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Posted: November 04, 2008

Older White Caregivers More Likely to Suffer from Poor Health

Elder-caregiving appears to take a heavier toll on the health of older white men and women than it does on older black women in the same situation, according to a report in the Archives of Internal Medicine.

"Among older white men and older white women, caregivers are 1.6 times more likely to die and 1.5 times more likely to develop mobility limitations than the non-caregivers," said Lisa Fredman, PhD, who led a study on caregiver health for Boston University. "But among black women, we find that caregivers have lower rates of mortality and incident mobility limitation than non-caregivers."


Discount Prescriptions
Although past studies have found that caregivers have weaker immune systems than non-caregivers, there has not been any consistent evidence that caregiving increases disease occurrence or death, according to background information in the medical journal article.


"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," wrote Fredman, an associate professor of epidemiology at BU’s School of Public Health.


Fredman and colleagues said they believe that since physical activity is associated with lower stress and depressive symptoms and protects against heart disease and mobility disability, including it in studies of caregiving "may provide a more accurate description of how caregiving affects physical health."


Fredman's research team assessed the health and physical activity -- including daily routine, exercise and caregiving activity -- of 3,075 healthy adults between the ages of 70 and 79, in 1997 and 1998. Of these, 680, or about 22%, were caregivers. Demographic information such as race and sex also were considered. Participants were clinically examined or interviewed every year for eight years, and short telephone interviews were conducted six months between each annual interview.


Of study participants, "black women were most likely to be caregivers (28.8%) and to spend the most time caregiving," the study found. "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%) and less involved in caregiving activities than other race-sex groups."


Approximately 20% of caregivers died and 50.9% developed mobility limitations, measured as difficulty walking one-quarter mile or climbing 10 steps during two consecutive semiannual follow-ups. Those numbers compared to 22% of non-caregivers who died and 48.9% who developed mobility limitations. 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," the authors wrote.


Elderly caregivers who took care of someone for 24 hours or more per week had higher rates of health decline when overall physical activity was taken into consideration.


"Regardless of the race-sex group, elderly caregivers who were most intensely involved in caregiving had the highest rates of mobility limitation compared with non-caregivers when adjusting for physical activity," the authors wrote. "These results indicate that caregiving may have deleterious effects on physical health and quality of life, even if it is not a strong risk factor for mortality."


The authors concluded that, "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."

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