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The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis

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  • Rafael del-Pino-Casado
  • Marta Rodríguez Cardosa
  • Catalina López-Martínez
  • Vasiliki Orgeta

Abstract

Background: Family carers are an important source of care for older people. Although several studies have reported that subjective caregiver burden is related to depressive symptoms there are no systematic reviews quantifying this association. Objective: To establish the extent to which subjective caregiver burden is associated with depressive symptoms and whether this association would vary by study or care characteristics. Methods: We searched major databases such as PubMed, CINAHL, PsycINFO, Scopus and ISI Proceedings up to March 2018, and conducted a meta-analysis of included studies. Summary estimates of the association were obtained using a random-effects model to improve generalisation of findings. Results: After screening of 4,688 articles, 55 studies were included providing a total of 56 independent comparisons with a total of 9,847 carers from data across 20 countries. There was a large, positive association between subjective caregiver burden and depressive symptoms (r¯ = 0.514; 95% CI = 0.486, 0.541), with very low heterogeneity amongst individual studies (I2 = 8.6%). Sensitivity analyses showed no differences between cross-sectional or repeated measures (r¯ = 0.521; 95% CI = 0.491, 0.550; 51 samples) and longitudinal studies (r¯ = 0.454; 95% CI = 0.398, 0.508; 6 samples). We found a higher effect size for those caring for people living with dementia compared to those caring for frail older people, and stroke survivors. Carer sex, age and kinship did not change the estimate of the effect. Conclusions: Subjective caregiver burden is a significant risk factor for depressive symptoms in carers of older people and may precipitate clinical depression. Those caring for people with dementia experience greater burden. There is a need for longitudinal evaluations examining the effects of potential mediators of the association of subjective burden and depressive symptoms. Future interventions should test whether minimizing subjective burden may modify the risk of developing depression in carers of older relatives.

Suggested Citation

  • Rafael del-Pino-Casado & Marta Rodríguez Cardosa & Catalina López-Martínez & Vasiliki Orgeta, 2019. "The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-16, May.
    • Handle: RePEc:plo:pone00:0217648
    DOI: 10.1371/journal.pone.0217648
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    1. Diego Montano & Richard Peter, 2022. "Informal care-giving and the intention to give up employment: the role of perceived supervisor behaviour in a cohort of German employees," European Journal of Ageing, Springer, vol. 19(3), pages 575-585, September.
    2. Cristina Gagliardi & Flavia Piccinini & Giovanni Lamura & Georgia Casanova & Paolo Fabbietti & Marco Socci, 2022. "The Burden of Caring for Dependent Older People and the Resultant Risk of Depression in Family Primary Caregivers in Italy," Sustainability, MDPI, vol. 14(6), pages 1-18, March.
    3. Jinpitcha Mamom & Hanvedes Daovisan, 2022. "Listening to Caregivers’ Voices: The Informal Family Caregiver Burden of Caring for Chronically Ill Bedridden Elderly Patients," IJERPH, MDPI, vol. 19(1), pages 1-15, January.
    4. Ronald Kamoga & Vincent Mubangizi & Judith Owokuhaisa & Moses Muwanguzi & Sylivia Natakunda & Godfrey Zari Rukundo, 2023. "Behavioral and Psychological Symptoms of Dementia: Prevalence, Symptom Severity, and Caregiver Distress in South-Western Uganda—A Quantitative Cross-Sectional Study," IJERPH, MDPI, vol. 20(3), pages 1-12, January.
    5. David Feligreras-Alcalá & Antonio Frías-Osuna & Rafael del-Pino-Casado, 2020. "Personal and Family Resources Related to Depressive and Anxiety Symptoms in Women during Puerperium," IJERPH, MDPI, vol. 17(14), pages 1-14, July.
    6. Joanne R. Campione & Katarzyna A. Zebrak, 2022. "The Chosen Child: Characteristics of Family Caregivers Selected at an Early Age to Provide Care to Their Parents," Journal of Elder Policy, John Wiley & Sons, vol. 2(1), pages 29-49, March.
    7. Perla Werner & Aviad Tur-Sinai & Hanan AboJabel, 2021. "Examining Dementia Family Caregivers’ Forgone Care for General Practitioners and Medical Specialists during a COVID-19 Lockdown," IJERPH, MDPI, vol. 18(7), pages 1-11, April.
    8. Lawrence B. Sacco & Stefanie König & Hugo Westerlund & Loretta G. Platts, 2022. "Informal Caregiving and Quality of Life Among Older Adults: Prospective Analyses from the Swedish Longitudinal Occupational Survey of Health (SLOSH)," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 845-866, April.
    9. Rafael del-Pino-Casado & Emilia Priego-Cubero & Catalina López-Martínez & Vasiliki Orgeta, 2021. "Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-20, March.
    10. Tatjana Rajovic & Natasa Todorovic & Milutin Vracevic & Nina Rajovic & Andrija Pavlovic & Vedrana Pavlovic & Igor Grbic & Rosa Sapic & Slavica Krsmanovic & Marijana Vukmirovic & Tamara Stanisavljevic , 2021. "From Burden to Depressive Symptoms in Informal Caregivers during the COVID-19 Pandemic: A Path Analysis," IJERPH, MDPI, vol. 18(18), pages 1-13, September.
    11. Aliya Zhylkybekova & Gulbakit K. Koshmaganbetova & Afshin Zare & Nadiar M. Mussin & Asset A. Kaliyev & Shabnam Bakhshalizadeh & Nurgul Ablakimova & Andrej M. Grjibovski & Natalya Glushkova & Amin Tama, 2024. "Global Research on Care-Related Burden and Quality of Life of Informal Caregivers for Older Adults: A Bibliometric Analysis," Sustainability, MDPI, vol. 16(3), pages 1-18, January.
    12. Sara Santini & Marco Socci & Paolo Fabbietti & Giovanni Lamura & Andrea Teti, 2022. "Factors Worsening and Mitigating the Consequences of the COVID-19 Outbreak on the Overall Health of Informal Caregivers of Older People with Long-Term Care Needs Living in Germany and in Italy," IJERPH, MDPI, vol. 19(3), pages 1-21, February.
    13. Takashi Oshio & Kemmyo Sugiyama, 2022. "Social Participation as a Moderator for Caregivers’ Psychological Distress: a Dynamic Panel Data Model Analysis in Japan," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 17(3), pages 1813-1829, June.

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