Department of Epidemiology & Biostatistics, UC San Francisco, San Francisco, California, USA.
Division of Community Health Sciences, University of Illinois, Chicago, Illinois, USA.
Int J Geriatr Psychiatry. 2021 May;36(5):775-783. doi: 10.1002/gps.5477. Epub 2020 Dec 11.
To evaluate associations between spousal caregiving and mental and physical health among older adults in Mexico.
Data come from the Mexican Health & Aging Study, a national population-based study of adults ≥50 years and their spouses (2001-2015). We compared outcomes for spousal caregivers to outcomes for those whose spouses had difficulty with at least one basic or instrumental activity of daily living (I/ADL) but were not providing care; the control group conventionally includes all married respondents regardless of spouse's need for care. We used targeted maximum likelihood estimation to evaluate the associations with past-week depressive symptoms, lower-body functional limitations, and chronic health conditions.
At baseline, 846 women and 629 men had a spouse with ≥1 I/ADL. Of these, 60.9% of women and 52.6% of men were spousal caregivers. Spousal caregiving was associated with more past-week depressive symptoms for men (Marginal Risk Difference (RD): 0.27, 95% confidence internal [CI]: 0.03, 0.51) and women (RD: 0.15, 95% CI: 0.07, 0.23). We could not draw conclusions about associations with lower-body functional limitations and chronic health conditions. On average, all respondents whose spouses had caregiving needs had poorer health than the overall sample.
We found evidence of an association between spousal caregiving and mental health among older Mexican adults with spouses who had need for care. However, our findings suggest that older adults who are both currently providing or at risk of providing spousal care may need targeted programs and policies to support health and long-term care needs.
评估墨西哥老年配偶照料与身心健康之间的关联。
数据来自墨西哥健康与老龄化研究，这是一项针对≥50 岁成年人及其配偶的全国性人口研究（2001-2015 年）。我们将配偶照料者的结果与配偶至少在一项基本或工具性日常生活活动（I/ADL）方面存在困难但未提供照料的结果进行比较；对照组传统上包括所有已婚受访者，无论其配偶是否需要照料。我们使用有针对性的最大似然估计来评估与过去一周抑郁症状、下半身功能限制和慢性健康状况的关联。
在基线时，846 名女性和 629 名男性的配偶有≥1 项 I/ADL。其中，60.9%的女性和 52.6%的男性是配偶照料者。配偶照料与男性（边际风险差异（RD）：0.27，95%置信区间（CI）：0.03，0.51）和女性（RD：0.15，95%CI：0.07，0.23）过去一周抑郁症状增加有关。我们无法得出与下半身功能限制和慢性健康状况有关的结论。平均而言，所有配偶有照料需求的受访者的健康状况均差于总体样本。
我们发现，墨西哥老年配偶照料与有照料需求的配偶的心理健康之间存在关联的证据。然而，我们的研究结果表明，目前正在提供或有提供配偶照料风险的老年成年人可能需要有针对性的计划和政策来支持他们的健康和长期护理需求。
