HEALTH DECLINE IN AGED CAREGIVERS: EPIDEMIOLOGIC STUDY

非正式的照顾者承受着很高的负担和心理痛苦，但照看是否会对照顾者的身体健康产生不利影响还不是很确定。拟议的研究旨在a)比较照顾者和非照顾者在两年期间身体健康的变化；以及b)比较与照看直接相关的因素(例如，照看活动中的小时/天)和与照看间接相关的因素(例如，使用精神药物)在两年期间对身体健康变化的影响。这项研究将作为骨质疏松性骨折(SOF)研究的辅助研究，这是一项对老年社区居住妇女的骨质疏松和相关情况进行的四点前瞻性研究。在第六次特别行动部队诊所访问时，将向所有符合条件的特别行动部队参与者，包括新招募的非裔美国人队列，发放筛选问卷，以确定600名非正式照顾者(包括大约100名非裔美国人照顾者)和600名非照顾者的样本，这些人在年龄、特别行动地点和种族方面匹配。本研究将在基线和基线后1年和2年，通过面对面访谈的面对面访谈，通过面对面的问卷调查，从照顾者和非照顾者那里收集数据。这些数据将涵盖照料活动、照料的体力活动、抑郁症状、压力、应对、与压力相关的行为以及体重和ADL/IADL功能。这些数据将与第六届SOF临床数据联系起来，这些数据涉及身体和机能健康、认知状态、体重、体力活动、睡眠障碍和神经肌肉功能，以及SOF关于跌倒、骨折、医疗保健使用和死亡率的后续数据。纵向分析将检验关于照顾者的健康衰退率比非照顾者更高的假设(例如，ADLS/IADLS的变化、跌倒、骨折、体重变化)，以及关于照顾者活动、压力相关行为和白人与非裔美国人照顾者健康下降之间关系的假设。这项研究将受益于它的前瞻性设计，它与一个大型的多地点老年女性人群队列的联系，以及关于身体健康的大量标准化的自我报告、临床和功能测量。在美国，老年照顾者的数量正在增加；这一群体因照料而对健康造成不利影响的风险最高。这些研究结果将为照顾者的不良身体健康后果提供流行病学证据，并对检测和预防照顾者的健康下降产生影响。

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.