People who love being single and want to stay single, such as the single at heart, are often taunted with the question, “But who will be there for you in later life? What if you get sick?” The assumption seems to be that married people have nothing to worry about. After all, they made the vow to be there for each other “in sickness and in health.”

Research just published in February (2025) in the Journal of Marriage and Family shows that the vow to stand by a marriage in times of sickness is not so sturdy when it is the wife in a heterosexual couple who becomes ill.

The Italian social scientists Daniele Vignoli, Giammarco Alderotti, and Cecilia Tomassini, in an 18-year study, tracked more than 25,000 heterosexual couples, ages 50 and older, from 27 European nations. The participants were surveyed repeatedly and asked each time about their health, depression, whether they had limitations on what they could do in everyday life without help, and whether they were still together. The findings were reported in “Partners’ health and silver splits in Europe: A gendered pattern?”

Vignoli and his colleagues looked separately at the couples who were between the ages of 50 and 64 and the couples in which at least one partner was 65 and older. Their results were stronger for the younger couples.

Couples between the ages of 50 and 64

For the 50- to 64-year-olds, when the wife was in poor health but the husband wasn’t, their marriage was more likely to end than when both were in good health. When the husband was in poor health but the wife wasn’t, they were no more likely to split than when both were in good health.

The same pattern emerged for everyday limitations. When the wife was severely limited in her ability to perform the tasks of everyday life but her husband wasn’t, the couple was more likely to divorce than when neither experienced severe limitations. Again, if the situation reversed and it was the husband who had severe limitations, the marriage was no more likely to end than if neither partner had severe limitations.

When a wife was depressed but her husband wasn’t, the marriage was more likely to end than if neither partner was depressed. But a marriage was at least as likely to end when the husband was depressed and the wife wasn’t.

Couples in which at least one partner was 65 or older

For the older couples, depression mattered more than physical health or activity limitations. For depression, the gendered pattern emerged: If the wife was depressed but the husband wasn’t, the marriage was more likely to end than if neither was depressed. But if the husband was depressed and the wife wasn’t, the couple was no more likely to divorce.

Why is a marriage more likely to end when a wife gets sick than when a husband does?

The researchers did not test any explanations for their findings, and they discuss them only briefly. They suggest that it is typically the wife who has the role of the caregiver and that it is more stressful for the couple when the wife is ill than when the husband is. They also note that women are often more financially dependent and economically vulnerable; those challenges could pose barriers to the wives who might want to exit a marriage.

I’d add that men may be more likely to go into a marriage expecting to be cared for. When the tables are turned and they are the ones who need to do the intensive caring, some will leave rather than step up.

Other important considerations

This was not the first study to show that a heterosexual marriage is more likely to end when a wife becomes seriously ill than when a husband does. In a study of married people diagnosed with a brain tumor or multiple sclerosis, the partner was more likely to be “abandoned” (in the authors’ words) when it was the wife who was ill. In those cases, 21 percent of the marriages ended. When it was the husband who became seriously ill, just 3 percent of the couples divorced.

That’s a big difference—marriages are about seven times more likely to end when the wife becomes seriously ill than when the husband does. But those numbers also show that most marriages do not end in divorce after a spouse becomes ill. Even when the wife is the patient, only about 1 in 5 marriages end in the next couple of years.

What happens after a marriage ends in later life? Some research (discussed in Single at Heart) shows that lifelong single people often fare better than the newly divorced or newly widowed. They know how to navigate single life. Unlike the couples who may have divided up various tasks and chores, single people have been figuring out how to do everything, or find help, all along. They are more likely to have maintained their ties with their friends and the other important people in their lives, rather than marginalizing them to attend primarily to their spouse. If they are single at heart, they are also comfortable in solitude.

“Who will be there for you?” and “How will you manage?” are not questions relevant solely to single people.