- Email: [email protected]
Grand-parenting for healthy ageing in women: Fact or fiction?
Maturitas 92 (2016) 130–133
Contents lists available at ScienceDirect
Maturitas journal homepage: www.elsevier.com/locate/maturitas
Grand-parenting for healthy ageing in women: Fact or fiction? a r t i c l e
i n f o
Keywords: Grandparent Healthy ageing Grandparenting Women’s health Mental health Cognition Mood Quality of life
a b s t r a c t Globally our populations are ageing and with this trend, there is a rise in chronic disease. We know that lifestyle and environment are significant contributors to risk for disease, quality of life and function. Despite this representing an opportunity to improve health and quality of life in ageing, there is a paucity of research in this field. The social aspects of this period of development which have been most researched include employment, function and disability. Grand-parenting is one of the most popular sources of childcare in the world and therefore research investigating this role is of vital significance. © 2016 Elsevier Ireland Ltd. All rights reserved.
1. The importance of grandparents to families Never before in our history has there been a majority of adults over 40 having living parents. Children today will know their grandparents and even their great-grandparents. There is an increase in grandparents, particularly grandmothers, taking on the care of their grandchildren throughout the world. Financial strain on families has resulted in a rising number of parents obliged to take on full-time employment. In Western countries, the low availability and/or high cost of childcare means that grandparents are often the best alternative for working parents [1]. In other parts of the world, multigenerational households are common, and grandparents are intrinsic to family function and structure. In some countries with high rates of parental absence or death, orphans are often cared for by grandparents [2]. Grandparents now represent a large proportion of childcare around the world and more adult children are living with their older parents than ever before [3]. Therefore the impact of caregiving responsibility on ageing health and well-being is important to examine. 2. The pros and cons of grand-parenting Being a grandparent encompasses a number of features that makes the role both rewarding and challenging. Grandparents and grandchildren share a unique bond which can be mutually beneficial. Grandchildren receive particular love and attention from their grandparents that is outside of what would be expected in a formal childcare arrangement [4], whilst grandparents are offered an opportunity to engage in stimulating activities that can promote health. In addition, the ability to watch your grandchildren thrive and grow and to be involved in that process is singularly fulfilling for a grandparent. However, some concerns have been raised http://dx.doi.org/10.1016/j.maturitas.2016.07.004 0378-5122/© 2016 Elsevier Ireland Ltd. All rights reserved.
about commencing what can be viewed as a “second parenthood” phase at a time when many older adults are experiencing a rise in morbidity and are otherwise winding down their responsibilities [5].
3. Current research on grandparents Research on grand-parenting has found a number of effects on physical and emotional health in ageing (see Table 1). Whilst there are positive effects on mood, social inclusion and cognition the amount of time spent with grandchildren is an important factor. Highly frequent grand-parenting can be associated with stress which can negate positive effects. While spending time with grandchildren can have benefits for healthy ageing, too much can be detrimental. The effects on physical and emotional health in ageing are therefore largely dependent upon the context and intensity of the care required. Prolonged periods of care, greater than five days per week in Australia and associated with co-resident care in China and the USA, were associated with increased stress, feelings of time restraints, poorer mental health and an associated decline in cognition. Taking on the sole-carer role clearly only includes high intensity and duration care and research has focussed on African-Americans and those from Subsaharan Africa. These studies represent two groups, grandparents caring for orphaned grandchildren as a result of the AIDS epidemic and grandmothers obliged to take on fulltime care due to the absence of their children as a result of death, incarceration or substance abuse. Amongst those grandparents in Subsaharan Africa, personal resilience and social and financial resources were seen as beneficial. Poor physical health was a particular concern amongst African-American carers, potentially due to some who, despite lacking the physical and personal resources,
Grand-parenting for healthy ageing in women: Fact or fiction? / Maturitas 92 (2016) 130–133
131
Table 1 Summary of the key findings of various studies investigating the impacts of grandparenting on health and wellbeing. Articles were obtained from the previous decades review (Silverstein, M. and R. Giarrusso, Aging and Family Life: A Decade Review. J Marriage Fam, 2010. 72(5): p. 1039–1058.) in addition to a PubMed search conducted using the term “grandparent”, restricting to human studies within the last 5 years which produced 384 results. “Caregiving” was added to the search term, limiting results to 31 items. A total of 25 studies relevant to the current topic are outlined. Reference
Study Period
Key findings
Casual Grand-parenting Cross-Sectional Anderson, S. G., et al. (2013). J Women Aging, 25(3), 242–259
XS
High reports of enjoyment &psychological benefits caring for grandchildren, difficulties such as age-related constrictions and time restraints. Minding grandchildren associated with higher verbal fluency Negative association between frequency of grandparenting and cognition Regular grandparenting predicted lower participation in other social activities Grandparents who were primary caregivers had poorer mental health than other caregivers Caring for grandchildren lowers subjective age in adults over 75 Peak cognitive performance associated with grandparenting one day per week Minding grandchildren predicted better cognitive function High-frequency predicted poorer cognition and increase in demands Grandparents minding grandchildren report higher stress levels than non-caregivers Grandparents report that caring for grandchildren provides happiness and purpose. Less privacy and time for other relationships − time constraints Grandparents reported lower stress and greater wellbeing is they received support from friends and the community Poorer physical and emotional health in custodial grandparents compared to single parents Grandparenting associated with greater life satisfaction
Arpino, B., & Bordone, V. (2014). European Demographic Research Papers, 76(2), 337–351.
XS
Arpino, B., & Bordone, V. (2016). Review of Economics of the Household, 1–40. Bigbee, J. L., et al. (2011). J Rural Health, 27(3), 2089-296.
XS XS
Bordone, V., & Arpino, B. (2015). Journal of Aging and Health, 0898264315618920. Burn, K. F., Ames, D., Henderson, V. W., Dennerstein, L., & Szoeke, C. (2014). Menopause, 21(10), 1069–1074. Burn, K. F., Ames, D., Henderson, V. W., Dennerstein, L., & Szoeke, C. (2014). Climacteric, 17(S1), 39.
XS
Musil, C. M., & Ahmad, M. (2002). Journal of Aging and Health, 14(1), 96–121. Pruchno, R. (1999). The Gerontologist, 39(2), 209–221.
XS
Sands, R. G., Goldberg-Glen, R., & Thornton, P. L. (2005). Journal of Gerontological Social Work, 45(4), 65–82. Whitley, D. M., & Fuller-Thomson, E. (2015). American Journal of Men’s Health, 1–13. Whitley, D. M., Kelley, S. J., & Sipe, T. A. (2001). Health & Social Work, 26(2), 105–114. Longitudinal Blustein, J., Chan, S., & Guanais, F. C. (2004). Health Services Research, 39(6p1), 1671–1690. Chen et al. (2015). J Gerontol B Psychol Sci Soc Sci, 70(5), 793–803.
XS XS
XS
XS XS XS
6 years 12 years
Chen, F. & Liu, G. (2012). J Gerontol B Psychol Sci Soc Sci, 67(1), 99–112.
15 years
Song, L., & Li, L. (2014). Paper presented at the XVIII ISA World Congress of Sociology, Yokohama, Japan.
11 years
Tsai, F.-J., Motamed, S., & Rougemont, A. (2013). BMC Public Health, 13(1), 567–575. Xu, L., et al. (2012). Fam Community Health, 35(4), 287–299.
14 years
Primary Carer-role Grand-parenting Cross-Sectional Crowther, M. R. et al. (2015). Ageing Ment Health, 19(9), 844–852.
8 years
XS
Kelley, S. J. (2013). Res Nurs Health, 36(4), 373–385.
XS
Ice, G. H., et al. (2012). Soc Sci Med, 74(12), 2020–2027.
XS
Mhaka-Mutepfa, M., et al. (2015). J Aging Health, 27(3), 454–479. Mhaka-Mutepfa, M., et al. (2014). Health Care Women Int, 35(7–9), 1022–1039. Shaibu, S. (2013). J Nurs Scholarsh, 45(4), 363–370.
XS
XS
Sprang, G., et al. (2015). Aging Ment Health, 19(4), 315–324.
XS
XS
feel obliged to take on a greater intensity of care than they would have chosen. Universal health and wellbeing benefits, irrespective of the duration and context, were reported with grand-parenting in
+/−
+
− − + + +/−
− +/−
+ − +
Full-time grandparents have higher probability of depressive symptoms Caring reduced frailty, Coresidence resulted in health deterioration Financial and social resources and higher frequency determine outcome Grandparents in three generation households show more rapid decline in health. Lower intensity grandparenting has protective effect on health Positive relationship between grandparenting and cognition overall Decrements in cognition associated with intense grandparenting Living with grandchildren protects against depression and loneliness more than other familial relationships Decreasing grandparenting intensity led to increased life satisfaction over time
−
Rewards/gains most common theme reported by custodial grandparents Some challenges reported, such as feeling overwhelmed, health concerns interfering with abilities 40% of caregiving grandmothers reported elevated psychological distress levels. Grandparental caregivers had higher perceived stress than non-caregivers. High personal and social assets increased resilience in grandparent caregivers Personal and social assets related to better physical and mental health in custodial grandparents Caring for grandchildren fraught with difficulties, especially financial issues and poor health. Child-grandparent conflicts associated with lower emotional wellbeing in custodial grandparents
+/−
+/−
+/−
+/−
+
− − +/− +/− − −
Taiwan, and in the United States improved abstinence behaviours in those with alcohol and drug problems was noted, presumably due to the focus on the needs of others and the requirement for sobriety when caring for children.
132
Grand-parenting for healthy ageing in women: Fact or fiction? / Maturitas 92 (2016) 130–133
160
Number of publications
140 120 100 80 60 40 20 0 1995
2000
2005 Publication Year
2010
2015
Fig. 1. A Medline trend analysis was conducted of all PubMed publications using the search term “grandparents”. The number of publications related to the search term are shown by year.
In summary the findings suggest that how a grandparent feels towards their responsibilities may be a key consideration when studying their impact on health. Caring for children requires significant physical and emotional investment. What may be physically or emotionally achievable for one grandparent may be unfeasible for another. There are also a number of elements of this role that may influence the outcome, such as how many grandchildren are being minded, the age of the grandchildren, and the types of activities that are undertaken with them. Understanding the subjective experience and the intricacies of this unique social role is vital to interpreting its effects. Older age is also a time when morbidity can accrue with reduced likelihood to take on new or additional roles. Elderly parents may move in with their adult children due to frailty or cognitive impairment, but at the same time have greater contact with their grandchildren. This area of research is growing. A PubMed search for the term “grandparents” demonstrated a clear increase in the number of studies in the literature each year, particularly in the last decade (Fig. 1). This is timely, as recent figures demonstrate that grandparents are one of the most popular sources of childcare in the Western world [1]. While studies in this area are now increasing, research is still limited. Earlier work on grand-parenting largely consisted of small, qualitative studies, and while studies from the past decade have been quantitative, these studies are predominantly crosssectional. With older populations, the chronic diseases of ageing are increasing in prevalence. These diseases have long prodromes and therefore long follow-up is required to understand impact. Longitudinal, quantitative studies are needed if we are to ascertain the effects of this social role on healthy ageing. 4. Conclusions There is emerging evidence that grand-parenting is associated with active and healthy ageing. This is a complex social activity and aspects of the role are relevant to caregiving research, which has outlined the importance of caregiver stress and burden of care. Individuals should choose the best grand-parenting arrangement for them, in consideration of the demonstrated health and social gains, but also mindful of the demands in order to optimise benefits. The early findings highlight the need for quantitative longitudinal research in ageing and the many varied roles that impact health in order to make clear recommendations to the wider commu-
nity. In particular grand-parenting by men is under-researched and increasingly relevant in the future where we expect to see more gender balance in childcare engagement. Conflict of interest S.C. and K.B. have no conflict of interest to declare. C.S. has provided clinical consultancy and been on scientific advisory committees for the Australian Commonwealth Scientific and Industrial Research Organisation, Alzheimer’s Australia, University of Melbourne and other relationships which are subject to confidentiality clauses. She has been a named Chief Investigator on investigator-driven collaborative research projects in partnership with Pfizer, Merck, Bayer and GE. She has been an investigator on clinical trials with Lundbeck within the last 2 years. The Healthy Ageing Program has received support from National Health and Medical Research Council, Alzheimer’s Association, Collier Trust, Scobie and Claire Mackinnon Foundation, JO and JR Wicking Trust, Shepherd Foundation, Brain Foundation, Mason Foundation, Ramaciotti Foundation, Alzheimer’s Australia, and The Royal Australian College of Physicians. She may accrue revenues from patents in pharmacogenomics prediction of seizure recurrence. Contributors S.C. wrote the manuscript and edited the final version. K.B. was responsible for completion of the original table and the systematic review. C.S. was responsible for the study design, wrote the manuscript and edited the final version. Provenance and peer review This article is commissioned; not externally peer reviewed. Acknowledgements Support for the Healthy Ageing Program (HAP) has been provided by the Australian Healthy Ageing Organisation and the Ramaciotti Foundation. The Principal Investigator of HAP (C.S.) is supported by the National Health and Medical Research Council (547500, 1032350 & 1062133).
Grand-parenting for healthy ageing in women: Fact or fiction? / Maturitas 92 (2016) 130–133
References [1] P.F. Adams, P.M. Barnes, Summary health statistics for the U.S. population: national health interview survey, 2004, Vital Health Stat. 10 (229) (2006) 1–104. [2] UNICEF, Africa’s Orphaned Generation, U.s. H.A. Unit, Editor. 2003: United Nations Children’s Fund. [3] K. Burn, C. Szoeke, Boomerang families and failure-to-launch: commentary on adult children living at home, Maturitas 83 (1) (2016) 9–12. [4] J. Wheelock, K. Jones, ‘Grandparents are the next best thing’: informal childcare for working parents in urban Britain, J. Soc. Policy 31 (03) (2002) 441–463. [5] M. Silverstein, R. Giarrusso, Aging and family life: a decade review, J. Marriage Fam. 72 (5) (2010) 1039–1058.
Dr. Stephen Campbell (FRACP) Katherine Burn (BPsych) Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
133
Prof. Cassandra Szoeke (PhD) a,b,∗ a Department of Medicine, University of Melbourne, Parkville, Victoria, Australia b Institute for Health and Ageing, Melbourne, Victoria, Australia ∗ Corresponding
author at : P.O. Box 2026, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia E-mail address: [email protected] (C. Szoeke) 2 July 2016 7 July 2016
Contents lists available at ScienceDirect
Maturitas journal homepage: www.elsevier.com/locate/maturitas
Grand-parenting for healthy ageing in women: Fact or fiction? a r t i c l e
i n f o
Keywords: Grandparent Healthy ageing Grandparenting Women’s health Mental health Cognition Mood Quality of life
a b s t r a c t Globally our populations are ageing and with this trend, there is a rise in chronic disease. We know that lifestyle and environment are significant contributors to risk for disease, quality of life and function. Despite this representing an opportunity to improve health and quality of life in ageing, there is a paucity of research in this field. The social aspects of this period of development which have been most researched include employment, function and disability. Grand-parenting is one of the most popular sources of childcare in the world and therefore research investigating this role is of vital significance. © 2016 Elsevier Ireland Ltd. All rights reserved.
1. The importance of grandparents to families Never before in our history has there been a majority of adults over 40 having living parents. Children today will know their grandparents and even their great-grandparents. There is an increase in grandparents, particularly grandmothers, taking on the care of their grandchildren throughout the world. Financial strain on families has resulted in a rising number of parents obliged to take on full-time employment. In Western countries, the low availability and/or high cost of childcare means that grandparents are often the best alternative for working parents [1]. In other parts of the world, multigenerational households are common, and grandparents are intrinsic to family function and structure. In some countries with high rates of parental absence or death, orphans are often cared for by grandparents [2]. Grandparents now represent a large proportion of childcare around the world and more adult children are living with their older parents than ever before [3]. Therefore the impact of caregiving responsibility on ageing health and well-being is important to examine. 2. The pros and cons of grand-parenting Being a grandparent encompasses a number of features that makes the role both rewarding and challenging. Grandparents and grandchildren share a unique bond which can be mutually beneficial. Grandchildren receive particular love and attention from their grandparents that is outside of what would be expected in a formal childcare arrangement [4], whilst grandparents are offered an opportunity to engage in stimulating activities that can promote health. In addition, the ability to watch your grandchildren thrive and grow and to be involved in that process is singularly fulfilling for a grandparent. However, some concerns have been raised http://dx.doi.org/10.1016/j.maturitas.2016.07.004 0378-5122/© 2016 Elsevier Ireland Ltd. All rights reserved.
about commencing what can be viewed as a “second parenthood” phase at a time when many older adults are experiencing a rise in morbidity and are otherwise winding down their responsibilities [5].
3. Current research on grandparents Research on grand-parenting has found a number of effects on physical and emotional health in ageing (see Table 1). Whilst there are positive effects on mood, social inclusion and cognition the amount of time spent with grandchildren is an important factor. Highly frequent grand-parenting can be associated with stress which can negate positive effects. While spending time with grandchildren can have benefits for healthy ageing, too much can be detrimental. The effects on physical and emotional health in ageing are therefore largely dependent upon the context and intensity of the care required. Prolonged periods of care, greater than five days per week in Australia and associated with co-resident care in China and the USA, were associated with increased stress, feelings of time restraints, poorer mental health and an associated decline in cognition. Taking on the sole-carer role clearly only includes high intensity and duration care and research has focussed on African-Americans and those from Subsaharan Africa. These studies represent two groups, grandparents caring for orphaned grandchildren as a result of the AIDS epidemic and grandmothers obliged to take on fulltime care due to the absence of their children as a result of death, incarceration or substance abuse. Amongst those grandparents in Subsaharan Africa, personal resilience and social and financial resources were seen as beneficial. Poor physical health was a particular concern amongst African-American carers, potentially due to some who, despite lacking the physical and personal resources,
Grand-parenting for healthy ageing in women: Fact or fiction? / Maturitas 92 (2016) 130–133
131
Table 1 Summary of the key findings of various studies investigating the impacts of grandparenting on health and wellbeing. Articles were obtained from the previous decades review (Silverstein, M. and R. Giarrusso, Aging and Family Life: A Decade Review. J Marriage Fam, 2010. 72(5): p. 1039–1058.) in addition to a PubMed search conducted using the term “grandparent”, restricting to human studies within the last 5 years which produced 384 results. “Caregiving” was added to the search term, limiting results to 31 items. A total of 25 studies relevant to the current topic are outlined. Reference
Study Period
Key findings
Casual Grand-parenting Cross-Sectional Anderson, S. G., et al. (2013). J Women Aging, 25(3), 242–259
XS
High reports of enjoyment &psychological benefits caring for grandchildren, difficulties such as age-related constrictions and time restraints. Minding grandchildren associated with higher verbal fluency Negative association between frequency of grandparenting and cognition Regular grandparenting predicted lower participation in other social activities Grandparents who were primary caregivers had poorer mental health than other caregivers Caring for grandchildren lowers subjective age in adults over 75 Peak cognitive performance associated with grandparenting one day per week Minding grandchildren predicted better cognitive function High-frequency predicted poorer cognition and increase in demands Grandparents minding grandchildren report higher stress levels than non-caregivers Grandparents report that caring for grandchildren provides happiness and purpose. Less privacy and time for other relationships − time constraints Grandparents reported lower stress and greater wellbeing is they received support from friends and the community Poorer physical and emotional health in custodial grandparents compared to single parents Grandparenting associated with greater life satisfaction
Arpino, B., & Bordone, V. (2014). European Demographic Research Papers, 76(2), 337–351.
XS
Arpino, B., & Bordone, V. (2016). Review of Economics of the Household, 1–40. Bigbee, J. L., et al. (2011). J Rural Health, 27(3), 2089-296.
XS XS
Bordone, V., & Arpino, B. (2015). Journal of Aging and Health, 0898264315618920. Burn, K. F., Ames, D., Henderson, V. W., Dennerstein, L., & Szoeke, C. (2014). Menopause, 21(10), 1069–1074. Burn, K. F., Ames, D., Henderson, V. W., Dennerstein, L., & Szoeke, C. (2014). Climacteric, 17(S1), 39.
XS
Musil, C. M., & Ahmad, M. (2002). Journal of Aging and Health, 14(1), 96–121. Pruchno, R. (1999). The Gerontologist, 39(2), 209–221.
XS
Sands, R. G., Goldberg-Glen, R., & Thornton, P. L. (2005). Journal of Gerontological Social Work, 45(4), 65–82. Whitley, D. M., & Fuller-Thomson, E. (2015). American Journal of Men’s Health, 1–13. Whitley, D. M., Kelley, S. J., & Sipe, T. A. (2001). Health & Social Work, 26(2), 105–114. Longitudinal Blustein, J., Chan, S., & Guanais, F. C. (2004). Health Services Research, 39(6p1), 1671–1690. Chen et al. (2015). J Gerontol B Psychol Sci Soc Sci, 70(5), 793–803.
XS XS
XS
XS XS XS
6 years 12 years
Chen, F. & Liu, G. (2012). J Gerontol B Psychol Sci Soc Sci, 67(1), 99–112.
15 years
Song, L., & Li, L. (2014). Paper presented at the XVIII ISA World Congress of Sociology, Yokohama, Japan.
11 years
Tsai, F.-J., Motamed, S., & Rougemont, A. (2013). BMC Public Health, 13(1), 567–575. Xu, L., et al. (2012). Fam Community Health, 35(4), 287–299.
14 years
Primary Carer-role Grand-parenting Cross-Sectional Crowther, M. R. et al. (2015). Ageing Ment Health, 19(9), 844–852.
8 years
XS
Kelley, S. J. (2013). Res Nurs Health, 36(4), 373–385.
XS
Ice, G. H., et al. (2012). Soc Sci Med, 74(12), 2020–2027.
XS
Mhaka-Mutepfa, M., et al. (2015). J Aging Health, 27(3), 454–479. Mhaka-Mutepfa, M., et al. (2014). Health Care Women Int, 35(7–9), 1022–1039. Shaibu, S. (2013). J Nurs Scholarsh, 45(4), 363–370.
XS
XS
Sprang, G., et al. (2015). Aging Ment Health, 19(4), 315–324.
XS
XS
feel obliged to take on a greater intensity of care than they would have chosen. Universal health and wellbeing benefits, irrespective of the duration and context, were reported with grand-parenting in
+/−
+
− − + + +/−
− +/−
+ − +
Full-time grandparents have higher probability of depressive symptoms Caring reduced frailty, Coresidence resulted in health deterioration Financial and social resources and higher frequency determine outcome Grandparents in three generation households show more rapid decline in health. Lower intensity grandparenting has protective effect on health Positive relationship between grandparenting and cognition overall Decrements in cognition associated with intense grandparenting Living with grandchildren protects against depression and loneliness more than other familial relationships Decreasing grandparenting intensity led to increased life satisfaction over time
−
Rewards/gains most common theme reported by custodial grandparents Some challenges reported, such as feeling overwhelmed, health concerns interfering with abilities 40% of caregiving grandmothers reported elevated psychological distress levels. Grandparental caregivers had higher perceived stress than non-caregivers. High personal and social assets increased resilience in grandparent caregivers Personal and social assets related to better physical and mental health in custodial grandparents Caring for grandchildren fraught with difficulties, especially financial issues and poor health. Child-grandparent conflicts associated with lower emotional wellbeing in custodial grandparents
+/−
+/−
+/−
+/−
+
− − +/− +/− − −
Taiwan, and in the United States improved abstinence behaviours in those with alcohol and drug problems was noted, presumably due to the focus on the needs of others and the requirement for sobriety when caring for children.
132
Grand-parenting for healthy ageing in women: Fact or fiction? / Maturitas 92 (2016) 130–133
160
Number of publications
140 120 100 80 60 40 20 0 1995
2000
2005 Publication Year
2010
2015
Fig. 1. A Medline trend analysis was conducted of all PubMed publications using the search term “grandparents”. The number of publications related to the search term are shown by year.
In summary the findings suggest that how a grandparent feels towards their responsibilities may be a key consideration when studying their impact on health. Caring for children requires significant physical and emotional investment. What may be physically or emotionally achievable for one grandparent may be unfeasible for another. There are also a number of elements of this role that may influence the outcome, such as how many grandchildren are being minded, the age of the grandchildren, and the types of activities that are undertaken with them. Understanding the subjective experience and the intricacies of this unique social role is vital to interpreting its effects. Older age is also a time when morbidity can accrue with reduced likelihood to take on new or additional roles. Elderly parents may move in with their adult children due to frailty or cognitive impairment, but at the same time have greater contact with their grandchildren. This area of research is growing. A PubMed search for the term “grandparents” demonstrated a clear increase in the number of studies in the literature each year, particularly in the last decade (Fig. 1). This is timely, as recent figures demonstrate that grandparents are one of the most popular sources of childcare in the Western world [1]. While studies in this area are now increasing, research is still limited. Earlier work on grand-parenting largely consisted of small, qualitative studies, and while studies from the past decade have been quantitative, these studies are predominantly crosssectional. With older populations, the chronic diseases of ageing are increasing in prevalence. These diseases have long prodromes and therefore long follow-up is required to understand impact. Longitudinal, quantitative studies are needed if we are to ascertain the effects of this social role on healthy ageing. 4. Conclusions There is emerging evidence that grand-parenting is associated with active and healthy ageing. This is a complex social activity and aspects of the role are relevant to caregiving research, which has outlined the importance of caregiver stress and burden of care. Individuals should choose the best grand-parenting arrangement for them, in consideration of the demonstrated health and social gains, but also mindful of the demands in order to optimise benefits. The early findings highlight the need for quantitative longitudinal research in ageing and the many varied roles that impact health in order to make clear recommendations to the wider commu-
nity. In particular grand-parenting by men is under-researched and increasingly relevant in the future where we expect to see more gender balance in childcare engagement. Conflict of interest S.C. and K.B. have no conflict of interest to declare. C.S. has provided clinical consultancy and been on scientific advisory committees for the Australian Commonwealth Scientific and Industrial Research Organisation, Alzheimer’s Australia, University of Melbourne and other relationships which are subject to confidentiality clauses. She has been a named Chief Investigator on investigator-driven collaborative research projects in partnership with Pfizer, Merck, Bayer and GE. She has been an investigator on clinical trials with Lundbeck within the last 2 years. The Healthy Ageing Program has received support from National Health and Medical Research Council, Alzheimer’s Association, Collier Trust, Scobie and Claire Mackinnon Foundation, JO and JR Wicking Trust, Shepherd Foundation, Brain Foundation, Mason Foundation, Ramaciotti Foundation, Alzheimer’s Australia, and The Royal Australian College of Physicians. She may accrue revenues from patents in pharmacogenomics prediction of seizure recurrence. Contributors S.C. wrote the manuscript and edited the final version. K.B. was responsible for completion of the original table and the systematic review. C.S. was responsible for the study design, wrote the manuscript and edited the final version. Provenance and peer review This article is commissioned; not externally peer reviewed. Acknowledgements Support for the Healthy Ageing Program (HAP) has been provided by the Australian Healthy Ageing Organisation and the Ramaciotti Foundation. The Principal Investigator of HAP (C.S.) is supported by the National Health and Medical Research Council (547500, 1032350 & 1062133).
Grand-parenting for healthy ageing in women: Fact or fiction? / Maturitas 92 (2016) 130–133
References [1] P.F. Adams, P.M. Barnes, Summary health statistics for the U.S. population: national health interview survey, 2004, Vital Health Stat. 10 (229) (2006) 1–104. [2] UNICEF, Africa’s Orphaned Generation, U.s. H.A. Unit, Editor. 2003: United Nations Children’s Fund. [3] K. Burn, C. Szoeke, Boomerang families and failure-to-launch: commentary on adult children living at home, Maturitas 83 (1) (2016) 9–12. [4] J. Wheelock, K. Jones, ‘Grandparents are the next best thing’: informal childcare for working parents in urban Britain, J. Soc. Policy 31 (03) (2002) 441–463. [5] M. Silverstein, R. Giarrusso, Aging and family life: a decade review, J. Marriage Fam. 72 (5) (2010) 1039–1058.
Dr. Stephen Campbell (FRACP) Katherine Burn (BPsych) Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
133
Prof. Cassandra Szoeke (PhD) a,b,∗ a Department of Medicine, University of Melbourne, Parkville, Victoria, Australia b Institute for Health and Ageing, Melbourne, Victoria, Australia ∗ Corresponding
author at : P.O. Box 2026, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia E-mail address: [email protected] (C. Szoeke) 2 July 2016 7 July 2016