Wahrendorf Morten, McMunn Anne, Xue Baowen, Schaps Valerie, Deindl Christian, Di Gessa Giorgio, Lacey Rebecca E
Institute of Medical Sociology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Research Department of Epidemiology and Public Health, University College London, London, UK.
J Gerontol B Psychol Sci Soc Sci. 2025 May 8;80(6). doi: 10.1093/geronb/gbaf053.
We examine the mental health trajectories of people who start providing personal care and compare their trajectories with matched controls who remain non-carers. We also investigate whether trajectories vary by gender, financial resources, and supportive long-term care policies.
Using 9 waves of the Survey of Health, Ageing, and Retirement in Europe, collected in 28 European countries from 2004 to 2022, we analyze longitudinal data from 68,075 men and women aged 50 or older. We identify transitions into regular personal care within the household and use depressive symptoms from up to 4 waves before and after transitioning into care to measure mental health trajectories. Financial resources are measured by household wealth, whereas 3 macro indicators assess (1) support for caregivers, (2) support for care recipients, and (3) public care service availability. Propensity score matching, applied separately for men and women, identifies matched noncaregivers from the same country, and we use piecewise growth curve models to examine changes before, during, and after becoming a carer.
Both men and women have a clear increase in depressive symptoms when becoming a regular carer, and this increase even begins before the transition. The increase during the transition is slightly more pronounced for women and those with lower wealth, but we find no systematic differences by policy indicators.
Our study highlights the need for improved support for carers. Although national policies may influence the likelihood of becoming a carer, their effectiveness in mitigating the mental health impact of caring remains unclear.
我们研究开始提供个人护理的人群的心理健康轨迹，并将他们的轨迹与仍未成为护理者的匹配对照组进行比较。我们还调查轨迹是否因性别、财务资源和支持性长期护理政策而异。
利用2004年至2022年在28个欧洲国家收集的9轮欧洲健康、老龄化和退休调查数据，我们分析了68075名50岁及以上男女的纵向数据。我们确定家庭内部向定期个人护理的转变，并使用转变为护理者之前和之后多达4轮的抑郁症状来衡量心理健康轨迹。财务资源通过家庭财富来衡量，而3个宏观指标评估（1）对护理者的支持，（2）对护理接受者的支持，以及（3）公共护理服务的可获得性。倾向得分匹配分别应用于男性和女性，从同一国家识别匹配的非护理者，我们使用分段增长曲线模型来研究成为护理者之前、期间和之后的变化。
男性和女性在成为定期护理者时抑郁症状都明显增加，而且这种增加甚至在转变之前就开始了。转变期间的增加对女性和财富较低的人更为明显，但我们发现政策指标没有系统性差异。
我们的研究强调了加强对护理者支持的必要性。尽管国家政策可能会影响成为护理者的可能性，但其在减轻护理对心理健康影响方面的有效性仍不明确。
