Age-dependency in mortality of family caregivers: a nationwide register-based study
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ORIGINAL ARTICLE
Age‑dependency in mortality of family caregivers: a nationwide register‑based study Tuija M. Mikkola1,2 · Hannu Kautiainen1,3 · Minna Mänty4,5 · Mikaela B. von Bonsdorff1,6 · Teppo Kröger7 · Johan G. Eriksson1,8,9,10 Received: 28 July 2020 / Accepted: 26 September 2020 © The Author(s) 2020
Abstract Background Evidence on family caregivers’ health is conflicting. Aim To investigate all-cause and cause-specific mortality in Finnish family caregivers providing high-intensity care and to assess whether age modifies the association between family caregiver status and mortality using data from multiple national registers. Methods The data include all individuals, who received family caregiver’s allowance in Finland in 2012 (n = 42,256, mean age 67 years, 71% women) and a control population matched for age, sex, and municipality of residence (n = 83,618). Information on dates and causes of death between 2012 and 2017 were obtained from the Finnish Causes of Death Register. Results Family caregivers had lower all-cause mortality than the controls over the follow-up (8.1 vs. 11.6%) both among women (socioeconomic status adjusted hazard ratio [HR]: 0.64, 95% CI 0.61–0.68) and men (adjusted HR: 0.73, 95% CI 0.70–0.77). When modelling all-cause mortality as a function of age, younger caregivers had only slightly lower or equal mortality to their controls, but older caregivers had markedly lower mortality than their controls, up to more than 10% lower. Caregivers had a lower mortality rate for all the causes of death studied, namely cardiovascular, cancer, neurological, external, respiratory, gastrointestinal and dementia. The lowest risk was for dementia (subhazard ratio = 0.29, 95% CI 0.25–0.34). Conclusions Older family caregivers had lower mortality than the age-matched general population while mortality did not differ according to caregiver status in young adulthood. This age-dependent advantage in mortality is likely to reflect the selection of healthier individuals into the family caregiver role. Keywords Informal caregiver · Family caregiver · Mortality · Cause of death · Register-based study · Aging
Introduction Family caregivers, that is those who take care of their relatives or loved ones because of an illness, disability or other specific need for care, form an important source of care in many societies, if not in all societies. A family caregiver can take care of, for example, his/her chronically ill spouse, child with a disability or an older neighbour. As the global population ages the importance of family caregiving is increasing at the societal level. It has been estimated that family caregivers provide the vast majority of long-term care in OECD countries while formal long-term care services only form "the tip of an iceberg" [1, 2]. To promote the continuity of * Tuija M. Mikkola [email protected] Extended author information available on the last page of the article
care in the society and the well-being of the family caregivers, it is important to study the heal
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