Abstract MP102: Family Caregiving is Associated with Increased Stroke Risk Among Strained Spouse Caregivers

Abstract

Background: As the American population ages, the number of family caregivers is expected to increase. Consequently, understanding the effects family caregiving has on the cardiovascular health of caregivers presents an important public health concern. Previous studies have observed associations between family caregiving and adverse cardiovascular health outcomes such as hypertension, coronary heart disease, and an increased Framingham Stroke Risk Score. However, the association between family caregiving and stroke risk is poorly understood. Hypothesis: We examined the association between family caregiving and risk of incident stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study to test the hypotheses that 1) family caregivers have higher risk of stroke compared to noncaregivers and 2) strained caregivers have higher risk of stroke compared to noncaregivers. Methods: The REGARDS study enrolled black and white participants, aged 45 and older, from 2003-2007. Participants were categorized as caregivers if they answered affirmatively to the baseline interview question, “Are you currently providing care on an on-going basis to a family member with a chronic illness or disability?” Caregivers were asked their relationship to the care recipient and the amount of perceived physical and mental strain they associated with care (none, some, a lot). Using a propensity score matching procedure based on 16 demographic, lifestyle, and stroke risk factors, caregivers (n=3,055) were individually matched with noncaregivers (n=3,055). Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incident stroke risk were calculated using Cox proportional hazards models. Results: During an average 8.5-year follow up period, 114 (3.73%) caregivers and 112 (3.67%) matched noncaregivers had an incident stroke. Caregivers did not have a higher risk of stroke compared to non-caregivers (HR=1.006, 95% CI=0.775, 1.306). The HRs (95% CIs) for incident stroke risk were 1.427 (0.938, 2.171) for caregivers reporting no caregiving strain, 0.918 (0.628, 1.341) for moderate strain, and 1.963 (0.977, 3.946) for high strain. Strained spouse caregivers who reported high or moderate strain had a 95% higher risk of stroke than matched noncaregivers (HR=1.958, 95% CI=1.002, 3.828). Conclusion: We observed that perceived caregiving strain, particularly among spouse caregiviers, is associated with increased risk of stroke. This group of caregivers may need targeted support. Further studies examining the nuanced effects of caregiver burden on cardiovascular health are required.