The Relationship Between Caregiving and Mortality After Accounting for Time-Varying Caregiver Status and Addressing the Healthy Caregiver Hypothesis

摘要: Background Previous studies have shown inconsistent associations between caregiving and mortality. This may be due to analyzing caregiver status at baseline only, that better health is probably related taking on responsibilities continuing in role. The latter termed Healthy Caregiver Hypothesis, similar the Worker Effect occupational epidemiology. We applied common approaches from epidemiology evaluate association mortality, including treating as time-varying lagging exposure up 5 years. Methods Caregiving among 1,068 women (baseline mean age = 81.0 years; 35% caregivers) participating Caregiver-Study of Osteoporotic Fractures study was assessed five interviews conducted 1999 2009. Mortality determined through January 2012. Cox proportional hazards models were used estimate adjusted hazard ratios 95% confidence intervals for sociodemographics, perceived stress, functional limitations. Results A total 483 participants died during follow-up (38.8% 48.7% caregivers noncaregivers, respectively). Using status, with mortality 0.77, 0.62-0.95. Models showed a more pronounced reduction current (hazard 0.54, 0.38-0.75), which diminished longer lag periods (3-year ratio 0.68, 0.52-0.88, 5-year 0.76, 0.60-0.95). Conclusions Overall, had lower rates than noncaregivers all analyses. These sensitive lagged period, indicating timing leaving does influence this relationship should considered future investigations.