70 Caregiving, all-cause mortality and cause specific mortality: findings from the NIH-AARP diet and health study

Abstract Background There have been conflicting findings in studies exploring the relationship between caregiving and mortality, which may relate to differences in type and intensity of caregiving. Methods In the prospective National Institutes of Health American Association of Retired Persons (NIH-AARP) Diet and Health Study (n = 148,792, mean age 70.8 years), we evaluated the association of caregiving with all-cause mortality and cause-specific mortality, and explore whether the association differed by type of caregiving (adult or children) and by duration (hours per week). Hazard ratios (HR) and 95% confidence intervals (CI) for mortality associated with caregiving of adults and of children were estimated with the use of Cox proportional-hazards regression models, with non-caregivers as the reference category. Results During a mean follow-up of 12.9 years, 59,046 deaths were recorded. Overall caregiving for adults (HR 0.90; 95%CI 0.88–0.93) and children (HR 0.71; 95%CI 0.70–0.73) were associated with a lower risk of all cause-mortality, which was consistent for cardiovascular and non-cardiovascular deaths. However, among adult caregivers, there was evidence of a dose–response with attenuation risk reduction among those caregiving for 7 hours per week or more (HR 0.95; 0.89–1.01) compared to those with short duration adult caregiving (HR 0.88; 0.85–0.91), on multivariable analyses. The association of caregiving of children was consistent across duration categories. Conclusion Among older adults, caregiving was associated with an overall reduced risk of mortality. However, we found differences in magnitude of association by caregiver type and duration and observed no reduction in mortality among those providing adult caregiving for 7 hours or more per week.