Centre for Education and Research on Ageing, University of Sydney and Concord Clinical School, Sydney, Australia.
Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
Age Ageing. 2019 Jul 1;48(4):571-576. doi: 10.1093/ageing/afz039.
while both negative and positive impacts of caregiving on health have been reported, findings regarding caregiver's mortality may be biased by the lack of consideration of changes in their health and caregiving status during follow-up. This study examines the impact of caregiving on the risk of death in older men, allowing for caregiving-transition by individuals and adjusting for changes over time in their health status.
data from 1639 men age ≥70 years old from the Concord Health and Ageing in Men Project (CHAMP) were collected between baseline (2005-07), 2-year and 5-year follow-up and linked to death records up to 30 September 2015. A time-varying Cox proportional hazards model was used to examine the risk of death from caregiving between 2005 and 2015, adjusting for baseline education, history of myocardial infarction, congestive heart failure, and risk factors which may change over time (age, income, self-rated overall health, number of morbidities, physical disability, depression and anxiety).
the average follow-up was 7.39 years (SD = 2.95) with 495 deaths observed. There was no significant difference in all-cause mortality between caregivers and non-caregivers in the multivariable model (HR: 0.95, 95% CI: 0.67-1.32, P = 0.73).
this study addressed the dynamic caregiving role and covariates which has been rarely considered in the literature. While there is concern that when older people take on a caring role their health suffers, we found no difference in mortality between older male caregivers and non-caregivers when we accounted for transitions in their caregiving status.
虽然已经报道了照顾对健康的负面影响和积极影响，但由于在随访期间没有考虑到照顾者健康和照顾状态的变化，因此关于照顾者死亡率的研究结果可能存在偏差。本研究通过允许个体在随访期间转换照顾角色，并调整其健康状况随时间的变化，考察了照顾对老年男性死亡风险的影响。
本研究的数据来自年龄≥70 岁的 1639 名男性，他们来自 Concord 健康和老龄化男性项目（CHAMP），数据收集于基线（2005-07 年）、2 年和 5 年随访期，并与截至 2015 年 9 月 30 日的死亡记录相关联。使用时变 Cox 比例风险模型来检查 2005 年至 2015 年期间因照顾而死亡的风险，调整了基线教育、心肌梗死史、充血性心力衰竭和可能随时间变化的风险因素（年龄、收入、自我评估总体健康状况、患病数量、身体残疾、抑郁和焦虑）。
平均随访时间为 7.39 年（SD = 2.95），观察到 495 例死亡。在多变量模型中，照顾者和非照顾者的全因死亡率没有显著差异（HR：0.95，95%CI：0.67-1.32，P = 0.73）。
本研究解决了动态照顾角色和文献中很少考虑的协变量问题。虽然人们担心当老年人承担照顾角色时，他们的健康会受到影响，但当我们考虑到他们照顾角色的转变时，我们发现老年男性照顾者和非照顾者的死亡率没有差异。
