

This study has several strengths, including the focus on middle-age and early older adulthood, the relatively large sample for a daily diary study, and the testing of daily within-person associations between relationship satisfaction and several markers of health, including subjective cognition, which has rarely been the focus in the romantic relationship literature. This study also has limitations. First, despite the current study suggesting daily variability in relationship satisfaction, which aligns with previous studies (Totenhagen et al., 2018; Zhao et al., 2022), we could not examine whether these temporal dynamics are related to stability in relationship satisfaction. Examining how daily fluctuations are related to stability and how daily associations in relationship satisfaction and health markers contribute to long-term associations is suggested for future research. Second, the study variables were assessed with a single item and subjective. Although this approach is in line with the previous daily studies (e.g., Girme et al., 2018; Maher et al., 2015), single items may underperform compared to multi-item measures. Future research would benefit from expanding these findings to multi-item measures and objective assessment. Third, we are not aware of the time spent together with the partner and other social interactions over the day, which could potentially contribute to relationship satisfaction as well as key health markers. It is suggested to examine all these aspects in future studies. Fourth, our study included adults aged 40–70 from the United States, which may limit the generalizability of findings to other cultural and relational contexts (e.g., caregiving in couples). Future studies could expand this research to include people from other cultural backgrounds and caregiving adults. Lastly, the non-experimental nature of the study does not provide insight into the causal relationship between relationship satisfaction and health. There is evidence of bidirectional associations between relationship satisfaction and certain aspects of health (Braithwaite & Holt-Lunstad, 2017; Gustavson et al., 2016; Jenkins et al., 2020; Whisman et al., 2018). Further, there may be other possible pathways in the association between relationship satisfaction and health outcomes. Future studies should address mechanisms that underlie this association with a more comprehensive approach to test causal assumptions.

Practical implications

The present study provides novel evidence that relationship satisfaction is associated with aspects of subjective cognition measured between-person and that within-person increases in daily relationship satisfaction relative to one’s average are associated with better health markers.

There is a robust benefit of these aspects of health for successful aging and longevity (Alonso Debreczeni & Bailey, 2020; Kotter-Grühn et al., 2015; Stephan et al., 2018; Stephan, Sutin, Wurm, & Terracciano, 2021; Sutin et al., 2023; Sutin et al., 2024; Zhu et al., 2022). The findings of the current study thus have some implications. Incorporating the assessment of functional aspects of romantic relationships, consistent with the stress-buffer model in addition to structural aspects (e.g., marital status), may help to assess the broader impact of relationship satisfaction on health outcomes. Additionally, practitioners working with individuals or couples who are dissatisfied with their relationship would benefit from including these health markers in their assessment tools and tracking them over weeks in the relationship context. Such work may help to assess the impact of relationship dissatisfaction on an individual’s life across various domains and allows practitioners and researchers to test whether individual or couple-based interventions to maintain or increase relationship satisfaction contribute to better health. The present research also focused on adults aged 40–70 and the transition into older adulthood. Given that midlife health is a predictor of health in older ages (Hagger-Johnson et al., 2017; Infurna et al., 2020), our findings support the relevance of relationship satisfaction across critical stages and transitions of adulthood (Bühler et al., 2021). One of the crucial next steps could be to inform individuals and policymakers about the importance of relationship satisfaction on health during middle age, even in daily life. Screening to identify dissatisfied couples and providing relationship counseling may promote better health within the relationship context. Understanding the factors that contribute to greater relationship satisfaction in middle adulthood could also be informative for health promotion interventions aimed at successful aging.

Conclusions

This study of middle-aged and early older adults found that on days when participants felt more satisfied in their relationships than their average, they felt healthier and younger, more satisfied with their lives, more purposeful, and had better subjective cognition. These findings highlight the importance of satisfying romantic relationships for health, including aspects of subjective cognition, and support the idea that relationship-based interventions could enhance physical, psychological, and cognitive aging.

Supplementary Material

suppl

Funding information

This study was supported by the National Institute on Aging of the National Institutes of Health under Award Numbers R56AG064952, RF1AG083878, and R01AG074573. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Footnotes

Conflict of Interest Disclosures

We declare no competing interests.

ETHICS STATEMENT

This study was approved by the Institutional Review Board of the Florida State University (ID: STUDY00000472). All participants provided written informed consent before participating and were compensated for their participation.

SUPPORTING INFORMATION

Additional supporting information can be found online in the Supporting Information section at the end of this article.

DATA SHARING

The datasets generated and/or analyzed during the current study are not publicly available because the restricted geographical location but are available from the corresponding author on reasonable request.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

suppl
NIHMS2049231-supplement-suppl.docx (32.7KB, docx)

Data Availability Statement

The datasets generated and/or analyzed during the current study are not publicly available because the restricted geographical location but are available from the corresponding author on reasonable request.

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