Alexandra M Wennberg1, Loretta R Anderson2, Lenis P Chen-Edinboro3, Annachiara Cagnin4, Lorenzo Pini5. 1. Unit of Epidemiology, Institutet of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 2. Program in Gerontology, Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland, USA. 3. School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, North Carolina, USA. 4. Department of Neuroscience (DNS), University of Padova, Padova, Italy. 5. Padova Neuroscience Center, University of Padova, Padova, Italy.
Abstract
Background and Objectives: Older adult caregivers have compounded risk for adverse health outcomes; however, evidence investigating the association between caregiving and frailty has been limited. In the National Study of Caregiving (NSOC), we examined the cross-sectional association between caregiving experiences and frailty and sleep disruption. Research Design and Methods: We included 621 caregivers aged 65 and older from the 2011 NSOC round. They completed a phone interview, including 36 items about caregiving. Using principal component analysis, we identified 3 caregiving components: general burden, positive emotions, and financial-led burden. Frailty was assessed via low energy, shrinking, weakness, reduced activity, and poor self-rated health. Sleep disruption was assessed with 2 questions regarding sleep interruption and trouble falling back asleep. Results: In models adjusted for age, sex, education, depression and anxiety symptoms, and medical conditions, positive emotions were associated with a reduced relative risk of frailty (relative risk [RR] = 0.94, 95% confidence interval [CI] 0.90, 0.99) while general burden (proportional odds ratio [POR] = 1.96, 95% CI 1.30, 2.93) and financial-led burden (POR = 1.94, 95% CI 1.22, 3.06) were associated with sleep interruption. Discussion and Implications: Caregiver burden was associated with increased frailty and sleep interruption. Positive emotions were associated with decreased frailty risk. Interventions aimed at reducing the burden and increasing positive emotions in caregivers may improve frailty outcomes.
Background and Objectives: Older adult caregivers have compounded risk for adverse health outcomes; however, evidence investigating the association between caregiving and frailty has been limited. In the National Study of Caregiving (NSOC), we examined the cross-sectional association between caregiving experiences and frailty and sleep disruption. Research Design and Methods: We included 621 caregivers aged 65 and older from the 2011 NSOC round. They completed a phone interview, including 36 items about caregiving. Using principal component analysis, we identified 3 caregiving components: general burden, positive emotions, and financial-led burden. Frailty was assessed via low energy, shrinking, weakness, reduced activity, and poor self-rated health. Sleep disruption was assessed with 2 questions regarding sleep interruption and trouble falling back asleep. Results: In models adjusted for age, sex, education, depression and anxiety symptoms, and medical conditions, positive emotions were associated with a reduced relative risk of frailty (relative risk [RR] = 0.94, 95% confidence interval [CI] 0.90, 0.99) while general burden (proportional odds ratio [POR] = 1.96, 95% CI 1.30, 2.93) and financial-led burden (POR = 1.94, 95% CI 1.22, 3.06) were associated with sleep interruption. Discussion and Implications: Caregiver burden was associated with increased frailty and sleep interruption. Positive emotions were associated with decreased frailty risk. Interventions aimed at reducing the burden and increasing positive emotions in caregivers may improve frailty outcomes.
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