Does Dementia Caregiving Accelerate Frailty? Findings From the Health and Retirement Study

Abstract

Purpose of the study: Numerous studies have discovered negative health consequences associated with spousal caregiving at the end of life; however, little is known about how care-recipient cognitive status impacts caregiver health outcomes, specifically in the area of frailty, and whether health consequences remain over time. This study examines differences in frailty between spousal caregivers of persons with and without a dementia diagnosis.

Design and methods: Using 7 biannual waves of the Health and Retirement Study data (1998-2010), we examined odds of becoming frailer among surviving spouses of individuals who died between 2000 and 2010 (N = 1,246) with and without dementia. To assess increased frailty, we used a Frailty Index, which assesses chronic diseases, mobility, functional status, depressive symptoms, and subjective health. Logistic regression was used to examine the relationship between care-recipient cognitive status and whether, compared with the wave prior to death of the care-recipient, spousal caregivers were frailer: (1) in the wave the death was reported and (2) 2 years after the death was reported.

Results: Dementia caregivers had 40.5% higher odds of experiencing increased frailty by the time the death was reported and 90% higher odds in the following wave compared with non-dementia caregivers.

Implications: Given our findings, we discuss public health implications regarding the health and well-being of caregivers of persons with dementia. Given projected increases in dementia diagnoses as the population ages, we propose a need for interventions that provide enhanced support for dementia caregivers.

Keywords: Cognition; Decline; Dementia.