[Alzheimer's disease, caregiving and frailty]

Do European co-residential caregivers aged 50+ have an increased risk of frailty?

One important health challenge associated with ageing is frailty, which has been acknowledged as a new public health priority. However, only a few studies have explored the relationship between providing care at older ages and frailty. The main objective of this study is to assess whether there is an association between providing co-residential care and frailty, according to gender and from a European cross-sectional perspective, among the population aged 50+. Data from 17 European countries that participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) is used (N = 52,073). Multinomial logistic regressions were used to estimate caregivers' chances of frailty. The results show that the prevalence of pre-frailty and frailty differs according to the caregiver's status, gender and the European region. The highest prevalence of pre-frailty was found in the group of female caregivers from Northern countries (57.3%), and the highest prevalence of frailty was found in the group of female caregivers from Southern countries (29.3%). Providing co-residential care is positively associated with the risk of being pre-frail in women, in all European regions (Northern: OR 1.724, 95% CI 1.190-2.496; Central: OR 1.213, 95% CI 1.010-1.456; Eastern: OR 1.227, 95% CI 1.031-1.460; Southern: OR 1.343, 95% CI 1.103-1.634), and with being frail for both genders in the Southern region (female: OR 1.527, 95% CI 1.060-2.200; male: OR 1.644, 95% CI 1.250-2.164). The results of this study suggest that female co-residential caregivers are a greater risk of being pre-frail in all European regions except Southern Europe, where male and female co-residential caregivers are a greater risk of being frail, compared with non-caregivers. European policy makers should create political measures to prevent and reverse frailty among European co-residential caregivers.

Health impact of providing informal care in Portugal

BACKGROUND

Middle-aged and older adults play an important role in the provision of informal support, however, the impact on the health of those individuals who provide informal care is unclear. The main objectives of this study are: (1) to assess the prevalence of co-residential caregiving provided by individuals aged 50+; (2) to analyze differences between the group of Portuguese co-residential caregivers and the group of Portuguese non-caregivers; (3) to examine the longitudinal effect of providing informal care on the health of co-residential informal caregivers in Portugal.

METHODS

Data from wave 4 and wave 6 of the Survey of Health Ageing and Retirement in Europe (SHARE) were used. A linear mixed model and a generalized mixed model were used to analyze the longitudinal effect of providing informal care on the health (physical health and depressive symptoms) of Portuguese individuals aged 50 + .

RESULTS

In both SHARE waves analyzed, Portugal had the highest percentage of co-residential caregivers aged 50+. At baseline, the Portuguese co-residential caregiver population, compared to non-caregivers, has a lower percentage of employed individuals (14.9% compared to 25.7%) and a higher percentage of individuals with four or more depressive symptoms (56.4% compared to 35.5%). The caregivers also have a lower quality of life (CASP-12) (30.93 compared to 32.59). Marginal differences in educational levels between the caregiver and non-caregiver groups were also found, with co-residential caregivers having lower levels of education (72.3% have ISCED 0-2 compared to 64.7%), lower levels of cognitive function (- 2.321 compared to - 1.784), lower levels of physical health (- 0.180 compared to - 0.076) and lower engagement in moderate or vigorous physical activity (14.9% compared to 21.5%). Longitudinal models reveal that providing care within the household is not associated with physical health (b = 0.048; se = 0.035; p = 0.167), but is associated with depressive symptoms (OR = 1.609; 95% CI = 1.141-2.271; p = < 0.010).

CONCLUSIONS

Portugal has the highest percentage of co-residential caregivers aged 50+. In that country, providing informal care to a household member is associated with depressive symptoms. Portuguese policymakers should therefore promote programs to prevent and alleviate the depressive symptoms experienced by individuals aged 50+, who provide co-residential care.

The double vulnerability of elderly caregivers: multimorbidity and perceived burden and their associations with frailty

Abstract Objective: To identify if multimorbidity and burden are associated with a greater likelihood of frailty in elderly caregivers of other elderly persons within the family context. Method: 148 elderly caregivers caring for other elderly persons [M=69.7 (±7.0) years old] were recruited using a criterion of convenience in public and private health services in the city of Campinas and surrounding areas. Information was gathered about socio-demographic context, context of care, physical health, care burden using the Zarit Burden Scale, and frailty, measured by subjective evaluation. Four groups of vulnerability were created based on the presence or absence of multimorbidities and high or low burden, in order to verify which group was most strongly associated with frailty. Data were analyzed using descriptive analysis, measurements of association and multivariate hierarchical logistic regression. Results: The prevalence of multimorbidity was 55.4%. The Zarit Burden Scale presented a median of 23 out of a total of 88 points. Of the sample, 35.1% were frail, 46.0% intermediate, and 18.9% robust. Elderly caregivers with multimorbidity and high burden had a greater probability of frailty (OR=3.6; CI 1.55-8.36), followed by those with multimorbidity and low burden (OR=2.8; CI 1.13-6.79). Conclusion: The sensation of burden among caregivers was reduced; those with double vulnerability were most prevalent among the four groups and had the greatest association with the occurrence of frailty; multimorbidity was associated with frailty. If combined with perceived burden, however, the odds ratios of the elderly caregivers being frail increased.