Differential effect of caregiving across age-groups: a census-based record linkage study

Foteini Tseliou; Michael Rosato; Aideen Maguire; David Wright; Dermot O'Reilly

doi:10.1016/S0140-6736(17)33025-8

Abstract

Background

Previous studies and reports have highlighted the effect of caregiving responsibilities on caregivers. However, the predominance of older caregivers and the exponential increased risk of death with age has led to the under-representation of young carers. This study aimed to investigate the association between caregiving and physical or mental health, and mortality risk among young carers compared with both their non-caregiving peers and older caregivers.

Methods

This was a census-based record linkage study of data on all residents enumerated in the 2011 Northern Ireland Census (providing self-reported assessment of chronic physical and mental health conditions) with subsequently registered mortality information until the end of 2015. The sample consisted of 433 328 individuals aged 5–24 years, with about 19 621 of the cohort (4·5%) reporting that they were providers of informal care. Logistic regression models adjusted for demography (age, sex, ethnicity), household (tenure, care availability), and area variables (urbanicity, deprivation). Cox regression further adjusted for physical and mental health.

Findings

Intense caregiving was associated with worse physical health among caregivers aged 5–17 years (odds ratio 1·61, 95% CI 1·16–2·23), but better physical health among those aged 18 or older (0·86, 0·69–1·08). A positive and dose-response association was observed between caregiving status and mental ill-health, with the effect being more evident among 5–17 year-olds than 18–24 year-olds. There is sufficient evidence to suggest that young caregivers differ from older care givers in terms of mortality risk (p<0·0001). In contrast to the association at older ages, caregiving in younger people was associated with an increased mortality risk (adjusted hazard ratio 1·54, 95% CI 1·10–2·14).

Interpretation

This population-based study shows that caregiving among young people, in contrast to their older peers, is associated with an increased mortality risk. A cross-sectional association with poor mental health is also demonstrated.

Original language	English
Pages (from-to)	S90
Number of pages	1
Journal	The Lancet
Volume	390
Issue number	Supplement 3
DOIs	https://doi.org/10.1016/S0140-6736(17)33025-8
Publication status	Published - Nov 2017

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title = "Differential effect of caregiving across age-groups: a census-based record linkage study",

abstract = "BackgroundPrevious studies and reports have highlighted the effect of caregiving responsibilities on caregivers. However, the predominance of older caregivers and the exponential increased risk of death with age has led to the under-representation of young carers. This study aimed to investigate the association between caregiving and physical or mental health, and mortality risk among young carers compared with both their non-caregiving peers and older caregivers.MethodsThis was a census-based record linkage study of data on all residents enumerated in the 2011 Northern Ireland Census (providing self-reported assessment of chronic physical and mental health conditions) with subsequently registered mortality information until the end of 2015. The sample consisted of 433 328 individuals aged 5–24 years, with about 19 621 of the cohort (4·5%) reporting that they were providers of informal care. Logistic regression models adjusted for demography (age, sex, ethnicity), household (tenure, care availability), and area variables (urbanicity, deprivation). Cox regression further adjusted for physical and mental health.FindingsIntense caregiving was associated with worse physical health among caregivers aged 5–17 years (odds ratio 1·61, 95% CI 1·16–2·23), but better physical health among those aged 18 or older (0·86, 0·69–1·08). A positive and dose-response association was observed between caregiving status and mental ill-health, with the effect being more evident among 5–17 year-olds than 18–24 year-olds. There is sufficient evidence to suggest that young caregivers differ from older care givers in terms of mortality risk (p<0·0001). In contrast to the association at older ages, caregiving in younger people was associated with an increased mortality risk (adjusted hazard ratio 1·54, 95% CI 1·10–2·14).InterpretationThis population-based study shows that caregiving among young people, in contrast to their older peers, is associated with an increased mortality risk. A cross-sectional association with poor mental health is also demonstrated.",

author = "Foteini Tseliou and Michael Rosato and Aideen Maguire and David Wright and Dermot O'Reilly",

year = "2017",

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doi = "10.1016/S0140-6736(17)33025-8",

language = "English",

volume = "390",

pages = "S90",

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publisher = "Elsevier Limited",

number = "Supplement 3",

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TY - JOUR

T1 - Differential effect of caregiving across age-groups: a census-based record linkage study

AU - Tseliou, Foteini

AU - Rosato, Michael

AU - Maguire, Aideen

AU - Wright, David

AU - O'Reilly, Dermot

PY - 2017/11

Y1 - 2017/11

N2 - BackgroundPrevious studies and reports have highlighted the effect of caregiving responsibilities on caregivers. However, the predominance of older caregivers and the exponential increased risk of death with age has led to the under-representation of young carers. This study aimed to investigate the association between caregiving and physical or mental health, and mortality risk among young carers compared with both their non-caregiving peers and older caregivers.MethodsThis was a census-based record linkage study of data on all residents enumerated in the 2011 Northern Ireland Census (providing self-reported assessment of chronic physical and mental health conditions) with subsequently registered mortality information until the end of 2015. The sample consisted of 433 328 individuals aged 5–24 years, with about 19 621 of the cohort (4·5%) reporting that they were providers of informal care. Logistic regression models adjusted for demography (age, sex, ethnicity), household (tenure, care availability), and area variables (urbanicity, deprivation). Cox regression further adjusted for physical and mental health.FindingsIntense caregiving was associated with worse physical health among caregivers aged 5–17 years (odds ratio 1·61, 95% CI 1·16–2·23), but better physical health among those aged 18 or older (0·86, 0·69–1·08). A positive and dose-response association was observed between caregiving status and mental ill-health, with the effect being more evident among 5–17 year-olds than 18–24 year-olds. There is sufficient evidence to suggest that young caregivers differ from older care givers in terms of mortality risk (p<0·0001). In contrast to the association at older ages, caregiving in younger people was associated with an increased mortality risk (adjusted hazard ratio 1·54, 95% CI 1·10–2·14).InterpretationThis population-based study shows that caregiving among young people, in contrast to their older peers, is associated with an increased mortality risk. A cross-sectional association with poor mental health is also demonstrated.

AB - BackgroundPrevious studies and reports have highlighted the effect of caregiving responsibilities on caregivers. However, the predominance of older caregivers and the exponential increased risk of death with age has led to the under-representation of young carers. This study aimed to investigate the association between caregiving and physical or mental health, and mortality risk among young carers compared with both their non-caregiving peers and older caregivers.MethodsThis was a census-based record linkage study of data on all residents enumerated in the 2011 Northern Ireland Census (providing self-reported assessment of chronic physical and mental health conditions) with subsequently registered mortality information until the end of 2015. The sample consisted of 433 328 individuals aged 5–24 years, with about 19 621 of the cohort (4·5%) reporting that they were providers of informal care. Logistic regression models adjusted for demography (age, sex, ethnicity), household (tenure, care availability), and area variables (urbanicity, deprivation). Cox regression further adjusted for physical and mental health.FindingsIntense caregiving was associated with worse physical health among caregivers aged 5–17 years (odds ratio 1·61, 95% CI 1·16–2·23), but better physical health among those aged 18 or older (0·86, 0·69–1·08). A positive and dose-response association was observed between caregiving status and mental ill-health, with the effect being more evident among 5–17 year-olds than 18–24 year-olds. There is sufficient evidence to suggest that young caregivers differ from older care givers in terms of mortality risk (p<0·0001). In contrast to the association at older ages, caregiving in younger people was associated with an increased mortality risk (adjusted hazard ratio 1·54, 95% CI 1·10–2·14).InterpretationThis population-based study shows that caregiving among young people, in contrast to their older peers, is associated with an increased mortality risk. A cross-sectional association with poor mental health is also demonstrated.

U2 - 10.1016/S0140-6736(17)33025-8

DO - 10.1016/S0140-6736(17)33025-8

M3 - Meeting abstract

VL - 390

SP - S90

JO - Lancet

JF - Lancet

SN - 0140-6736

IS - Supplement 3

ER -

Differential effect of caregiving across age-groups: a census-based record linkage study

Abstract

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