Most caregivers of disabled or chronically ill older adults face multiple stressors on a daily basis due to factors such as those related to the care recipient (e.g., behavioral problems) or the caregiving situation (e.g., duration of care). Studies consistently find that informal caregivers report higher rates of stress than non-caregivers. Further, although there is growing empirical evidence that chronic stress demonstrates adverse effects on cognitive functioning in middle-aged and older adults, studies are lacking that have evaluated this association in caregivers, a natural group to target when studying the long-term effects of chronic stress. The proposed investigation will examine individual trajectories of the rate of change in stress over three annual time points using the Caregiver Study of Osteoporotic Fractures (CGSOF) sample, an ancillary study of the Study of Osteoporotic Fractures (SOF). CGSOF is a prospective cohort study of 375 elderly women caregivers matched on age and race to 694 elderly women non-caregivers, all of whom are SOF respondents. The general hypothesis of this study is that stress wilt intensify over time for caregivers, with the most rapid increases in stress found in caregivers who are exposed to risk factors (e.g., behavioral problems) and/or lack exposure to protective factors (e.g., social support). In turn, chronic prolonged stress will have a negative impact on cognitive performance. This study will use secondary data analyses of the CGSOF sample to expand on the existing literature by modeling growth curves of change in caregiver stress utilizing Hierarchical Linear Modeling (HLM). Growth curve modeling is ideal for examining change over time because it allows for the estimation of inter-individual differences in intra-individual change. Longitudinal techniques that are commonly used such as repeated measures analysis of variance provide estimates of average growth for discrete groups; they provide a representation of average tendencies. The proposed study wilt also add to the literature by assessing the association between chronic, prolonged stress and cognitive performance in older women caregivers and non-caregivers. The implications for this study are twofold. First, the findings from this investigation will inform an R01 proposal by providing data on individual rates of change in stress as well as the effects of chronic stress on cognition as an outcome. Second, these results have potentional public health significance since cognitive functioing has been identified as a risk factor for increased morbidity and mortality.
| Bertrand, Rosanna M; Fredman, Lisa; Saczynski, Jane (2006) Are all caregivers created equal? Stress in caregivers to adults with and without dementia. J Aging Health 18:534-51 |
