February 21, 2006
Older people who care for a loved one with Alzheimer's disease or other serious illnesses are more likely to die prematurely, a nine-year study in a large number of seniors shows. The findings have important implications for the estimated five million Americans who currently care for someone with Alzheimer's disease. Many more people are expected to assume caregiving roles in the coming years as the population continues to age and more seniors become afflicted with Alzheimer's disease and other grave ailments.
Studying 518,240 older couples (ages 65 to 98) enrolled in Medicare, researchers at Harvard University found that spouses whose loved one entered the hospital as a result of particular ailments, including dementia, were 20 percent more likely to die within 30 days than those whose husbands and wives were in good health. The increased risk of death persisted, even two years later. "You can die of a broken heart, not just when your partner dies, but also when your partner falls ill," says Nicholas Christakis, co-author of the study, which was published in the New England Journal of Medicine. "People are interconnected and their health is, too."
Only certain medical problems that affect the body or mind, including Alzheimer's and other forms of dementia, strokes, or hip fractures, increased mortality risk. For example, the hospitalization of a wife for a hip fracture increases her husband's chances of death by 15 percent, and by 22 percent if she has dementia. For other diseases, such as leukemia, lung, or colon cancer, there was no increased risk of death for the non-ailing spouse.
The authors attribute the increase in risk to a range of factors, including increased stress and the loss of social, emotional, and financial support when a loved one falls ill or dies. Some caregivers may turn to alcohol when their partners fall ill, they note. Others may suffer because of problems like poor hearing or eyesight or fading memory.
The findings are consistent with earlier research showing that Alzheimer's caregiving, a job that can easily consume 100 hours a week or more, may be hazardous to your health. Not only is caring for a spouse or family member with Alzheimer's incredibly stressful, leading to emotional distress and depression. It can also impair physical well-being. Men and women who care for a family member or spouse with dementia, for example, are more susceptible to gum disease and infections, and also have higher levels of stress hormones and poorer general health.
Experts urge that caregivers take measures to help minimize the physical and emotional stresses of caring for a loved with Alzheimer's. Researchers at New York University School of Medicine have shown that a targeted program of counseling and support services can do much to allay feelings of depression, isolation, and stress, offering benefits that may last for years. Counseling is not only effective in alleviating caregiver emotional distress, it can also significantly extend the time that caregivers can keep loved ones with Alzheimer's at home, rather than feeling compelled to place them in a nursing home or hospital. [See the article, "Social Support and Counseling Help Ease the Burden of Caregiving".]
"The training and assistance of spouses who serve as caregivers can lower costs and also improve the health of patients and partners alike," the authors of the current study write. "Our work suggests that such interventions might even decrease mortality among partners. Our work also suggests that such interventions are especially likely to be useful in certain diseases, such as stroke and dementia."
www.Alzinfo.org, offers a wealth of expert advice on caring for a loved one with Alzheimer's.
Nicholas A. Christakis, M.D., Ph.D., M.P.H., and Paul D. Allison: "Mortality after the Hospitalization of a Spouse." The New England Journal of Medicine, Volume 354, Number 7, February 16, 2006, pages 719-730.