Depression, sleep problems, and perceived stress among informal caregivers in 58 low-, middle-, and high-income countries: A cross-sectional analysis of community-based surveys

Abstract

Caregiving has been associated with adverse health outcomes. However, there is a paucity of multi-country, population-based studies on mental health outcomes of caregivers especially from low- and middle-income countries (LMICs). Thus, we assessed the association of caregiving with depression, sleep problems, and perceived stress in 10 high-, 27 middle-, and 21 low-income countries. Cross-sectional community-based data of the World Health Survey including 258,793 adults aged ≥18 years were analyzed. Multivariable logistic and linear regression analyses were conducted to explore the association of past 12-month caregiving with past 12-month DSM-IV depression, and past 30-day perceived stress [range 0 (low)-100 (high)] and severe/extreme sleep problems. Nearly 20% of the individuals were engaged in caregiving with particularly high rates observed in high-income countries (HICs) (e.g., Finland 43.3%). Across the entire sample, after adjustment for potential confounders, caregivers had a significantly higher likelihood of having depression (OR = 1.54; 95%CI = 1.37-1.73), sleep problems (OR = 1.37; 95%CI = 1.25-1.50), while their mean perceived stress score was 3.15 (95%CI = 2.46-3.84) points higher. These associations tended to be stronger in HICs. A greater number of caregiving activities was associated with a greater likelihood of depression, sleep problems, and perceived stress regardless of country income levels. In conclusion, caregiving has a negative impact on mental health worldwide with possibly greater effects in HICs. Given the growing contribution of caregivers in long-term care, interventions and policies to alleviate the mental health burden of caregivers are urgently needed to maintain sustainable and effective care practices.

The Burden of Care: A National Survey on the Prevalence, Demographic Characteristics and Health Problems Among Young Adult Carers Attending Higher Education in Norway

“…Whereas previous studies have found that young carers experience the caring responsibility as rewarding (Chikhradze et al, 2017), carers in different age groups also report adverse effects (Pakenham et al, 2006;Berglund et al, 2015;Pakenham and Cox, 2015;Greene et al, 2017;Kallander et al, 2018). In line with increased rate of health problems found among carers in general (Koyanagi et al, 2018), the negative outcomes among YACs in the present study were evident on several health markers, i.e., anxiety and depressive symptoms, sleep problems, and somatic symptoms. These results should, however, be understood in the context of the transition period of emerging adulthood (e.g., leaving home, starting higher education) (Arnett, 2007).…”

Associations between TV viewing, sitting time, physical activity and insomnia among 100,839 Brazilian adolescents

“…The continuing dearth of studies from this part of the world also highlights the gap between where research is conducted and where the largest public health impacts of physical inactivity will occur (Sallis et al, 2016). However, given that sleep problems have been highlighted as a growing problem in LMICs (Koyanagi et al, 2018;Peltzer and Pengpid, 2017;Stranges et al, 2012) and that interaction between factors that result in insomnia tend to vary according to social and cultural conditions, information from nationally representative samples in LMICs is warranted. Therefore, the present study examined the relationship between insomnia and levels of physical activity, and time spent sitting and time spent TV viewing in a representative sample of Brazilian adolescents.…”

Age-dependency in mortality of family caregivers: a nationwide register-based study

“…Taking care of another person may bring joy, a feeling of being needed and a sense of purpose in life to the family caregiver [3,4] but still, several studies report poorer mental health [5,6], more sleep problems [6], and higher stress levels [5][6][7] in family caregivers compared to non-caregivers. The findings in relation to physical health outcomes among caregivers compared to non-caregivers are contradictory [8][9][10][11][12][13][14].…”