NIH grant: Health Trajectories During Transitions Into and Out of Caregiving in Later Life: The Role of Caregiving History (1R03AG104414-01)

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NIH grant 1R03AG104414-01: Health Trajectories During Transitions Into and Out of Caregiving in Later Life: The Role of Caregiving History
Institute: {'code': 'AG', 'abbreviation': 'NIA', 'name': 'National Institute on Aging', 'admin_org_id': '12500002', 'admin_funding_url': ''}. PI: I-Fen  Lin. Award: $78750.
Start: 2026-09-05T00:00:00.
PROJECT SUMMARY
Nearly one in four U.S. adults—about 63 million people—provide unpaid care to family or friends with health needs. More than half of these caregivers are aged 50 or older, a life stage when individuals also are facing their own age-related health challenges. Despite extensive evidence showing that caregiving can compromise health, we know surprisingly little about how caregivers’ health evolves as they enter, navigate, and exit caregiving roles, particularly across multiple dimensions of health and beyond immediate transitions. Most studies are limited by comparisons between caregivers and non-caregivers, a focus on a single health measure, or short-term assessments at just two time points: the transition into caregiving and shortly thereafter. Additionally, as the caregiver support ratio continues to decline, caregiving responsibilities are increasingly concentrated among fewer individuals, many of whom take on the role more than once in their lives. Repeated caregiving exposures may either compound health risks through cumulative strain or foster preparedness that enables caregivers to better adjust to subsequent caregiving. Yet, how prior caregiving experience shapes health trajectories during subsequent care episodes remains largely unknown as most research treats caregiving as a discrete, one-time event. Together, these gaps raise critical questions about when health risks are most acute during the caregiving episode, how these risks vary across mental, physical, and cognitive health, and whether repeated caregiving undermines or promotes health. This project addresses these gaps by linking the retrospective Life History Mail Survey with the prospective Health and Retirement Study to capture both lifetime caregiving histories and multidimensional health measures from around age 50 onward. Using event history analysis, we first identify who enters and exits caregiving roles in later life, shedding light on how prior caregiving, demographic, health, and family factors influence these transitions. For those who begin or end caregiving, we use growth mixture models to trace potentially distinct patterns of within-person changes in depressive symptoms, chronic conditions, and cognitive functioning, anchored on caregiving onset and cessation, extending beyond immediate transitions to detect longer-term health trajectories. Throughout the project, we compare health outcomes between first-time and repeat caregivers to assess how any prior caregiving experience and its various components, such as age at first caregiving, total duration, number of episodes, and overlapping caregiving (simultaneous care for multiple recipients), up until the caregiving episode observed in the HRS influence subsequent caregiver health trajectories. Findings from this project are expected to enhance our understanding of the social and behavioral drivers of aging and to improve health and well-being in later life.

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