HEALTH DECLINE IN AGED CAREGIVERS: EPIDEMIOLOGIC STUDY

非正式照顾者的负担和心理困扰率很高，但非正式照顾是否对照顾者的身体健康产生不利影响还不太确定。 拟议的研究旨在a）比较照顾者和非照顾者在2年期间的身体健康变化;和B）比较与照顾直接相关的因素（例如，照顾活动的小时/天）和与照顾间接相关的因素（例如，精神药物的使用）在2年内身体健康的变化。 本研究将作为骨质疏松性骨折研究（SOF）的辅助研究进行，SOF是一项在老年社区居住妇女中进行的骨质疏松症和相关疾病的4中心前瞻性研究。 在第6次SOF诊所访视时，将对所有合格的SOF参与者（包括新招募的非洲裔美国人队列）进行筛选问卷调查，以确定600名SOF参与者（非正式护理人员）（包括估计100名非洲裔美国人护理人员）和600名非护理人员的样本，年龄、SOF研究中心和种族匹配。 本研究将在基线和基线后1年和2年通过面对面访谈中的访谈者管理的问卷从护理人员和非护理人员收集数据。 这些数据将涵盖运动活动、运动的体力、抑郁症状、压力、应对、压力相关行为、体重和ADL/IADL功能。 这些数据将与第6次SOF临床数据（关于身体和功能健康、认知状态、体重、体力活动、睡眠障碍和神经肌肉功能）以及SOF随访数据（关于福尔斯、骨折、医疗保健使用和死亡率）相关联。 纵向分析将检验以下假设：照顾者的健康下降率高于非照顾者（例如，ADL/IADL的变化、福尔斯、骨折、体重变化）以及关于白色与非裔美国人照顾者之间的活动、压力相关行为和健康下降之间的关联的假设。这项研究将受益于其前瞻性设计，其与大型多中心老年女性人群队列的联系，以及大量关于身体健康的标准化自我报告，临床和功能措施。 在美国，老年护理人员的数量正在增加;这一群体面临着最高的健康风险。 这些研究结果将提供流行病学证据的不良身体健康后果的照顾，并为检测和预防健康下降的照顾者的影响。

Informal caregivers experience high rates of burden and psychological distress, but whether caregiving has adverse effects on the caregiver's physical health is less well-established. The proposed study aims to a) compare change in physical health between caregivers and non-caregivers over a 2-year period; and b) compare the effects of factors directly associated with caregiving (e.g, hours/day in caregiving activities) and indirectly associated with caregiving (e.g., use of psychotropic medications) on change in physical health over a 2-year period. This study will be conducted as an ancillary study to the Study of Osteoporotic Fractures (SOF), a 4-site prospective study of osteoporosis and related conditions among elderly community-dwelling women. A screening questionnaire will be administered to all eligible SOF participants, including the newly-recruited African-American cohort, at the 6th SOF clinic visit to identify a sample of 600 SOF participants who are informal caregivers (including an estimated 100 African-American caregivers) and 600 non-caregivers, matched on age-, SOF site-, and race. This study will collect data from caregivers and non-caregivers through interviewer-administered questionnaires in face-to-face interviews at baseline and at 1- and 2-years post-baseline. These data will cover caregiving activities, physical effort of caregiving, depressive symptoms, stress, coping, stress-related behaviors, and weight and ADL/IADL functioning. These data will be linked to the 6th SOF clinic data on physical and functional health, cognitive status, weight, physical activities, sleep disturbance, and neuromuscular functioning, and SOF follow-up data on falls, fractures, heath care use, and mortality. Longitudinal analyses will test hypotheses that caregivers have a higher rate of health decline than non-caregivers (e.g., change in ADLs/IADLs, falls, fractures, weight change) and hypotheses on the associations among caregiving activities, stress-related behaviors and health decline among white versus African-American caregivers. This study will benefit from its prospective design, its link to a large multi-site population-based cohort of elderly women, and a wealth of standardized self-report, clinical, and functional measures on physical health. The number of elderly caregivers in the United States is growing; this group is at highest risk of adverse health effects of caregiving. These study results will provide epidemiologic evidence of adverse physical health outcomes of caregiving, and implications for detection and prevention of health decline in caregivers.