Current and long-term spousal caregiving and onset of cardiovascular disease

• Published in: Journal of epidemiology and community health (1979) Vol. 66; no. 10; pp. 951 - 956
• Main Authors: Capistrant, Benjamin D, Moon, J Robin, Berkman, Lisa F, Glymour, M Maria
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.10.2012; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Activities of Daily Living; Adult; Age; Aged; Aged, 80 and over; Ageing; Biological and medical sciences; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Caregivers; Caregivers - psychology; CHD/coronary heart; Coronary artery disease; Demography; Depressive disorders; Disease risk; epidemiology; Estimates; Ethnicity; Female; Follow-Up Studies; General aspects; gerontology; Health risk assessment; Health risks; Heart; Humans; Hypertension; Incidence; Interviews; Interviews as Topic; Long term health care; Long-Term Care; Male; Medical sciences; Middle Aged; Miscellaneous; Proportional Hazards Models; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Self Report; social epidemiology; social inequalities; Socioeconomic Factors; Socioeconomic status; Socioeconomics; Spouses; Spouses - psychology; Stress, Psychological - complications; Stroke; Studies; United States - epidemiology; Womens health; United States; Medicine; Cardiovascular disease; Long term; Public health; Caregiver
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2011-200040

BackgroundPrior 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.MethodsMarried, 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.ResultsCaregiving 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).ConclusionsSpousal 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.