The health of persons giving care to the demented elderly: a critical review of the literature.

The majority of the demented elderly live at home, usually cared for by their spouse or an adult child. Clinical impressions suggest that caring for an older person suffering from a dementing disorder may lead to physical and mental health problems for the caregiver. A critical review of the research literature on this topic was carried out. The review revealed that a multitude of physical and mental health outcomes as well as numerous correlates of health problems have been studied in relation to caregiving. Furthermore, several methodological problems were identified in the studies reviewed: inadequate sample size, unrepresentative study samples, uncontrolled confounding factors, inappropriate study design, multidimensional outcome measures, and absence of comparison groups. The diversity of outcomes studied and the numerous methodological problems make it difficult to make statements about the causal effect of caregiving on health, or to assess the public health impact of caring for a demented elderly person. Nevertheless, the work done to date suggests interesting directions for future research.