Spousal Caregiving Is Associated with an Increased Risk of Frailty: A Case-Control Study

BACKGROUND: Evidence suggests that providing care for a disabled elderly person may have implications for the caregiver's own health (decreased immunity, hypertension, and depression).

OBJECTIVE: Explore if older spousal caregivers are at greater risks of frailty compared to older people without a load of care.

DESIGN: Case-control study.

SETTING: Participants were assessed at home in Wallonia, Belgium.

PARTICIPANTS: Cases: community-dwelling spousal caregivers of older patients, recruited mainly by the geriatric outpatient clinic.

CONTROLS: people living at home with an independent spouse at the functional and cognitive level matched for age, gender and comorbidities.

MEASUREMENTS: Mini nutritional assessment-short form (MNA-SF), short physical performance battery (SPPB), frailty phenotype (Fried), geriatric depression scale (GDS-15), clock drawing test, sleep quality, and medications. The multivariable analysis used a conditional logistic regression.

RESULTS: Among 79 caregivers, 42 were women; mean age and Charlson comorbidity index were 79.4±5.3 and 4.0±1.2, respectively. Among care-receivers (mean age 81.4±5.2), 82% had cognitive impairment. Caregiving was associated with a risk of frailty (Odd Ratio (OR) 6.66; 95% confidence interval (CI) 2.20-20.16), the consumption of antidepressants (OR 4.74; 95% CI 1.32 -17.01), shorter nights of sleep (OR 3.53; 95% CI 1.37-9.13) and more difficulties maintaining a social network (OR 5.25; 95% CI 1.68-16.40).

CONCLUSIONS: Spousal caregivers were at an increased risk of being frail, having shorter nights of sleep, taking antidepressants and having difficulties maintaining their social network, compared to non-caregiver controls. Older spousal caregivers deserve the full attention of professionals to prevent functional decline and anticipate a care breakdown.