title: Caregiving, metabolic syndrome indicators, and 1-year decline in walking speed: results of Caregiver-SOF.
abstract: BACKGROUND
  Chronic stress may lead to health decline through metabolic syndrome. Thus, persons in stressful caregiving situations who also have more indicators of metabolic syndrome may experience more decline than other caregivers or noncaregivers.
  
  
  METHODS
  The sample included 921 women (338 caregivers and 583 noncaregivers) from the Caregiver-Study of Osteoporotic Fractures study. Participants had home-based baseline and 1-year follow-up interviews between 1999 and 2003. At baseline, caregivers were categorized as long term ((3)4 years) versus short term (<4 years), and caring for someone with Alzheimer's disease/dementia or not. A metabolic risk composite score was the sum of four indicators: body mass index (3)30, and diagnosis or using medications for hypertension, diabetes, or high cholesterol. Walking speed (m/second) was measured at both interviews.
  
  
  RESULTS
  Walking speed declined for the total sample (adjusted mean = -0.005 m/second, +/-0.16) over an average of 1.04 years (+/-0.16). Overall, caregiving was not associated with decline. Increasing metabolic risk score was associated with greater decline for the total sample and long-term and dementia caregivers, but not other caregivers or noncaregivers. Metabolic risk score modified the adjusted associations between years of caregiving and dementia caregiving with walking speed decline (p values for interaction terms were 0.039 and 0.057, respectively). The biggest declines were in long-term caregivers and dementia caregivers who also had 3-4 metabolic indicators (-0.10 m/second and -0.155 m/second, respectively).
  
  
  CONCLUSIONS
  Walking speed declined the most among older women who had both stressful caregiving situations and more metabolic syndrome indicators, suggesting these caregiver subgroups may have increased risk of health decline.
authors.affiliation: Department of Epidemiology, Boston University School of Public Health. 715 Albany Street, Boston, MA 02118, USA. lfredman@bu.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Fredman
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Doros
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Hillier
authors.forename: Marc C
authors.initials: MC
authors.lastname: Hochberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D017028:Caregivers / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D007407:Interviews as Topic; D024821:Metabolic Syndrome / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D013997:Time Factors; D016138:Walking / Q000502:physiology* / Q000523:psychology