HEALTH DECLINE IN AGED CAREGIVERS: EPIDEMIOLOGIC STUDY

非正式照顾者的负担和心理困扰率很高，但照顾是否对照顾者的身体健康有不利影响尚不清楚。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；b)比较2年期间与护理直接相关的因素（例如，护理活动的小时数/天）和与护理间接相关的因素（例如，使用精神药物）对身体健康变化的影响。本研究将作为一项辅助研究进行骨质疏松性骨折（SOF）的研究，这是一项针对老年社区妇女骨质疏松症及相关疾病的四点前瞻性研究。在第6次SOF诊所访问时，将对所有符合条件的SOF参与者（包括新招募的非裔美国人队列）进行筛选问卷调查，以确定600名非正式护理人员（包括估计100名非裔美国人护理人员）和600名非护理人员的样本，他们在年龄、SOF地点和种族上相匹配。本研究将通过访谈者在基线和基线后1年和2年的面对面访谈中填写问卷，收集照顾者和非照顾者的数据。这些数据将涵盖护理活动、护理的体力劳动、抑郁症状、压力、应对、与压力相关的行为、体重和ADL/IADL功能。这些数据将与第六届SOF临床数据相关联，包括身体和功能健康、认知状态、体重、身体活动、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随访数据。纵向分析将检验护理者比非护理者健康下降率更高的假设（例如，日常生活能力/日常生活能力的变化、跌倒、骨折、体重变化），以及白人与非裔美国护理者之间护理活动、压力相关行为和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，它与大型多地点人群为基础的老年妇女队列的联系，以及大量标准化的自我报告、临床和身体健康的功能测量。美国老年护理人员的数量正在增长；这一群体受到护理对健康不利影响的风险最高。这些研究结果将提供护理不良身体健康结果的流行病学证据，以及对护理者健康衰退的检测和预防的影响。

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.