According to an article published in the October 27 issue of Archives of Internal Medicine, poorer health outcomes were more likely among older white caregivers than black female caregivers who provide regular care or assistance for a child or who care for a disabled or sick adult.
There are few studies, yielding inconsistent results, which suggest a relationship between caregiving and an increased likelihood of disease occurrence or death. Previous studies, however, have documented that caregivers generally have poorer immune systems than non-caregivers. Author Lisa Fredman, Ph.D. (Boston University School of Public Health) and colleagues write that, “These inconsistent results suggest the need to examine factors that may influence the association between caregiving and health decline in older adults, particularly race, sex and overall level of physical activity of caregivers and non-caregivers.” The researchers included physical activity in their study of caregivers because of its association with lower stress, fewer depressive symptoms and protection against heart disease, death and mobility disability. Therefore, they set out to “provide a more accurate description of how caregiving affects physical health.”
The researchers analyzed the physical activity and health of 3,075 healthy adults from 1997 to 1998. The participants were between 70 and 79 years of age, and 22% (680) were caregivers. The researchers collected information such as race and sex as well as indicators of physical activity such as daily routine, exercise and caregiving activity. Every year for eight years, researchers clinically examined or interviewed the participants. In addition, participants responded to short telephone interviews that were conducted six months after each annual interview.
“Black women were most likely to be caregivers (28.8 percent) and to spend the most time caregiving,” according to Fredman and colleagues. “Nineteen percent of black women spent eight or more hours a week performing caregiving activities, whereas white men were least likely to be caregivers (18.2 percent) and less involved in caregiving activities than other race-sex groups.”
About 20% of caregivers died, and 50.9% developed difficulty walking one-quarter mile or climbing 10 steps (mobility limitations). These figures compare to a 22% death rate and 48.9% mobility limitation development rate for non-caregivers. However, “Associations differed by race and sex. Mortality [death] and mobility limitation rates were 1.5 times higher in white caregivers but not for black female caregivers vs. non-caregivers,” write the authors. Similarly, higher rates of health decline were noted when physical activity was taken into consideration among caregivers who took care of someone for 24 hours or more per week. When physical activity was not considered, however, this group actually demonstrated lower rates of health decline.
“Given the increasing number of elderly caregivers in the United States, these results underscore the potential toll of caregiving on physical health and the need for services to reduce caregivers’ stress and maintain their health and ability to provide optimal care for their family members,” conclude the researchers.
Caregiving, Mortality, and Mobility Decline: The Health, Aging, and Body Composition (Health ABC) Study
Lisa Fredman; Jane A. Cauley; Suzanne Satterfield; Eleanor Simonsick; S. Melinda Spencer; Hilsa N. Ayonayon; Tamara B. Harris; for the Health ABC Study Group
Archives of Internal Medicine (2008); 168[19]: pp. 2154-2162.
Written by: Peter M Crosta