COMMUNITY EPIDEMIOLOGIC STUDY OF CAREGIVING AND HEALTH

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This is a revision of an application which was not funded. A population-based longitudinal study of the physical and psychological health effects of caregiving among African American and white community residents over age 65 is proposed to test the following hypotheses: 1) Caregivers will experience greater declines in physical health than non-caregivers as measured by: a. self-reported physical disability and health status; b. direct tests of physical performance; and c. self-reported health behaviors; 2) Caregivers will experience greater declines in psychological heal5th (depressive symptoms, anxiety, anger) and smaller increases in six measures of positive well-being than non-caregivers; 3) Negative consequences of caregiving will be modified both by characteristics of the care recipient and by the resources available to the caregiver: a. Negative consequences will increase with the severity of the care recipient's cognitive, physical, and behavioral problems and with greater duration and time spent providing care; b. Negative consequences will decrease with greater caregiver income and social support; 4) African American caregivers will experience fewer negative consequences than white caregivers, which will be explained by more positive appraisals of caregiving and greater religiosity. The study design permits observation of the full range of caregiving activities, consequences and mitigating factors in a population representative group of caregivers. The study will distinguish between health changes occurring in this age group due to other causes and those due to caregiving because caregivers will be compared to a truly representative group of non-caregivers selected from the same community cohort. Observations for some will begin before start of caregiving and extend after its end. The study will use standardized measures and will build on data already collected in conjunction with a group which has been successful in achieving high rates of follow-up participation in biracial community studies. Results will quantify the caregiving exposures that lead to health consequences. Factors found to minimize negative health effects will provide potential interventions to minimize stress and maintain the health of older caregivers, and thereby minimize the social and economic impacts of caregiving.