This study investigated whether transitioning into the role of activities of daily living (ADL) spousal caregiver is associated with increased depressive symptoms for older husbands and wives among a sample of coresiding community-dwelling older couples. Using data from the Health and Retirement Study, we estimated a two-level linear model to examine the association between change in caregiver status and respondents’ depressive symptoms at follow-up, controlling for other factors identified in Pearlin’s stress process model (PSPM). Results indicate that both husbands and wives who become ADL caregivers have more follow-up depressive symptoms than noncaregivers. Furthermore, wives continuing as caregivers have more follow-up depressive symptoms than wives who do not provide care. Finally, the physical health of the spousal caregiver is related to depressive symptoms at follow-up. We conclude with policy and practice implications of these three main findings.
AdamsK. B. (2008). Specific effects of caring for a spouse with dementia: Differences in depressive symptoms between caregiver and non-caregiver spouses. International Psychogeriatrics, 20, 508–520. doi:10.1017/S1041610207006278
2.
American Association of Retired Persons. (2001). Caregiver identification study. Washington, DC: Author.
3.
AneshenselC. S.PearlinL. I.MullanJ. T.ZaritS. H.WhitlachC. J. (1995). Profiles in caregiving: The unexpected career. San Diego, CA: Academic Press.
4.
BarberC. E.PasleyB. K. (1994). Family care of Alzheimer’s patients: The role of gender and generational relationship on caregiver outcomes. Journal of Applied Gerontology, 14, 172–192. doi:10.1177/073346489501400203
5.
BeachS. R.SchulzR.YeeJ. L.JacksonS. (2000). Negative and positive health effects of caring for a disabled spouse: Longitudinal findings from the Caregiver Health Effects Study. Psychology and Aging, 15, 259–271. doi:10.1037/0882-7974.15.2.259
6.
BurtonL. C.NewsomJ.ShulzR.HirschC.GermanP. (1997). Preventive health behaviors among spousal caregivers. Preventive Medicine, 26, 162–169. doi:10.1006/Pmed.1996.1029
7.
BurtonL. C.ZdaniukB.SchulzR.JacksonS.HirschC. (2003). Transitions in spousal caregiving. The Gerontologist, 43, 230–241. doi:10.1093/geront/43.2.230
8.
CalasantiT.BowenM. E. (2006). Spousal caregiving and crossing gender boundaries: Maintaining gendered identities. Journal of Aging Studies, 20, 253–263. doi:10.1016/j.jaging.2005.08.001
9.
CannuscioC.JonesC.KawachiI.ColditzG. A.BerkmanL.RimmE. (2002). Reverberation of family illness: A longitudinal assessment of informal caregiver and mental health status in the nurses’ health study. American Journal of Public Health, 92, 1305–1311. doi:10.2105/AJPH.92.8.1305
10.
CapistrantB. D.MoonJ. R.GlymourM. M. (2012). Spousal caregiving and incident hypertension. American Journal of Hypertension, 25, 437–443. doi:10.1038/ajh.2011.232
11.
ColeM.DendukuriN. (2003). Risk factors for depression among elderly community subjects: A systematic review and meta-analysis. American Journal of Psychiatry, 160, 1147–1156. doi:10.1176/appi.ajp.160.6.1147
12.
ElliottA. F.BurgioL. D.DeCosterJ. (2010). Enhancing caregiver health: Findings from the resources for enhancing Alzheimer’s Caregiver Health II intervention. Journal of the American Geriatrics Society, 58, 30–37. doi:10.1111/j.1532-5415.2009.02631.x
13.
ElliottM. E. (2001). Gender differences in causes of depression. Women’s Health, 33, 163–177. doi:10.1300/J013v33n03_11
14.
EttersL.GoodallD.HarrisonB. E. (2008). Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners, 20, 423–438. doi:10.1111/j.1745-7599.2008.00342.x
15.
FreedmanV. A.AykanH.MartinL. G. (2001). Aggregate changes in severe cognitive impairment among older Americans: 1993 and 1998. Journals of Gerontology: Social Sciences, 56B, S100–S111. doi:10.1093/geronb/56.2.S100
16.
GauglerJ. E.KaneR. A.LangloisJ. (2000). Assessment of family caregivers of older adults. In KaneR. L.KaneR. A.. (Eds.), Assessing the well-being of older people: Measures, meaning and practical applications (pp. 320–359). New York, NY: Oxford University Press.
17.
GauglerJ. E.MittelmanM. S.HepburnK.NewcomerR. (2009). Predictors of change in caregiver burden and depressive symptoms following nursing home admission. Psychology & Aging, 24, 385–396. doi:10.1037/a0016052
18.
Gijsbers van WijkC. M.HuismanH.KolkA. M. (1999). Gender differences in physical symptoms and illness behaviours: A health diary study. Social Sciences & Medicine, 49, 1061–74. doi:10.1016/S0277-9536(99)00196-3
19.
GoodeK. T.HaleyW. E.RothD. L.FordG. R. (1998). Predicting longitudinal changes in caregiver physical and mental health: A stress process model. Health Psychology, 17, 190–198. doi:10.1037/0278-6133.17.2.190
20.
HaleyW. E.BergmanE. J.RothD. L.McVieT.GauglerJ. E.MittelmanM. S. (2008). Long-term effects of bereavement and caregiver intervention on dementia caregiver depressive symptoms. The Gerontologist, 48, 732–740. doi:10.1093/geront/48.6.732
21.
HayslipB.KaminskiP. (2005). Grandparents raising their grandchildren: A review of the literature and suggestions for practice. The Gerontologist, 45, 262–269. doi:10.1093/geront/45.2.262
LiL. W. (2005). From caregiving to bereavement: Trajectories of depressive symptoms among wife and daughter caregivers. Journals of Gerontology, Psychological Sciences, 60, 190–198. doi:10.1093/geronb/60.4.P190
24.
LiL. W.SeltzerM. M.GreenbergJ. S. (1999). Change in depressive symptoms among daughter caregivers: An 18-month longitudinal study. Psychology and Aging, 14, 206–219. doi:10.1037/0882-7974.14.2.206
25.
LimaJ. C.AllenS. M.GoldscheiderF.IntratorO. (2008). Spousal caregiving in late midlife versus older ages: Implications of work and family obligations. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 63, S229–S238. doi:10.1093/geronb/63.4.S229
26.
LorantL.DeliegeD.EatonW.RobertA.PhilippotP.AnsseauM. (2003). Socioeconomic inequalities in depression: A meta-analysis. American Journal of Epidemiology, 57, 98–112. doi:10.1093/aje/kwf182
27.
MarksN. F.LambertJ. D.ChoiH. (2002). Transition to caregiving, gender, and psychological well-being: A prospective U.S. national study. Journal of Marriage and Family, 64, 657–667. doi:10.1111/j.1741-3737.2002.00657.x
28.
MeylerD.StimpsonJ. P.PeekM. K. (2007). Health concordance within couples: A systematic review. Social Science & Medicine, 64, 2297–2310doi:10.1016/j.socscimed.2007.02.007
29.
MittelmanM. S.HaleyW. E.ClayO. J.RothD. L. (2006). Improving caregiver well-being delays nursing home placement of patients with Alzheimer’s disease. Neurology, 67, 1592–1599. doi:10.1212/01.wnl.0000242727.81172.91
National Center for Health Statistics. (2006). Health, United States, 2006, Special Except: Trend Tables on 65 and Older Population. United States Dept of HHS, CDC and Prevention, Hyattsville, MD.
32.
O'ConnorD. L. (2007). Self-identifying as a caregiver: Exploring the positioning process. Journal of Aging Studies, 21, 165–174. doi:10.1016/j.jaging.2006.06.002
33.
PearlinL. I.MullanJ. T.SempleS. J.SkaffM. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583–594. doi:10.1093/geront/30.5.583
34.
PenninxB. W. J. H.GeerlingsS. W.DeegD. J. H.van EijkJ.van TilburgW.BeekmanA. (1999). Minor and major depression and the risk of death in older persons. Archives of General Psychiatry, 56, 889–895. doi:10.1001/archpsyc.56.10.889
35.
PinquartM.SörensenS. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology & Aging, 18, 250–267. doi:10.1037/0882-7974.18.2.250
36.
PinquartM.SörensenS. (2006). Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. Journals of Gerontology Psychological Sciences, 61, 33–45. doi:10.1093/geronb/61.1.P33
37.
PinquartM.SörensenS. (2007). Correlates of physical health of informal caregivers: A meta-analysis. Journal of Gerontology: Psychological Sciences, 62B, P126–P137. doi:dx.doi.org/10.1093/geronb/62.2.P126
38.
PinquartM.SörensenS. (2011). Spouses, adult children, and children-in-law as caregivers of older adults: A meta-analytic comparison. Psychology & Aging, 26, 1–14. doi:10.1037/a0021863
39.
RadloffL. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306
40.
RodgersW. L.OfstedalM. B.HerzogA. R. (2003). Trends in scores on tests of cognitive ability in the elderly U.S. population, 1993–2000. The Journals of Gerontology, Social Sciences, 58B, S338–S346. doi:10.1093/geronb/58.6.S338
41.
SchulzR.BeachS. R. (1999). Caregiving as a risk factor for mortality. Journal of the American Medical Association, 282, 2215–2219. doi:10.1001/jama.282.23.2215
42.
SchulzR.MendelsohnA. B.HaleyW. E.MahoneyD.AllenR. S.ZhangS.ThompsonL.BelleS. H. (2003). End-of-life care and the effects of bereavement on family caregivers of persons with dementia. The New England Journal of Medicine, 349, 1936–1942. doi:10.1056/NEJMsa035373
43.
SeltzerM. M.LiL. W. (2000). The dynamics of caregiving: Transitions during a three-year prospective study. The Gerontologist, 40, 165–178. doi:10.1093/geront/40.2.165
44.
SonJ.ErnoA.SheaD. G.FimaE. E.ZaritS. H.StephensM. A. P. (2007). The caregiver stress process and health outcomes. Journal of Aging and Health, 19, 871–887. doi:10.1177/0898264307308568
45.
SpinhovenP.KooimanC. G. (1997). Defense style in depressed and anxious psychiatric outpatients: An explorative study. Journal of Nervous and Mental Disease, 185, 87–94. doi:10.1097/00005053-199702000-00004
46.
SteffensD. C.BosworthH. B.ProvenzaleJ. M.MacFallJ. R. (2002). Subcortical white matter lesions and functional impairment in geriatric depression (2002). Depression and Anxiety, 15, 23–28. doi:10.1002/da.1081
SugiuraK.ItoM.KutsumiM.MikamiH. (2009). Gender differences in spousal caregiving in Japan. Journal of Gerontology: Social Sciences, 64B, 147–156. doi:10.1093/geronb/gbn005
49.
SunF.HilgemanM. M.DurkinD.AllenR. S.BurgioL. D. (2009). Perceived income inadequacy as a predictor of psychological distress in Alzheimer’s caregivers. Psychology and Aging, 24, 177–183. doi:10.1037/a0014760
50.
ThompsonR. L.LewisS. L.MurphyM. R.HaleJ. M.BlackwellP. H.ActonG. J.…BonnerP. N. (2004). Are there sex differences in psychological and biological responses in spousal caregivers of patients with Alzheimer's disease?Biological Research for Nursing, 5, 319–330. doi:10.1177/1099800404263288
51.
TurveyC. L.WallaceR. B.HerzogR. (1999). A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly. International Psychogeriatrics, 11, 139–148. doi:10.1017/S1041610299005694
52.
VitalianoP. P.ZhangJ.ScanlanJ. M. (2003). Is caregiving hazardous to one’s physical health? A meta-analysis. Psychological Bulletin, 129, 946–972. doi:10.1037/0033-2909.129.6.946
53.
WolffJ. L.KasperJ. D. (2006). Caregivers of frail elders: Updating a national profile. The Gerontologist, 46, 344–356. doi:10.1093/geront/46.3.344
54.
YeeJ. L.SchulzR. (2000). Gender differences in psychiatric morbidity among family caregivers: A review and analysis. The Gerontologist, 40, 147–164. doi:10.1093/geront/40.2.147
