Health decline in aged caregivers: epidemiologic study

老年护理人员的健康状况下降：流行病学研究

• 批准号: 7671404
• 负责人: Lisa Fredman
• 金额: $ 45.25万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7671404
• 关键词: Adverse effects; Affect; Age; Ancillary Study; Attention; Biological; Biological Markers; Body Weight Changes; Calendar; Caregivers; Caring; Cessation of life; Chronic stress; Code; Cognitive; Cohort Studies; Cox Proportional Hazards Models; Data; Data Collection; Dementia; Digit structure; Disease model; Elderly; Elderly woman; Emotional; Epidemiologic Studies; Evaluation; Event; Exhibits; Fracture; Friends; Growth; Health; Health Status; Heart Diseases; Home environment; Impairment; Individual Differences; Intervention; Interview; Interviewer; Life; Link; Measurement; Measures; Mediator of activation protein; Memory; Methods; Modeling; Mortality Decline; Nursing Homes; Outcome; Participant; Pathway interactions; Patient Self-Report; Performance; Persons; Physical Function; Physical activity; Physiological; Problem behavior; Prospective Studies; Questionnaires; Race; Reaction; Relative (related person); Reporting; Research; Research Personnel; Respondent; Risk; Risk Factors; Role; Sampling; Serum; Site; Social support; Speed; Spouse Caregiver; Stress; Study of serum; Subgroup; Techniques; Testing; Time; Training; Unmarried; Verbal Learning; Visit; Walking; Weight; Weights and Measures; aged; base; caregiving; cognitive function; coping; depressive symptoms; experience; falls; follow-up; functional status; grasp; inflammatory marker; innovation; insight; mortality; osteoporosis with pathological fracture; physical conditioning; programs; psychologic; psychosocial; respite care

DESCRIPTION (provided by applicant): Whether care giving has adverse effects on the caregiver's physical and cognitive functioning remains uncertain due to inconsistent research findings and methodological limitations that include: assessment of caregiver status at baseline only - not incorporating changes in caregiver status over the follow up period; evaluation of health outcomes at a single follow up time; and absence of measures of perceived stress and biological markers that would allow direct tests of bio-psychosocial models of care giving-related stress and health decline. The proposed study is a competitive renewal of Caregiver-SOF, which is an ancillary study to the Study of Osteoporotic Fractures (SOF), a multi-site study of the risk of fractures and falls in elderly women. The Caregiver-SOF sample has 1069 SOF participants (mean age=81 years) who were informal caregivers (n=375) and non-caregivers (n=694) matched on SOF site, age, race, and zip code. They have had three annual home-based interviews that included standardized questions on the care-giving situation and caregiver status transitions, perceived stress, depressive symptoms, and self-reported ADLs and lADLs; performance-based measures of physical functioning (timed walk, grip strength, chair stands); cognitive tests of speed/attention (Digit Substitution Test) and verbal memory (Hopkins Verbal Learning Test); and measured weight. This proposed study will add two home-based interviews with 734 surviving Caregiver-SOF participants. Trained SOF interviewers will re-administer the questionnaires and physical and cognitive measures that have been administered previously, for a total of five assessment points. These data will be linked to SOF data on mortality and lnterleukin-6 (IL-6) using stored serum from a concurrent SOF exam at two SOF sites. Hypotheses will be tested that 1) compare caregivers and non-caregivers, and transitions in caregiver status, on change in physical (namely, self-reported and performance-based functional status, weight change, and mortality) and cognitive health status using repeated measures and Cox proportional hazards modeling; 2) examine the role of IL-6 as a mediator in the pathway from care-giving and chronic stress to physical and cognitive health decline; 3) evaluate methodologic reasons for higher rates of health decline in spouse caregivers that have been observed in recent studies; and 4) use growth curve modeling to analyze trajectories of change in stress and health outcomes. This study will replicate and extend the results of previous studies by providing insight into etiologic, biological, and methodological factors in the associations of care-giving stress with physical and cognitive health outcomes. Study results will guide interventions to reduce effects of stress on physical and cognitive health in older caregivers, and older adults in general.

描述（由申请人提供）：护理给予对照料者的身体和认知功能是否不利影响，因为研究结果不一致，包括：仅在基线时评估护理人员状态 - 不纳入随访期间的护理人员状况的变化；在一次随访时间内评估健康结果；缺乏感知的压力和生物标记的度量，这些措施将允许直接测试与护理相关压力和健康下降的生物心理社会模型。拟议的研究是对护理人员索的竞争性更新，这是对骨质疏松性裂缝（SOF）研究的辅助研究，这是对老年妇女裂缝和下降风险的多站点研究。护理人员SOF样本有1069名参与者（平均年龄= 81岁），他们是非正式的护理人员（n = 375）和非照料者（n = 694）（n = 694），在SOF网站，年龄，种族和邮政编码上匹配。他们进行了三次基于家庭的访谈，其中包括有关护理情况和护理人员状况过渡，感知压力，抑郁症状以及自我报告的ADL和LADL的标准化问题；基于绩效的身体功能措施（定时步行，握力，椅子架）；速度/注意力（​​数字替代测试）和言语记忆（霍普金斯语言学习测试）的认知测试；并测量的重量。这项拟议的研究将增加两次基于家庭的访谈，对734名尚存的护理人员参与者。训练有素的SOF访调员将重新管理以前已经管理的问卷以及物理和认知措施，总共五个评估点。这些数据将使用来自两个SOF位置的并发SOF检查的储存血清链接到有关死亡率和Lnterleukin-6（IL-6）的SOF数据。假设将测试1）对身体变化（即，自我报告和基于绩效的功能状况，体重变化和死亡率）以及使用重复措施和COX的认知健康状况的变化（即，自我报告和基于绩效的功能状况，自我报告和基于绩效的功能状态）和COX危害危害建模； 2）检查IL-6作为介体在从护理和慢性压力到身体和认知健康下降的途径中的作用； 3）评估方法学原因是在最近的研究中观察到的配偶护理人员的健康下降率较高； 4）使用生长曲线建模来分析压力和健康结果变化的轨迹。这项研究将通过洞悉护理压力与身体和认知健康结果的关联中的病因，生物学和方法论因素来复制和扩展先前研究的结果。研究结果将指导干预措施，以减少压力对老年护理人员和老年人的身体和认知健康的影响。