Association of informal caregiving with body mass index and frequency of sporting activities: evidence of a population-based study in Germany

How does beginning or ceasing of informal caregiving of individuals in poor health influence sleep quality? Findings from a nationally representative longitudinal study

BACKGROUND

Various cross-sectional studies exist examining the association between informal caregiving and sleep quality. However, there is a lack of longitudinal studies investigating whether beginning and ceasing of informal caregiving is associated with changes in sleep quality.

AIMS

Investigating whether beginning and ceasing of informal caregiving of individuals in poor health is associated with changes in sleep quality in both sexes.

METHODS

Data were taken from a nationally representative sample of individuals ≥ 40 years in Germany from 2008 to 2017. In our analytical sample, n equaled 22,910 observations. Based on the Pittsburgh Sleep Quality Index, the sleep quality was assessed by the difficulties falling asleep during the last month, difficulties with sleep because of waking up during the last month (in both cases: (from 1 = not during the last month to 4 = three or more times a week) and the overall assessment of sleep quality during the last month (from 1 = very good to 4 = very bad).

RESULTS

Asymmetric fixed effects regressions showed that in men beginning to provide informal care was associated with decreased overall sleep quality (β=-.09 (95% CI: -.15 - -.03), p<.01) and an increased likelihood of difficulties because of waking up (OR: 1.54 (95% CI: 1.07-2.20), p<.05), whereas ceasing to provide informal care was not associated with the outcome measures (both, in women and in men).

DISCUSSION

Starting informal caregiving had deleterious effects on sleep quality in men.

CONCLUSIONS

Efforts to assist men in maintaining sleep quality may be beneficial.

[Highly Burdened Groups of Family Caregivers - Results of a Cluster Analysis]

AIM

The aim of this study was to explore caregiving situations and to identify highly burdened caregiver groups.

METHODOLOGY

Survey data was collected from 1,429 family caregivers. Family caregivers were defined as relatives, friends, or neighbors who take care of and look after a person in need of care. Cluster analysis identified groups of family caregivers. Group differences were tested for statistical significance using the chi-squared test and analysis of variance.

RESULTS

Five groups of family caregivers were identified based on their caregiving tasks. Groups were characterized by the care situation (relationship to the person in need, intensity, and duration of care) and socio-demographic factors (gender, age, and employment). Groups differed in the perception of the care-related burden. While emotional burden was high in almost all groups, caregivers who provided everyday care reported high physical burden and those who provided continuous care over a long period reported high financial burden.

CONCLUSIONS

Caregivers are not a homogeneous group. They take on different roles and are exposed to various health and financial burdens. Information and services need to be addressed target group specifically. The presented typology supports health insurances and municipalities by enabling effective support approaches for highly burdened groups of family caregivers.

Vereinbarkeit von Beruf und Pflege: Wie wirkt sich Erwerbstätigkeit auf die Gesundheit pflegender Angehöriger aus?

Ziel Die Studie untersucht, inwieweit die Gesundheitsauswirkungen der informellen Pflege durch den kontextuellen Faktor Erwerbstätigkeit beeinflusst werden.

Methodik Die Analyse basiert auf repräsentativen Bevölkerungsdaten aus den Jahren 2015 und 2016 (n=19 791). Als Untersuchungsgruppe „pflegende Angehörige“ definiert werden Personen, die mindestens eine Stunde pro Woche eine pflegebedürftige Person informell unterstützen, betreuen oder versorgen. Durch Anwendung von Propensity Score Matching wird eine strukturangepasste Vergleichsgruppe identifiziert. Anhand eines multivariaten Regressionsmodells werden Zusammenhänge in der Gruppe der pflegenden Angehörigen und der strukturangepassten Vergleichsgruppe analysiert. Für eine grafische Darstellung werden Untergruppen zum zeitlichen Einsatz im Hinblick auf Angehörigenpflege und Erwerbstätigkeit gebildet.

Ergebnisse Die psychische Gesundheit pflegender Angehöriger verschlechtert sich mit zunehmendem Aufwand für die Betreuung (B=-0,44; p=0,02). Die negativen gesundheitlichen Auswirkungen der Angehörigenbetreuung werden durch die Erwerbstätigkeit verringert (B=0,58; p<0,01), allerdings nur bis zum einem bestimmten zeitlichen Arbeitseinsatz. Bei einem höheren zeitlichen Aufwand für beide Tätigkeiten nimmt der moderierende Effekt ab (bis zu 32% der Standardabweichung).

Schlussfolgerungen Der signifikante moderierende Effekt der Erwerbstätigkeit ist in der Wirkung maßgeblich durch die Gesamtbelastung aus den beiden Tätigkeitsbereichen geprägt. Die Ergebnisse vermitteln einen Eindruck von der potentiell stärkenden und schützenden Wirkung von Erwerbstätigkeit auf die gesundheitlich negativen Auswirkungen der Angehörigenbetreuung.

Biomedical health profiles of unpaid family carers in an urban population in South Australia

OBJECTIVES

To compare the biomedical health profile and morbidity of adult carers with non-carers.

METHODS

The North West Adelaide Health Study (NWAHS) is a representative population-based longitudinal biomedical cohort study of 4056 participants aged 18 years and over at Stage One. Informal (unpaid) carers were identified in Stage 3 of the project (2008-2010). Risk factors, chronic medical conditions and biomedical, health and demographic characteristics using self-report and blood measured variables were assessed. Data were collected through clinic visits, telephone interviews and self-completed questionnaires. Risk factors included blood pressure, cholesterol/lipids, body mass index (BMI), smoking and alcohol intake. Chronic medical conditions included cardiovascular and respiratory diseases, diabetes, and musculoskeletal conditions. Blood measured variables were routine haematology, biochemistry, Vitamin D, and the inflammatory biomarkers high sensitivity C-Reactive Protein (hs-CRP), Tumor Necrosis Factor alpha (TNFα) and Interleukin-6 (Il-6).

RESULTS

The prevalence of carers aged 40 years and over was 10.7%, n = 191. Carers aged 40 years and over were more likely to assess their health status as fair/poor and report having diabetes, arthritis, anxiety and depression. They also reported insufficient exercise and were found to have higher BMI compared with non-carers. Significant findings from blood measured variables were lower serum Vitamin D and haemoglobin. Male carers had raised diastolic blood pressure, higher blood glucose, lower haemoglobin and albumin levels and slightly elevated levels of the inflammatory biomarkers TNFα and hs-CRP.

DISCUSSION AND CONCLUSIONS

This study confirms informal carers had different biomedical profiles to non-carers that included some chronic physical illnesses. It identifies that both female and male carers showed a number of risk factors which need to be considered in future caregiver research, clinical guidelines and policy development regarding carer morbidity.

Informal caregiving and markers of adiposity in the UK Household Longitudinal Study

OBJECTIVES

The aim was to investigate associations between caregiving and adiposity using a representative UK longitudinal study. We also investigated whether associations differed by age, gender and caregiving characteristics.

METHODS

Data on 9,421 participants aged 16+ from three waves (2009-2012) of the UK Household Longitudinal Study were used. Body mass index, waist circumference and percentage body fat were assessed. Caregiving and caregiving characteristics (hours per week, number of people cared for, co-resident caregiving and combining working and caregiving) was available from the prior wave. Gender-stratified associations between caregiving/caregiving characteristics with adiposity were tested. Covariates included caregiver's health, socioeconomic position, parenthood and partnerships.

RESULTS

Caregiving was associated with higher adiposity for women but not men. Younger women caregivers had particularly higher levels of adiposity. Men combining part-time paid work with caregiving had higher levels of adiposity than men working full-time and not caregiving. Women aged 16-44 or 65+ had particularly high levels of adiposity when combining full-time work and caregiving, compared to full-time work alone.

CONCLUSION

The health of caregivers should be a public health priority, particularly for younger women and those combining paid work with caregiving responsibilities.

Informal caregiving and metabolic markers in the UK Household Longitudinal Study

OBJECTIVES

Informal caregiving is associated with poorer mental and physical health. Little research has yet focused on objectively measured health risk factors, such as metabolic markers. The aim of this study was to investigate whether informal caregiving was associated with markers of metabolism in a large, representative UK longitudinal study. We also investigated whether more intensive caregiving, as indicated by more caregiving hours, was associated with a less favourable metabolic profile.

STUDY DESIGN/OUTCOME MEASURES

Using data on 9408 participants aged 16+ from the UK Household Longitudinal Study, we explored the relationship between caregiving and metabolic markers (blood pressure, total and high density lipoprotein cholesterol, glycated haemoglobin and triglycerides). We additionally investigated the importance of caregiving intensity (number of hours spent caregiving per week). Associations between caregiving/caregiving intensity and metabolic markers were tested using gender-stratified linear regression models adjusted for age, household income, education, social class, chronic illness, number of dependent children in the household, body mass index and partnership status.

RESULTS

Men who were informal caregivers had higher total cholesterol levels than non-caregivers (3.25% higher, 95% CI: 0.07, 6.53). Women caregivers also had higher total cholesterol levels and women providing intensive care (over 20 h per week) had higher triglyceride levels (19.91% higher, 95% CI: 7.22, 34.10) and lower levels of high density lipoprotein cholesterol (8.46% lower, 95% CI: 14.51, 1.99); however, associations for women were attenuated in our final models.

CONCLUSIONS

Informal caregiving is associated with less favourable lipid profiles. This may be one mechanism through which informal caregiving is associated with increased disease risk. The health of informal caregivers should be a priority for public health.