Citation
Capistrant, Benjamin D.; Moon, J. Robin; Berkman, Lisa; & Glymour, M. Maria (2012). Current and Long-Term Spousal Caregiving and Onset of Cardiovascular Disease. Journal of Epidemiology and Community Health, 66(10), 951-956. PMCID: PMC3855843Abstract
BACKGROUND: Prior evidence suggests that caregiving may increase risk of cardiovascular disease (CVD) onset. This association has never been examined in a nationally (USA) representative sample, and prior studies could not fully control for socioeconomic confounders. This paper seeks to estimate the association between spousal caregiving and incident CVD in older Americans.METHODS: Married, CVD-free Health and Retirement Study respondents aged 50+ years (n=8472) were followed up to 8 years (1669 new stroke or heart disease diagnoses). Current caregiving exposure was defined as assisting a spouse with basic or instrumental activities of daily living >/=14 h/week according to the care recipients' report in the most recent prior biennial survey; we define providing >/=14 h/week of care at two consecutive biennial surveys as 'long-term caregiving'. Inverse probability weighted discrete-time hazard models with time-updated exposure and covariate information (including socioeconomic and cardiovascular risk factors) were used to estimate the effect of caregiving on incident CVD.
RESULTS: Caregiving significantly predicted CVD incidence (HR=1.35, 95% CI 1.06 to 1.68) in the population overall. Long-term caregiving was associated with double the risk of CVD onset (HR=1.95, 95% CI 1.19 to 3.18). This association for long-term care givers varied significantly by race (p<0.01): caregiving predicted CVD onset for white (HR=2.37, 95% CI 1.43 to 3.92) but not for non-white (HR=0.28, 95% CI 0.06 to 1.28).
CONCLUSIONS: Spousal caregiving independently predicted risk of CVD in a large sample of US adults. There was significant evidence that the effect for long-term care givers differs for non-whites and white.
URL
http://dx.doi.org/10.1136/jech-2011-200040Reference Type
Journal ArticleYear Published
2012Journal Title
Journal of Epidemiology and Community HealthAuthor(s)
Capistrant, Benjamin D.Moon, J. Robin
Berkman, Lisa
Glymour, M. Maria