Associations between spousal caregiving and health among older adults in Mexico: A targeted estimation approach.
Torres JM; Department of Epidemiology & Biostatistics, UC San Francisco, San Francisco, California, USA.
Mitchell UA; Division of Community Health Sciences, University of Illinois, Chicago, Illinois, USA.
Sofrygin O; Division of Research, Kaiser Permanente, Oakland, California, USA.
Rudolph KE; Department of Epidemiology, Columbia University, New York, New York, USA.
López-Ortega M; Research Department, National Institute of Geriatrics, Ciudad de Mexico, Mexico.
Sharif MZ; Department of Community Health Sciences, UC Los Angeles, Los Angeles, California, USA.
Wong R; Sealy Center on Aging, University of Texas - Medical Branch, Galveston, Texas, USA.
Glymour MM; Department of Epidemiology & Biostatistics, UC San Francisco, San Francisco, California, USA.
International journal of geriatric psychiatry [Int J Geriatr Psychiatry] 2021 May; Vol. 36 (5), pp. 775-783. Date of Electronic Publication: 2020 Dec 11.
Typ publikacji :
Journal Article; Research Support, N.I.H., Extramural
Imprint Name(s) :
Publication: Chichester : John Wiley
Original Publication: Chichester, Sussex, England ; [New York] : Wiley, c1986-
MeSH Terms :
Aged ; Female ; Humans ; Male ; Marriage ; Mental Health ; Mexico
United Nations Department of Economic and Social Affairs, Population Division. World Population Ageing 2015. New York, NY: United Nations ST/ESA/SER.A/390; 2015.
Pinquart M , Sörensen S . Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2007;62(2):P126-P137.
Capistrant BD , Berkman LF , Glymour MM . Does duration of spousal caregiving affect risk of depression onset? Evidence from the Health and Retirement Study. Am J Geriatr Psychiatry. 2014;22(8):766-770.
Roth DL , Haley WE , Hovater M , Perkins M , Wadley VG , Judd S . Family caregiving and all-cause mortality: findings from a population-based propensity-matched analysis. Am J Epidemiol. 2013;178(10):1571-1578.
Kaschowitz J , Brandt M . Health effects of informal caregiving across Europe: a longitudinal approach. Soc Sci Med. 2017;173:72-80.
Pinquart M , Sörensen S . Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2003;58(2):P112-P128.
Lee S , Colditz GA , Berkman LF , Kawachi I . Caregiving and risk of coronary heart disease in U.S. women: a prospective study. Am J Prev Med. 2003;24(2):113-119.
Capistrant BD , Moon JR , Berkman LF , Glymour MM . Current and long-term spousal caregiving and onset of cardiovascular disease. J Epidemiol Community Health. 2012;66(10):951-956.
Capistrant BD , Moon JR , Glymour MM . Spousal caregiving and incident hypertension. Am J Hypertens. 2012;25(4):437-443.
Schulz R , Beach SR . Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA. 1999;282(23):2215-2219.
O'Reilly D , Rosato M , Maguire A . Caregiving reduces mortality risk for most caregivers: a census-based record linkage study. Int J Epidemiol. 2015;44(6):1959-1969.
Mayston R , Lloyd-Sherlock P , Gallardo S , et al. A journey without maps-Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru. PLoS One. 2017;12(8):e0182360.
United Nations, Department of Economic, Affairs Social, Division Population. Living Arrangements of Older Persons: a Report on an Expanded International Dataset. New York, NY: United Nations; 2017.
Prince M , Group DR . Care arrangements for people with dementia in developing countries. Int J Geriatr Psychiatry. 2004;19(2):170-177.
Wagner M , Brandt M . Long-term care provision and the well-being of spousal caregivers: an analysis of 138 European regions. J Gerontol B Psychol Sci Soc Sci. 2018;73(4):e24-e34.
Aneshensel CS , Mitchell UA . The Stress Process: Its Origins, Evolution, and Future. In: Johnson R , Turner R , Link B , eds. Sociology of Mental Health. SpringerBriefs in Sociology. Cham, Switzerland: Springer; 2014.
Pearlin LI , Mullan JT , Semple SJ , Skaff MM . Caregiving and the stress process: an overview of concepts and their measures. Gerontologist. 1990;30(5):583-594.
Capistrant B . Caregiving for older adults and the caregivers’ health: an epidemiologic review. Curr Epidemiol Rep. 2016;3:72-80.
Mendez-Luck CA , Kennedy DP , Wallace SP . Guardians of health: the dimensions of elder caregiving among women in a Mexico City neighborhood. Soc Sci Med. 2009;68(2):228-234.
Pinquart M , Sörensen S . Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging. 2003;18(2):250-267.
Beeson RA . Loneliness and depression in spousal caregivers of those with Alzheimer's disease versus non-caregiving spouses. Arch Psychiatr Nurs. 2003;17(3):135-143.
Cannuscio C , Colditz G , Rimm E , Berkman L , Jones C , Kawachi I . Employment status, social ties, and caregivers’ mental health. Soc Sci Med. 2004;58(7):1247-1256.
Roth DL , Fredman L , Haley WE . Informal caregiving and its impact on health: a reappraisal from population-based studies. Gerontologist. 2015;55(2):309-319.
Calvo E , Berho M , Roqué M , et al. Comparative analysis of aging policy reforms in Argentina, Chile, Costa Rica, and Mexico. J Aging Soc Policy. 2019;31(3):211-233.
López-Ortega M , Aranco N . Envejecimiento y atención a la dependencia en México. Washington, DC: Banco Interamericano de Desarrollo/Inter-American Development Bank; 2019.
Águila E , López-Ortega M , Angst S . Do income supplemental programs for older Adults' help reduce primary caregiver burden? Evidence from Mexico. J Cross Cult Gerontol. 2019;34(4):385-402.
Wong R , Michaels-Obregon A , Palloni A . Cohort profile: the Mexican health and aging study (MHAS). Int J Epidemiol. Int J Epidemiol. 2017;46:e2.
Radloff LC . The CES-D scale, a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385-401.
Steffick DE . Documentation of Affective Functioning Measures in the Health and Retirement Study. Ann Arbor, MI: Survey Research Center, University of Michigan; 2000.
Schuler MS , Rose S . Targeted maximum likelihood estimation for causal inference in observational studies. Am J Epidemiol. 2017;185(1):65-73.
Gruber S , van der Laan MJ . Targeted Maximum Likelihood Estimation: A Gentle Introduction (Working Paper 252). Berkeley, CA: UC Berkeley Division of Biostatistics Working Paper Series; 2009.
Sofrygin O , Zhu Z , Schmittdiel JA , et al. Targeted learning with daily EHR data. Stat Med. 2019;38(16):3073-3090.
Polley E , LeDell E , Kennedy C , Lendle S , van der Laan M . SuperLearner: Superlearner Prediction. R Package version 2.0-22. 2017.
Lendle SD , Schwab J , Petersen ML , van der Laan MJ . Ltmle: an R Package Implementing Targeted Minimum Loss-Based Estimation for Longitudinal Data, R Package Version 1.1-0. 2018.
Honaker J , King G , Blackwell M . Amelia II: a Program for Missing Data R Package Version 1.7.4. 2015.
Rubin DB . Multiple Imputation for Nonresponse in Surveys. New York, NY: Wiley; 1987.
Pinquart M , Sörensen S . Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2006;61(1):P33-P45.
Mendez-Luck CA , Kennedy DP , Wallace SP . Concepts of burden in giving care to older relatives: a study of female caregivers in a Mexico City neighborhood. J Cross Cult Gerontol. 2008;23(3):265-282.
Fredman L , Doros G , Ensrud KE , Hochberg MC , Cauley JA . Caregiving intensity and change in physical functioning over a 2-year period: results of the caregiver-study of osteoporotic fractures. Am J Epidemiol. 2009;170(2):203-210.
McCann JJ , Hebert LE , Bienias JL , Morris MC , Evans DA . Predictors of beginning and ending caregiving during a 3-year period in a biracial community population of older adults. Am J Public Health. 2004;94(10):1800-1806.
Díaz-Venegas C , Wong R . Recovery from physical limitations among older Mexican adults. Arch Gerontol Geriatr. 2020;91:104208.
Bobinac A , van Exel NJ , Rutten FF , Brouwer WB . Caring for and caring about: disentangling the caregiver effect and the family effect. J Health Econ. 2010;29(4):549-556.
Amirkhanyan AA , Wolf DA . Caregiver stress and noncaregiver stress: exploring the pathways of psychiatric morbidity. Gerontol. 2003;43(6):817-827.
Grant Information :
R01 AG018016 United States AG NIA NIH HHS; U54 MD012523 United States MD NIMHD NIH HHS; R00 DA042127 United States DA NIDA NIH HHS; R01 AI074345 United States AI NIAID NIH HHS; K01 AG056602 United States AG NIA NIH HHS
Contributed Indexing :
Keywords: caregiver health*; depressive symptoms*; epidemiologic methods*; spousal caregiving*
Entry Date(s) :
Date Created: 20201201 Date Completed: 20210423 Latest Revision: 20210423
Update Code :
Objective: To evaluate associations between spousal caregiving and mental and physical health among older adults in Mexico.
Methods: Data come from the Mexican Health & Aging Study, a national population-based study of adults ≥50 years and their spouses (2001-2015). We compared outcomes for spousal caregivers to outcomes for those whose spouses had difficulty with at least one basic or instrumental activity of daily living (I/ADL) but were not providing care; the control group conventionally includes all married respondents regardless of spouse's need for care. We used targeted maximum likelihood estimation to evaluate the associations with past-week depressive symptoms, lower-body functional limitations, and chronic health conditions.
Results: At baseline, 846 women and 629 men had a spouse with ≥1 I/ADL. Of these, 60.9% of women and 52.6% of men were spousal caregivers. Spousal caregiving was associated with more past-week depressive symptoms for men (Marginal Risk Difference (RD): 0.27, 95% confidence internal [CI]: 0.03, 0.51) and women (RD: 0.15, 95% CI: 0.07, 0.23). We could not draw conclusions about associations with lower-body functional limitations and chronic health conditions. On average, all respondents whose spouses had caregiving needs had poorer health than the overall sample.
Conclusion: We found evidence of an association between spousal caregiving and mental health among older Mexican adults with spouses who had need for care. However, our findings suggest that older adults who are both currently providing or at risk of providing spousal care may need targeted programs and policies to support health and long-term care needs.
(© 2020 John Wiley & Sons Ltd.)