Mortality associated with caregiving, general stress, and caregiving-related stress in elderly women: results of caregiver-study of osteoporotic fractures.

Fredman L, Cauley JA, Hochberg M, Ensrud KE, Doros G, Study of Osteoporotic Fractures. Mortality associated with caregiving, general stress, and caregiving-related stress in elderly women: results of caregiver-study of osteoporotic fractures. Journal of the American Geriatrics Society. 2010 May 1; 58(5):937-43.

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Abstract:

OBJECTIVES: To investigate the separate and combined effects of caregiver status and high stress on mortality risk over 8 years in elderly women. DESIGN: Prospective cohort study conducted in four U.S. communities followed from 1999/01 (baseline) to December 31, 2007. SETTING: Home-based interviews. PARTICIPANTS: Three hundred seventy-five caregiver and 694 noncaregiver participants from the Caregiver-Study of Osteoporotic Fractures (Caregiver-SOF) who participated in the baseline Caregiver-SOF interview. MEASUREMENTS: Caregiver status was based on SOF respondents'' self-report of performing one or more instrumental or basic activities of daily living for a relative or friend with impairments. Two measures of stress were used: Perceived Stress Scale and stress related to caregiving tasks. All-cause mortality was the outcome. RESULTS: Caregivers were more stressed than noncaregivers; 19.7% of caregivers and 27.4% of noncaregivers died. Mortality was lower in caregivers than noncaregivers (adjusted hazard ratio, (AHR) = 0.74, 95% confidence interval (CI) = 0.56-0.89). High-stress respondents had greater mortality risk than low-stress respondents over the first 3 years of follow-up (AHR = 1.81, 95% CI = 1.16-2.82) but not in later years. Likewise, high-stress caregivers and noncaregivers had higher mortality risk than low-stress noncaregivers, although low-stress caregivers had significantly lower mortality than did noncaregivers, whether perceived stress or caregiving-related stress was measured (AHR = 0.67 and 0.57). Similar results were observed in analyses comparing spouse caregivers with married noncaregivers. CONCLUSION: Short-term effects of stress, not caregiving per se, may increase the risk of health decline in older caregivers.