Does Dementia Caregiving Accelerate Frailty? Findings From the Health and Retirement Study
Does Dementia Caregiving Accelerate Frailty? Findings From the Health and Retirement Study
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DOI：
10.1093/geront/gnu078
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发表时间：
2016-06-01
期刊：
影响因子：
5.7
通讯作者：
Carr, Dawn C.
中科院分区：
文献类型：
--
作者：
Dassel, Kara B.;Carr, Dawn C.
研究目的：许多研究发现，在生命末期照顾配偶会带来负面的健康后果；然而，关于照顾者的认知状况如何影响照顾者的健康结果，特别是在脆弱领域，以及健康后果是否会随着时间的推移而保持下去，人们知之甚少。这项研究考察了患有和不患有痴呆症的人的配偶照顾者之间的脆弱程度的差异。设计和方法：使用健康和退休研究数据(1998-2010)的7个半年波，我们检查了2000年至2010年期间死亡(N，246)患有和不患有痴呆症的人的尚存配偶变得更加脆弱的几率。为了评估增加的脆弱程度，我们使用了脆弱指数，该指数评估慢性病、活动能力、功能状态、抑郁症状和主观健康。结果：与非痴呆症照顾者相比，痴呆症照料者在死亡前一波中的脆弱几率增加了40.5%，而在下一波中则增加了90%。意义：根据我们的研究结果，我们讨论了与痴呆症照顾者的健康和幸福感有关的公共健康问题。鉴于随着人口老龄化，痴呆症诊断的预期增加，我们建议需要干预措施，为痴呆症照顾者提供更好的支持。
Purpose of the Study: Numerous studies have discovered negative health consequences associated with spousal caregiving at the end of life; however, little is known about how care-recipient cognitive status impacts caregiver health outcomes, specifically in the area of frailty, and whether health consequences remain over time. This study examines differences in frailty between spousal caregivers of persons with and without a dementia diagnosis.Design and Methods: Using 7 biannual waves of the Health and Retirement Study data (1998-2010), we examined odds of becoming frailer among surviving spouses of individuals who died between 2000 and 2010 (N 1,246) with and without dementia. To assess increased frailty, we used a Frailty Index, which assesses chronic diseases, mobility, functional status, depressive symptoms, and subjective health. Logistic regression was used to examine the relationship between care-recipient cognitive status and whether, compared with the wave prior to death of the care-recipient, spousal caregivers were frailer: (1) in the wave the death was reported and (2) 2 years after the death was reported.Results: Dementia caregivers had 40.5% higher odds of experiencing increased frailty by the time the death was reported and 90% higher odds in the following wave compared with non-dementia caregivers.Implications: Given our findings, we discuss public health implications regarding the health and well-being of caregivers of persons with dementia. Given projected increases in dementia diagnoses as the population ages, we propose a need for interventions that provide enhanced support for dementia caregivers.