LONGITUDINAL ANALYSIS OF MULTIPLE INDICATORS OF HEALTH DECLINE AMONG SPOUSAL CAREGIVERS

The hazards for experiencing major health events were studied longitud inally among 150 spousal caregivers of Alzheimer's disease (AD) patien ts and 46 married control participants. Based on longitudinal assessme nts from one to six years, the hazards of reaching any of three health events (extended physical illness or disability > 1 month, unhealthy medical rating from a nurse interview, or hospitalization) were not si gnificantly different in a group comparison of caregivers to controls (Con proportional hazards assumption, p > .05). However there was a tr end [X-2(1, N = 107) = 3.13, p = .08] for caregivers to have a greater hazard for serious illness. Among caregivers only, a greater hazard f or reaching at least one of these health events was associated with pr oviding more activities of daily living (ADL) assistance [X-2(1, N = 1 25) = 3.83, p = .05] but not with problem behaviors of the AD patient (p > .05). These results suggest that providing extensive ADL assistan ce may have health implications for spousal AD caregivers, while careg iving, per se, does not. Furthermore, these physical health impacts of caregiving may be best characterized using multidimensional assessmen ts. Contrary to our guiding hypothesis, caregivers encountering more p roblem behaviors of their AD spouse were less likely to be hospitalize d, X-2(1, N = 145) = 5.88, p = .02. This finding may reflect a relucta nce by caregivers to schedule necessary medical care when their spouse s are most problematic, and this may have further long-term health imp lications for caregivers.