The present longitudinal study investigated changes in the mental and physical health of older caregivers over a 6-year period. Differences between patterns of caregiving were also examined. Data were collected in 2008, 2010, 2012, and 2014 from a sample of older New Zealanders (N= 803, 54% female) aged between 56 and 72 as part of the Health, Work, and Retirement study. Of participants, n= 258 were caregivers and n= 545 never provided care. Females were more likely to be caregivers. Analyses indicated that mental health declined over time for both caregiver and non-caregiver groups with the decrease being substantially larger for caregivers. There was also a gender effect suggesting that male caregivers’ mental health declined to a greater extent. Non-caregivers reported more doctor visits over time and hospital admission increased for both groups but this increase was larger for caregivers. Male caregivers were admitted to hospital more often than female caregivers. Analyses were conducted to differentiate among different patterns of caregiving over the 6 year period (continued caring, stopped caring, on-and-off caring). There was no difference between caregiving groups in terms of gender, age, smoking and drinking behaviour. However, on-and-off carers had poorer mental health than those who provided care continuously. In sum, caregivers experienced more mental health problems over time, visited their doctors less but were more likely to be admitted to hospital. Male caregivers were more vulnerable to health decline. Furthermore, transitioning in and out of the caregiver role had a negative impact on wellbeing.