Ping Yongjing, Lim-Soh Jeremy, Østbye Truls, A'Azman Shamirah D/O, Ting Yong, Malhotra Rahul
Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore.
Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, National University of Singapore, Singapore.
Innov Aging. 2025 Feb 9;9(4):igaf014. doi: 10.1093/geroni/igaf014. eCollection 2025.
Informal caregiving for older adults can be both burdensome and beneficial. Given that the informal caregiving situation may evolve over time, and care needs of older adults can result from diverse health conditions, it is valuable to understand the trajectories of burden or benefits of caregiving and how these trajectories vary across health conditions common among older care-recipients. This review is the first to summarize the literature on trajectories of burden or benefits of caregiving, including caregiver and care-recipient characteristics associated with the trajectories.
We reviewed longitudinal observational quantitative studies, from 5 bibliographic databases, that assessed burden or benefits of caregiving at 3 or more time points among informal caregivers of older adults (60 years or above).
The narrative synthesis included 41 studies, with only 7 (17%) considering trajectories of benefits. A stable average trajectory of burden or benefits of caregiving was the most common pattern over time across various care-recipient health conditions. However, an increasing burden over time was primarily observed among caregivers of persons with dementia, while a decreasing burden was noted among caregivers of persons discharged from the hospital after an acute health event. Only 6 (10%) studies, which reported heterogeneity in the progression of burden or benefits separately or jointly, identified distinctive trajectories within the same set of caregivers. Risk factors consistently identified to be associated with trajectories indicating persistently higher burden or persistently lower benefits included more care-recipient functional limitations and behavioral problems, being a non-spousal caregiver, being a solo caregiver, and perceiving less self-efficacy or competence.
Future studies should focus on the trajectories of benefits of caregiving, untangle heterogeneity in trajectories of burden or benefits of caregiving, and consider both burden and benefits concurrently to identify factors that both enhance benefits and alleviate burden over time.
对老年人的非正式照护既可能带来负担，也可能有益。鉴于非正式照护情况可能随时间演变，且老年人的照护需求可能源于多种健康状况，了解照护负担或益处的轨迹以及这些轨迹在老年受照护者常见健康状况中的差异具有重要价值。本综述首次总结了关于照护负担或益处轨迹的文献，包括与这些轨迹相关的照护者和受照护者特征。
我们检索了5个文献数据库中的纵向观察性定量研究，这些研究评估了60岁及以上老年人的非正式照护者在3个或更多时间点的照护负担或益处。
叙述性综合分析纳入了41项研究，其中仅有7项（17%）考虑了益处轨迹。在不同的受照护者健康状况下，随着时间推移，照护负担或益处的稳定平均轨迹是最常见的模式。然而，随着时间推移负担增加主要出现在痴呆症患者的照护者中，而急性健康事件后出院患者的照护者负担则有所减轻。只有6项（10%）研究分别或联合报告了负担或益处进展的异质性，在同一组照护者中确定了不同的轨迹。始终被确定与表明持续较高负担或持续较低益处的轨迹相关的风险因素包括受照护者更多的功能限制和行为问题、非配偶照护者、单独照护者以及自我效能感或能力较低。
未来的研究应关注照护益处的轨迹，理清照护负担或益处轨迹的异质性，并同时考虑负担和益处，以确定随着时间推移既能增强益处又能减轻负担的因素。
