Current and long-term spousal caregiving and onset of cardiovascular disease.

TitleCurrent and long-term spousal caregiving and onset of cardiovascular disease.
Publication TypeJournal Article
Year of Publication2012
AuthorsCapistrant, BD, J Moon, R, Berkman, LF, M. Glymour, M
JournalJ Epidemiol Community Health
Date Published2012 Oct
ISSN Number1470-2738
KeywordsActivities of Daily Living, Adult, Aged, Aged, 80 and over, Cardiovascular Diseases, Caregivers, Female, Follow-Up Studies, Humans, Incidence, Interviews as Topic, Long-term Care, Male, Middle Aged, Proportional Hazards Models, Risk Factors, Self Report, Socioeconomic factors, Spouses, Stress, Psychological, United States

BACKGROUND: Prior evidence suggests that caregiving may increase risk of cardiovascular disease (CVD) onset. This association has never been examined in a nationally (USA) representative sample, and prior studies could not fully control for socioeconomic confounders. This paper seeks to estimate the association between spousal caregiving and incident CVD in older Americans.

METHODS: Married, CVD-free Health and Retirement Study respondents aged 50+ years (n=8472) were followed up to 8 years (1669 new stroke or heart disease diagnoses). Current caregiving exposure was defined as assisting a spouse with basic or instrumental activities of daily living ≥14 h/week according to the care recipients' report in the most recent prior biennial survey; we define providing ≥14 h/week of care at two consecutive biennial surveys as 'long-term caregiving'. Inverse probability weighted discrete-time hazard models with time-updated exposure and covariate information (including socioeconomic and cardiovascular risk factors) were used to estimate the effect of caregiving on incident CVD.

RESULTS: Caregiving significantly predicted CVD incidence (HR=1.35, 95% CI 1.06 to 1.68) in the population overall. Long-term caregiving was associated with double the risk of CVD onset (HR=1.95, 95% CI 1.19 to 3.18). This association for long-term care givers varied significantly by race (p<0.01): caregiving predicted CVD onset for white (HR=2.37, 95% CI 1.43 to 3.92) but not for non-white (HR=0.28, 95% CI 0.06 to 1.28).

CONCLUSIONS: Spousal caregiving independently predicted risk of CVD in a large sample of US adults. There was significant evidence that the effect for long-term care givers differs for non-whites and white.

User Guide Notes

Endnote Keywords

Spousal care/cardiovascular disease/Socioeconomic Differences/risk Factors/Activities Of Daily Living/IADLs

Endnote ID


Alternate JournalJ Epidemiol Community Health
Citation Key7625
PubMed ID22080816
PubMed Central IDPMC3855843
Grant ListU01 AG009740 / AG / NIA NIH HHS / United States
AG034385-01 / AG / NIA NIH HHS / United States
R21 AG034385 / AG / NIA NIH HHS / United States
R24 HD050924 / HD / NICHD NIH HHS / United States
T32-HL098048-01 / HL / NHLBI NIH HHS / United States
U01AG009740 / AG / NIA NIH HHS / United States
T32 HL098048 / HL / NHLBI NIH HHS / United States