Spousal Caregiving Is Associated with an Increased Risk of Frailty: A Case-Control Study.

BACKGROUND

Evidence suggests that providing care for a disabled elderly person may have implications for the caregiver's own health (decreased immunity, hypertension, and depression).

OBJECTIVE

Explore if older spousal caregivers are at greater risks of frailty compared to older people without a load of care.

DESIGN

Case-control study.

SETTING

Participants were assessed at home in Wallonia, Belgium.

PARTICIPANTS

Cases: community-dwelling spousal caregivers of older patients, recruited mainly by the geriatric outpatient clinic.

CONTROLS

people living at home with an independent spouse at the functional and cognitive level matched for age, gender and comorbidities.

MEASUREMENTS

Mini nutritional assessment-short form (MNA-SF), short physical performance battery (SPPB), frailty phenotype (Fried), geriatric depression scale (GDS-15), clock drawing test, sleep quality, and medications. The multivariable analysis used a conditional logistic regression.

RESULTS

Among 79 caregivers, 42 were women; mean age and Charlson comorbidity index were 79.4±5.3 and 4.0±1.2, respectively. Among care-receivers (mean age 81.4±5.2), 82% had cognitive impairment. Caregiving was associated with a risk of frailty (Odd Ratio (OR) 6.66; 95% confidence interval (CI) 2.20-20.16), the consumption of antidepressants (OR 4.74; 95% CI 1.32 -17.01), shorter nights of sleep (OR 3.53; 95% CI 1.37-9.13) and more difficulties maintaining a social network (OR 5.25; 95% CI 1.68-16.40).

CONCLUSIONS

Spousal caregivers were at an increased risk of being frail, having shorter nights of sleep, taking antidepressants and having difficulties maintaining their social network, compared to non-caregiver controls. Older spousal caregivers deserve the full attention of professionals to prevent functional decline and anticipate a care breakdown.