Genomes and Genes
Health decline in aged caregivers: epidemiologic study
Principal Investigator: Lisa Fredman
Abstract: DESCRIPTION (provided by applicant): The Stress Process Model predicts that caregivers should have higher rates of health decline than non-caregivers because of their higher stress levels. However, recent studies have found lower rates of mortality, frailty, and physical and cognitive functioning in older caregivers than non-caregivers. The proposed study will investigate four possible mechanisms for these better health outcomes: inflammatory burden as a psycho-neuroimmunological mechanism;the Healthy Caregiver Hypothesis, as a basic health advantage in older adults who become caregivers and continue caregiving;positive affect as a general psychological protective effect;and personal gain from caregiving as a caregiving-specific mechanism. This revised proposal is a competitive renewal of Caregiver-SOF, which is an ancillary study to the Study of Osteoporotic Fractures (SOF), a multi-site cohort study of elderly women. The Caregiver-SOF sample includes 1069 SOF participants: 375 caregivers and 694 non-caregivers matched on SOF site, age, race, and zip code. Caregiver-SOF participants have been followed since 1999 through 5 home-based interviews (3 annual interviews followed by 2 at 18-month intervals) that included standardized questions on caregiving and caregiver status transitions, perceived stress, physical and psychological health status;performance- based measures of physical functioning (timed walk, grip strength, chair stands) and cognitive functioning (Digit Substitution Test and Hopkins Verbal Learning Test). The proposed study will link to SOF to update mortality data, test the Healthy Caregiver Hypothesis, and use stored serum from SOF visits 8 and 9 for assays on 3 inflammatory markers (Interleukin-6, IL-6;C-reactive protein, CRP;and Tumor Necrosis Factor- alpha, TNF-1). We will use mixed longitudinal models and Cox proportional hazards models to test four hypotheses in all participants and in caregivers only. H1) Higher inflammatory burden (a summary score of IL-6, CRP, and TNF- 1 levels) will mediate associations between caregiving, including high-stress caregiver subgroups (e.g., dementia caregivers), and adverse health outcomes (i.e., mortality, decline in physical functioning, cognitive functioning). H2) SOF participants who were caregivers at both screening interviews for the Caregiver-SOF study, or who became caregivers at the second screening interview, will have better health status and less health decline than those who remained as non-caregivers or stopped caregiving. H3) Respondents with high positive affect, based on the positive affect subscale of the CES-D scale, will have less adverse health outcomes than other respondents;caregivers with high positive affect will be more likely to continue caregiving and adapt to cessation of caregiving. H4) Caregivers with more personal gain from caregiving will be more likely to continue caregiving, have lower inflammatory burden, and fewer adverse health outcomes. This study will provide important insights into associations between caregiving and health decline and will guide interventions to promote physical and cognitive health in older caregivers.
Funding Period: 1999-09-30 - 2015-06-30
more information: NIH RePORT
- Leisure-time exercise and overall physical activity in older women caregivers and non-caregivers from the Caregiver-SOF StudyLisa Fredman
Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, MA 02118, USA
Prev Med 43:226-9. 2006..However, through caregiving tasks, caregivers may be as physically active as non-caregivers. This study compared leisure-time exercise and overall physical activity in elderly women caregivers and non-caregivers...
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Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, 185 Berry Street, Lobby 5, Suite 5700, San Francisco, CA 94107
J Gerontol A Biol Sci Med Sci 69:595-601. 2014..This study examines the association of nearly 20 years of cumulative depressive symptoms with cognitive outcomes in a cohort of older women...
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Hebrew Senior Life Institute for Aging Research, Boston, MA Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA Electronic address
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Department of Psychiatry, University of California, San Francisco, CA 94121, USA
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Boston University, Massachusetts, USA
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Domestic Health Division, Health Policy, Abt AssociatesInc, Cambridge, MA, USA
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Epidemiology Department, School of Public Health, Boston University, Boston, Massachusetts, USA
J Am Geriatr Soc 59:1697-704. 2011..To determine whether self-reported insomnia symptoms were associated with weight change in older women and whether caregiving, comorbidities, sleep medication, or stress modified this association...
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Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
Am J Epidemiol 173:882-9. 2011..88%), whereas low-intensity caregivers in excellent/good SRH had no decline (2.61%). In summary, poorer SRH was associated with decline in walking speed in older women, and the stress of caregiving may have exacerbated its impact...
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Epidemiology Department, School of Public Health, Boston University, Boston, Massachusetts 02118, USA
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Department of Epidemiology, Boston University School of Public Health 715 Albany Street, Boston, MA 02118, USA
J Gerontol A Biol Sci Med Sci 65:565-72. 2010..Chronic stress may lead to health decline through metabolic syndrome. Thus, persons in stressful caregiving situations who also have more indicators of metabolic syndrome may experience more decline than other caregivers or noncaregivers...
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One Veterans Dr 111J, Minneapolis, MN 55417, USA
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Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts 02118, USA
Am J Epidemiol 170:203-10. 2009..Higher levels of physical performance persisted over 2 years among high-intensity caregivers, which did not support the traditional stress hypothesis...
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Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland, USA
J Am Geriatr Soc 57:627-33. 2009....
- Racial differences in self-rated health at similar levels of physical functioning: an examination of health pessimism in the health, aging, and body composition studyS Melinda Spencer
Department of Health Promotion, Education, and Behavior and the Institute for Southern Studies, University of South Carolina, Columbia, 29208, USA
J Gerontol B Psychol Sci Soc Sci 64:87-94. 2009..The current analysis examined the factors associated with SRH and tested the health pessimism hypothesis among older adults at similar levels of physical functioning...
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Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
Arch Intern Med 168:2154-62. 2008..We hypothesized that caregivers may be more physically active than noncaregivers, which may protect them from health decline...
- Sleep problems in elderly women caregivers depend on the level of depressive symptoms: results of the Caregiver--Study of Osteoporotic FracturesJinesh Kochar
Division of Aging, Department of Medicine, Brigham and Women s Hospital, Boston, Massachusetts, USA
J Am Geriatr Soc 55:2003-9. 2007..To determine whether depressive symptoms modify the association between caregiving and sleep problems in elderly women...
- Elderly patients with hip fracture with positive affect have better functional recovery over 2 yearsLisa Fredman
Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts 02118, USA
J Am Geriatr Soc 54:1074-81. 2006..To evaluate whether patients with hip fracture with high positive affect had better functioning than those with low positive affect or depressive symptoms in three performance-based measures over 2 years after the fracture...
- Are all caregivers created equal? Stress in caregivers to adults with and without dementiaRosanna M Bertrand
Boston University School of Public Health, USA
J Aging Health 18:534-51. 2006..This study of 349 elderly caregivers explored mediators of the caregiving / stress relationship for caregivers to adults with (n = 106), and without (n = 243) dementia...
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