Mikkola Tuija M, Kautiainen Hannu, Mänty Minna, von Bonsdorff Mikaela B, Kröger Teppo, Eriksson Johan G
Folkhälsan Research Center, Helsinki, Finland.
Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Aging Clin Exp Res. 2021 Jul;33(7):1971-1980. doi: 10.1007/s40520-020-01728-4. Epub 2020 Oct 11.
Evidence on family caregivers' health is conflicting.
To investigate all-cause and cause-specific mortality in Finnish family caregivers providing high-intensity care and to assess whether age modifies the association between family caregiver status and mortality using data from multiple national registers.
The data include all individuals, who received family caregiver's allowance in Finland in 2012 (n = 42,256, mean age 67 years, 71% women) and a control population matched for age, sex, and municipality of residence (n = 83,618). Information on dates and causes of death between 2012 and 2017 were obtained from the Finnish Causes of Death Register.
Family caregivers had lower all-cause mortality than the controls over the follow-up (8.1 vs. 11.6%) both among women (socioeconomic status adjusted hazard ratio [HR]: 0.64, 95% CI 0.61-0.68) and men (adjusted HR: 0.73, 95% CI 0.70-0.77). When modelling all-cause mortality as a function of age, younger caregivers had only slightly lower or equal mortality to their controls, but older caregivers had markedly lower mortality than their controls, up to more than 10% lower. Caregivers had a lower mortality rate for all the causes of death studied, namely cardiovascular, cancer, neurological, external, respiratory, gastrointestinal and dementia. The lowest risk was for dementia (subhazard ratio = 0.29, 95% CI 0.25-0.34).
Older family caregivers had lower mortality than the age-matched general population while mortality did not differ according to caregiver status in young adulthood. This age-dependent advantage in mortality is likely to reflect the selection of healthier individuals into the family caregiver role.
关于家庭照顾者健康状况的证据相互矛盾。
利用多个国家登记处的数据，调查提供高强度护理的芬兰家庭照顾者的全因死亡率和特定病因死亡率，并评估年龄是否会改变家庭照顾者身份与死亡率之间的关联。
数据包括2012年在芬兰领取家庭照顾者津贴的所有个体（n = 42256，平均年龄67岁，71%为女性）以及按年龄、性别和居住城市匹配的对照人群（n = 83618）。2012年至2017年期间的死亡日期和死因信息来自芬兰死亡原因登记处。
在随访期间，家庭照顾者的全因死亡率低于对照组（8.1%对11.6%），女性（社会经济地位调整后的风险比[HR]：0.64，95%可信区间0.61 - 0.68）和男性（调整后的HR：0.73，95%可信区间0.70 - 0.77）均如此。将全因死亡率建模为年龄的函数时，年轻的照顾者死亡率仅略低于或等于对照组，但年长的照顾者死亡率明显低于对照组，低至超过10%。在研究的所有死因中，即心血管疾病、癌症、神经系统疾病、外部原因、呼吸系统疾病、胃肠道疾病和痴呆症，照顾者的死亡率较低。痴呆症的风险最低（亚风险比 = 0.29，95%可信区间0.25 - 0.34）。
年长的家庭照顾者死亡率低于年龄匹配的普通人群，而在年轻成年期，死亡率并未因照顾者身份而有所不同。这种与年龄相关的死亡率优势可能反映了选择更健康的个体担任家庭照顾者角色。
