The research project described in this proposal is designed to be carried out as an ancillary study of the national Cardiovascular Health Study (CHS) of the elderly. It takes advantage of the sampling and recruitment efforts of the CHS, the large quantities of physical health and functioning data collected by the CHS, and the expertise of investigators from five different universities. The CHS is a prospective epidemiologic study designed to investigate the etiology and natural history of atherosclerosis and its clinical sequelae in persons 65 years and older. To accomplish this, the CHS has recruited a random sample of 5,201 men and women in four communities in the United States. The original study, now in its third year of data collection, called for participants to provide clinic and interview data at regular intervals in order to answer questions regarding a) risk factors for coronary heart disease and stroke, b) correlates of prevalent atherosclerosis and abnormalities of cardiac structure and function and pulmonary disease, and c) sequelae of clinical disease, including mortality, disability, and use of medical resources. The purpose of the Caregiver Study (CS) is to assess the physical and psychiatric health effects of caregiving in a representative sample of elderly persons aged 65 and over. A subsample of 400 caregivers and care receivers, and 400 non-caregiving matched controls will be recruited by the four participating CHS field centers. The physical health and functioning data collected by the CHS will be supplemented by data collected by the CS. We propose to follow caregivers, care-receivers, and controls for a period of two years after recruitment and annually collect data assessing types and quantity of caregiving tasks performed, duration of caregiving, and psychological, physical, and financial burdens associated with caregiving. Psychiatric morbidity among caregivers and controls will be assessed using the Schedule for Affective Disorders and Schizophrenia. Care-receivers will be assessed to determine level and types of disability and medical diagnoses. This will be the first study to collect detailed, objective physical and mental health status, physical functioning, and health care utilization data on a representative sample of elderly caregivers. As a result, we will be able to answer a number of fundamental questions regarding the prevalence and causes of psychiatric and physical morbidity as well as pre-clinical disease among caregivers. Given the projected increase in the number of caregivers in the next three decades, it is essential that we obtain reliable and valid information on the health effects of taking on the caregiving role.
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