Impact of Caregiving on Health and Quality of Life: A Comparative Population-Based Study of Caregivers for Elderly Persons and Noncaregivers
Abstract
This study aims to investigate the impact of caregiving on the health status and quality of life (QOL) of primary informal caregivers (PCGs) of elderly care recipients in Hong Kong. A total of 246 PCGs and 492 matched noncaregiver (NCG) controls were identified in a population-based cross-sectional study through random telephone dialing. Their health status and QOL were assessed based on structured questionnaires and Short Form 36 (SF-36) Health Survey. Multiple conditional logistic regression analysis showed that compared with NCGs, PCGs had significantly increased risks for reporting worse health, more doctor visits, anxiety and depression, and weight loss. Female PCGs were more likely to report chronic diseases, symptoms, and insomnia. PCGs, particularly women, had significantly lower scores in all eight domains of SF-36 Health Survey. High caregiver burden score (Zarit Burden Scale) was positively associated with adverse physical and psychological health and poorer QOL. The results indicate that PCGs, particularly women, had an adverse physical and psychological health profile and poorer QOL compared with NCGs.
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Informal caregivers have worse health, more medical consultations, anxiety and depression, and lower quality of life than those who do not provide such care.
“Primary informal caregivers have worse health profile, more medical consultations, anxiety and depression, weight loss, and lower quality of life compared with their counterparts [6].”
From Mindfulness-Based Intervention for Caregivers of Frail Older Chinese Adults: A Study Protocol (2022) · cites this paper as [6]
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Semere, W., Crossley, S. A., Karter, A. J., Lyles, C. R., Brown, W., Reed, M., McNamara, D. S., Liu, J. Y., & Schillinger, D. (2019) · Journal of General Internal Medicine · doi:10.1007/s11606-019-05259-1 · Cited by 27 · see citing works
Ornstein, K. A., Garrido, M. M., Siu, A. L., Bollens‐Lund, E., Rahman, O., & Kelley, A. S. (2019) · PharmacoEconomics · doi:10.1007/s40273-019-00787-4 · Cited by 26 · see citing works
Du, J., Shao, S., Jin, G., Qian, C.-G., Xu, W., & Lu, X. (2017) · Medicine · doi:10.1097/md.0000000000008489 · Cited by 26 · see citing works
Vicente, M. M., Delgado, M. G., Prieto, J. P., Adsuar, J. C., & Gusi, N. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17031078 · Cited by 26 · see citing works
“In particular, somatization episodes can be due to the ailments derived from physical problems such as back pain, pain in the knees, body pain or fatigue that have been reported in previous studies with caregivers of patients with AD [11,12,14,22].”
BackgroundResultChiatti, C., Rosa, M. D., Melchiorre, M. G., Manzoli, L., Rimland, J. M., & Lamura, G. (2013) · Aging & Mental Health · doi:10.1080/13607863.2013.765830 · Cited by 25 · see citing works
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Caregiver Attributions for Late‐Life Depression and Their Associations with Caregiver Burden
Polenick, C. A., & Martire, L. M. (2013) · Family Process · doi:10.1111/famp.12032 · Cited by 24 · see citing works
“Such assessment may be helpful in identifying caregivers who are at risk for higher levels of burden and thus a greater likelihood of physical and psychological morbidity (Ho et al., 2009; Martire & Schulz, 2012).”
BackgroundAspectos psicológicos da qualidade de vida de cuidadores de idosos: uma revisão integrativa
Flesch, L. D., Batistoni, S. S. T., (Unicamp), U. E. D. C., Paulo, U. D. S., Neri, A. L., (Unicamp), U. E. D. C., Cachioni, M., (Unicamp), U. E. D. C., & Paulo, U. D. S. (2017) · Geriatrics Gerontology and Aging · doi:10.5327/z2447-211520171700041 · Cited by 24 · see citing works
Yiengprugsawan, V., Harley, D., Seubsman, S., & Sleigh, A. C. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-1111 · Cited by 23 · see citing works
“A study in Hong Kong noted adverse physical and psychological health, and poor quality of life among caregivers of the elderly [14].”
BackgroundPsychometric Evaluation of the Caregiving Competence Scale Among Chinese Family Caregivers
Cheng, H. Y., Chair, S. Y., & Chau, J. P. C. (2015) · Rehabilitation Nursing · doi:10.1002/rnj.207 · Cited by 23 · see citing works
Liu, C., Zhang, L., Ahmed, F., Shahid, M., Wang, X.-H. F., Wang, Y., Wang, J., & Guo, J. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.700493 · Cited by 23 · see citing works
Cause-Specific Mortality Among Spouses of Parkinson Disease Patients
Nielsen, M. M., Hansen, J., Ritz, B. R., Nordahl, H., Schernhammer, E. S., Wermuth, L., & Rod, N. H. (2013) · Epidemiology · doi:10.1097/ede.0000000000000042 · Cited by 23 · see citing works
Psychological distress and mental health of Thai caregivers
Yiengprugsawan, V., Seubsman, S., & Sleigh, A. C. (2012) · Psychology of Well-Being Theory Research and Practice · doi:10.1186/2211-1522-2-4 · Cited by 23 · see citing works
“This includes a study in Hong Kong which reported adverse physical and psychological health and poorer quality of life among caregivers (Ho et al. 2009).”
BackgroundTrends in Alzheimer's Disease and Dementia in the Asian-Pacific Region
Aggarwal, N. T., Tripathi, M., Dodge, H. H., Alladi, S., & Anstey, K. J. (2012) · International Journal of Alzheimer s Disease · doi:10.1155/2012/171327 · Cited by 23 · see citing works
Secinti, E., Lewson, A. B., Wu, W., Kent, E. E., & Mosher, C. E. (2021) · Annals of Behavioral Medicine · doi:10.1093/abm/kaab007 · Cited by 22 · see citing works
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Quality of life among older adults in China and India: Does productive engagement help?
Hu, S., & Das, D. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.06.028 · Cited by 19 · see citing works
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Pan, Y., Jones, P. S., & Pothier, P. K. T. (2017) · Journal of Family Nursing · doi:10.1177/1074840717718540 · Cited by 19 · see citing works
“of caregivers of elders (Ho et al., 2009; X. Yang et al., 2012) in Taiwan, Hong Kong, and mainland China.”
BackgroundResultThe Role and Wellbeing of Female Family Caregivers in the Provision of Aged Care in China
Huang, G., Guo, F., & Chen, G. (2021) · Social Indicators Research · doi:10.1007/s11205-021-02769-6 · Cited by 18 · see citing works
“…compared with non-caregivers, caregivers suffer a higher probability of psychological stress and emotional disorders, for example, more anxiety (Ho et al., 2009), depression (Coe & Van Houtven, 2009), burden (Buyck et al., 2011), resentment (Parks & Pilisuk, 1991), and sense of guilt (Fast…”
BackgroundResultInfluentialTabler, J., & Geist, C. (2019) · Journal of Women & Aging · doi:10.1080/08952841.2019.1681243 · Cited by 19 · see citing works
Cuidadores familiares de idosos com doença de Alzheimer em uma intervenção psicoeducacional
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Disability trends in Canada: 2001–2014 population estimates and correlates
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Psychological distress of family members of vegetative and minimally conscious state patients
Corallo, F., Bonanno, L., Buono, V. L., Salvo, S. D., Rifici, C., Bramanti, P., & Marino, S. (2015) · Acta medica Mediterranea/Acta medica mediterranea · Cited by 17 · see citing works
Biomedical health profiles of unpaid family carers in an urban population in South Australia
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“In the caregiving literature, parent carers, dementia and mental health carers have reported lower perceived health status [55,56].”
BackgroundPersonal and organizational resources of family caregivers ' well-being
Krisor, S. M., & Rowold, J. (2014) · Personnel Review · doi:10.1108/pr-11-2012-0196 · Cited by 16 · see citing works
Kyei‐Arthur, F., & Codjoe, S. N. A. (2020) · Clinical Nursing Research · doi:10.1177/1054773820982307 · Cited by 19 · see citing works
“…poorer physical and mental health (Carrion & Nedjat-Haiem, 2013; Ho et al., 2009; Rafnsson et al., 2015; Xie et al., 2016); poorer quality of life (Ho et al., 2009; Rafnsson et al., 2015); weight loss (Ho et al., 2009); loss of income (Sanuade & Boatemaa, 2015); financial difficulties (Nortey et…”
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“UI is the most common urologic disorder affecting both men and women in the United States [7,8].”
BackgroundAll Hospice Patients Are Not Equal: Development of a Visit-Based Acuity Index
Harrold, J. K., Byhoff, E., Harris, P. S., Szolarova, R., Bender, L., Craig, T. R., & Casarett, D. (2013) · Journal of Palliative Medicine · doi:10.1089/jpm.2013.0109 · Cited by 14 · see citing works
“8,9 However, other studies have found the reverse to be true.”
Tabatabaee, M., Nooraie, R. Y., Aghaei, A. M., Abadi, Y. R., Ansari, M., Sharifi, S., & Sharifi, V. (2022) · International Journal of Social Psychiatry · doi:10.1177/00207640221077580 · Cited by 13 · see citing works
“Caregiving has been associated with adverse effects on the caregivers’ quality of life and general health (DelPino-Casado et al., 2021; Ho et al., 2009).”
BackgroundVrettos, I., Anagnostopoulos, F., Voukelatou, P., Panayiotou, S., Kyvetos, A., Nikas, A., Kollia, D., & Niakas, D. A. (2023) · Psychogeriatrics · doi:10.1111/psyg.12930 · Cited by 13 · see citing works
Alhumaidi, F. S., Siddiqui, M. I., Altowairqi, A. F., Alshawkani, H. H., Babkour, B. O., & Alaugla, F. K. (2020) · The Egyptian Journal of Neurology Psychiatry and Neurosurgery · doi:10.1186/s41983-020-00220-0 · Cited by 13 · see citing works
The Psychology of Respite Care for People with Dementia in Australia
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Mallya, S., & Fiocco, A. J. (2019) · Mindfulness · doi:10.1007/s12671-019-01155-1 · Cited by 14 · see citing works
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Silverman, M. (2013) · Journal of Aging Studies · doi:10.1016/j.jaging.2013.06.001 · Cited by 12 · see citing works
Shame feeling in the Intensive Care Unit patient’s family members
Koulouras, V. P., Konstanti, Z., Lepida, D., Παπαθανάκος, Γ., & Gouva, M. (2017) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2017.03.011 · Cited by 12 · see citing works
Association Between Social Support and Health of Aging Adults with Dementia
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“The literature on caretakers of those with dementia being in close proximity to provide support coincides with this finding (Ho et al. 2009).”
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“Other studies have used the Short FormHealth Survey (SF-36 or SF-12) (e.g., Frias et al., 2005; Ho et al., 2009) and the Behavioral Risk Factor Surveillance System Survey (e.”
MethodChan, W. C., Lautenschlager, N. T., Dow, B., Ma, S. L., Wong, C. S. M., & LAM, L. C. W. (2016) · Trials · doi:10.1186/s13063-016-1582-z · Cited by 11 · see citing works
“It is now evident that informal caregivers of persons with dementia are at an elevated risk of developing depression and anxiety, and report poorer quality of life [3–5].”
Background
- Authors
- Ho, S. C., Chan, A., Woo, J., Chong, P., & Sham, A.
- Affiliations
- Chinese University of Hong Kong (HK)
- Lingnan University (HK)
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-04-07
- Volume
- 64A
- Issue
- 8
- Pages
- 873-879
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2096800364
- Cited by
- 217
- References
- 37
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 11 · 2023: 12 · 2022: 11 · 2021: 18 · 2020: 15 · 2019: 13 · 2018: 22 · 2017: 12 · 2016: 12 · 2015: 17 · 2014: 18 · 2013: 19 · 2012: 12
- FWCI
- 20.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons - Lingnan (Lingnan University) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- University of Hong Kong
- Chinese University of Hong Kong
- Directorate for Biological Sciences
- Health Care and Promotion Fund
- Topics
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- informal caregivers, primary caregivers, caregiver burden, quality of life, health status, anxiety, depression, insomnia, weight loss, chronic disease, sex differences, Hong Kong
- MeSH terms
- Adult, Aged, Female, Health Status, Humans, Male, Middle Aged, Quality of Life, Logistic Models, Caregivers
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