3109.0: Monday, November 13, 2000 - 2:50 PM

Abstract #13592

A longitudinal analysis of informal care provision and women's mental health status: Analysis in the Nurses' Health Study

Carolyn C. Cannuscio, ScD1, Eric B. Rimm, ScD2, Camara P. Jones, MD, DrPH3, Ichiro Kawachi, MD, PhD4, Graham A. Colditz, MD, DrPH5, and Lisa F. Berkman, PhD4. (1) Department of Outcomes Research and Management, Merck and Co., Inc, South Broad Street and Sumneytown Pike, WP39-166, West Point, PA 19486, 215.652.0554, carolyn_cannuscio@merck.com, (2) Departments of Epidemiology and Nutrition, Harvard School of Public Health, (3) Centers for Disease Control & Prevention, 4770 Buford Highway, MS K-30, Atlanta, GA 30341, (4) Department of Health and Social Behavior, Harvard School of Public Health, (5) Department of Epidemiology and Channing Laboratory, Harvard School of Public Health, Harvard Medical School, and Brigham and Women's Hospital

The National Alliance for Caregiving reports that informal care was provided in more than 22.4 million U.S. homes in 1997. We conducted a longitudinal study to assess whether new caregivers would exhibit an elevation in depressive symptoms, relative to non-caregivers. Participants were members of the Nurses' Health Study, who were married registered nurses between the ages of 30-55 and living in one of 11 states at enrollment in 1976 (n=121,700). This analysis of 1992 and 1996 data includes 37,725 women who were married through 1996 and free at baseline from major disease or depressive symptoms. Mental health was measured using the Short Form-36 (SF-36) Mental Health Index.

Among new caregivers for disabled spouses/parents, we observed a decline in mental health and an increase in depressive symptoms. There was a dose-response relation between spouse care time commitment and depressive symptoms (b=0.34, p<.0001). Women who provided 36+ weekly hours of spouse care were six times more likely than non-caregivers to exhibit depressive symptoms (multivariate OR=5.8, 95% CI 3.8, 8.6). Notably, the association for providing care to a parent was not as strong (multivariate OR for 36+ hours=2.0, 95% CI 0.9, 4.3). Cross-sectionally, the combination of high time commitment (i.e., 36+ hours/week of spouse care) and social isolation was strongly associated with depressive symptoms (multivariate OR=11.8, 95% CI 4.8, 28.9).

Health care providers and policymakers must develop a long-term care infrastructure that supports informal caregivers and assures access to high-quality care for those who need it.

Learning Objectives: After participating in this session, attendees will be able to: 1) Identify the magnitude of mental health risk associated with informal care provision to a disabled or ill family member; 2) Cite factors that influence the association between informal care provision and mental health status (e.g., caregiving time commitment, relationship to care recipient, access to social ties); 3) Access important longitudinal data to fuel discussion regarding the nation's long-term care agenda

Keywords: Caregivers, Mental Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA