Background: Caregiving is commonly undertaken by older, postmenopausal women, and is thought to have both beneficial and adverse consequences. However, findings from studies that test associations between caregiving and mortality have been inconsistent. Using a large prospective cohort, we examined the association of caregiving with mortality among postmenopausal women.

Methods: Participants were 158,987 postmenopausal women from the Women’s Health Initiative (WHI), aged 50-79 years who provided information on current caregiving status and frequency of caregiving activities at baseline (1993-1998) and follow-up (2004-2005). Mortality was determined from baseline through March 2019 (mean follow-up = 17.5 years). Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations of caregiving status (as a time-varying exposure) with mortality, adjusting for sociodemographic factors, history of smoking, and diabetes, hypertension, and history of cardiovascular disease (CVD) and cancer.

Results: At study baseline, 40.7% of women (mean age=63.3 years) reported being a caregiver. Women who were caregivers had 9% lower all-cause mortality in multivariable models (HR=0.91, 95% CI 0.89-0.93) compared to non-caregivers. The association of caregiving status and weekly reported frequency of caregiving with all-cause mortality did not differ significantly by age, depressive symptoms, or optimism (P-value, test for interaction >0.05-all analyses). Associations for caregiving status with CVD and cancer mortality were similarly associated with lower mortality.

Discussion: Among postmenopausal women participating in the WHI, caregiving was associated with lower mortality. Studies detailing type and amount of caregiving are needed to further determine the impact of caregiving in older women.