Variability in perceived burden and health trajectories among older caregivers: a population-based study in Sweden

Background: The extent to which caregivers incur the negative effects of informal caregiving is affected not only by the characteristics of the caregiver-care receiver dyad but also by the context of care.We aimed to identify subgroups of older informal caregiversmost susceptible to these consequences.
Methods: We identified older informal caregivers (n=620, 18.9% at baseline, mean age 69.9years) in the Swedish longitudinal study on Aging and Care in Kungsholmen (SNAC-K). Limitations to life and perceived burden were self-reported during nurse-led interviews. Health status was assessed using the comprehensive clinical and functionalHealth Assessment Tool (HAT) score, ranging from 0 to 10. Ordered logistic regression models and linear mixed models were used to estimate the associations between caregiving-related exposures and self-reported orobjective health outcomes, respectively.
Results: Having a dual role (providing and receiving caresimultaneously), caring for a spouse, living in the same household as the care receiver, and greater intensity of caregivingwere significantly associated with more limitations and burden. In addition, having a dual role (β= -0.12, 95% CI -0.23; -0.02) and caring fora spouse (β= -0.07, 95% CI -0.14; -0.01) were associated with a faster HAT score decline.Being female and having a poor social network were associated with a marked exacerbation of the health decline linked to caregiving.
Conclusions: Both the heterogeneity amongcaregivers and the contextual factors influencing the process of caregivingshould be accounted for in future studies investigating the potential health impact of informal caregiving.