Spousal health and older adults’ biomarker change over six years: Investigation of gender differences

•Married couples display concordance in both physical and mental biomarkers.•Health concordance in married couples were more evident in women.•Women were more vulnerable to the adverse change of their spouse’s health.•Men were more sensitive to positive health changes in their spouse. Relationship of spousal health and biomarkers over six years were examined. Nationally representative sample of 483 adults aged 54+ in Taiwan were followed for six years. Four classes of spousal health changes and three categories of biomarker indexes were examined. Biomarkers were assessed by counting the adverse progression on items of allostatic load (AL), cardiovascular disease biomarkers (CVD), and metabolic syndromes, respectively. When the health status of an individual’s spouse became worse, women increased their AL by 0.48 (P