“Caregiving as a risk factor for mortality” (1999 article)

This email may be of interest to caregivers.

I was trying to find some published data on the percentage of caregivers who die before their care recipients.  Surprisingly, I couldn’t find anything on the Family Caregiver Alliance’s website (caregiver.org) about this but I did find this related statistic:

Researchers know a lot about the effects of caregiving on health and well being. For example, if you are a caregiving spouse between the ages of 66 and 96 and are experiencing mental or emotional strain, you have a risk of dying that is 63 percent higher than that of people your age who are not caregivers. The combination of loss, prolonged stress, the physical demands of caregiving, and the biological vulnerabilities that come with age place you at risk for significant health problems as well as an earlier death.  (From “Taking Care of YOU,” Family Caregiver Alliance)

So I pulled up the reference for that statistic and found that different parts of the 1999 “Caregiver Health Effects Study” were published in various medical journals.  Below, I’ve copied the abstract of the article “Caregiving as a risk factor for mortality.”

One point made in this 1999 article was also made in the “Caregiver Burnout” PBS video:

“Primary care physicians who care for…older adults may be in the best position to identify caregivers at risk. Older married couples should be evaluated as a unit, both in terms of their health status as well as the caregiving demands that exist in the home environment.”



jama.ama-assn.org/content/282/23/2215.long   (full article available online at no charge)

JAMA. 1999 Dec 15;282(23):2215-9.

Caregiving as a risk factor for mortality: the Caregiver Health Effects Study.

Schulz R, Beach SR.
Department of Psychiatry and University Center for Social & Urban Research, University of Pittsburgh, PA 15260, USA. [email protected]

There is strong consensus that caring for an elderly individual with disability is burdensome and stressful to many family members and contributes to psychiatric morbidity. Researchers have also suggested that the combination of loss, prolonged distress, the physical demands of caregiving, and biological vulnerabilities of older caregivers may compromise their physiological functioning and increase their risk for physical health problems, leading to increased mortality.

To examine the relationship between caregiving demands among older spousal caregivers and 4-year all-cause mortality, controlling for sociodemographic factors, prevalent clinical disease, and subclinical disease at baseline.

Prospective population-based cohort study, from 1993 through 1998 with an average of 4.5 years of follow-up.

Four US communities

A total of 392 caregivers and 427 noncaregivers aged 66 to 96 years who were living with their spouses.

Four-year mortality, based on level of caregiving: (1) spouse not disabled; (2) spouse disabled and not helping; (3) spouse disabled and helping with no strain reported; or(4) spouse disabled and helping with mental or emotional strain reported.

After 4 years of follow-up, 103 participants (12.6%) died. After adjusting for sociodemographic factors, prevalent disease, and subclinical cardiovascular disease, participants who were providing care and experiencing caregiver strain had mortality risks that were 63% higher than noncaregiving controls (relative risk [RR], 1.63; 95% confidence interval [CI], 1.00-2.65). Participants who were providing care but not experiencing strain (RR, 1.08; 95 % CI, 0.61-1.90) and those with a disabled spouse who were not providing care (RR, 1.37; 95% CI, 0.73-2.58) did not have elevated adjusted mortality rates relative to the noncaregiving controls.

Our study suggests that being a caregiver who is experiencing mental or emotional strain is an independent risk factor for mortality among elderly spousal caregivers. Caregivers who report strain associated with caregiving are more likely to die than noncaregiving controls.