ArticleBMC psychology2025
The association between caregiving for disabled spouses and depressive symptoms among middle-aged and older adults in China.
Article in BMC psychology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIt is widely recognized that individuals with disabilities are at a significantly higher risk of mental health issues. However, the mental health status of their spousal caregivers often tends to be overlooked.
objectiveTo investigate the association between caring for a disabled spouse and depressive symptoms among middle-aged and older adults, and to assess whether this association differs by caregiver gender.
methodsCross-sectional data were drawn from the 2020 China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms in respondents were measured by the CESD-10. Associations were estimated using generalized estimating equations (GEE) with a logit link to account for intra-household correlation. Models adjusted for sociodemographic and health-related confounders. We conducted gender-stratified analyses, tested the interaction between gender and caregiving, performed an analysis restricted to caregivers (n = 1,357), and examined the relation between the number/types of recipient disabilities and caregiver depressive symptoms.
resultsIn multivariable GEE models, spousal caregiving was associated with higher odds of depressive symptoms (OR = 1.278, 95% CI 1.127 to 1.449, P < 0.001). Stratified analyses indicated a stronger association among female caregivers (OR = 1.459, 95% CI 1.204 to 1.768, P < 0.001) than male caregivers (OR = 1.207, 95% CI 1.013 to 1.438, P = 0.036); however, the gender × caregiving interaction was not statistically significant (P = 0.271). Within the caregiver subsample, female caregivers had markedly higher odds of depressive symptoms compared with male caregivers (OR = 1.824, 95% CI 1.355 to 2.455). Moreover, a greater number or severity of recipient disabilities was associated with incrementally higher depressive risk among caregivers, suggesting a dose-response relationship.
conclusionsSpousal caregiving was associated with elevated odds of depressive symptoms, with larger effect estimates among women. Limitations include cross-sectional design, self-reported measures, and potential residual confounding. Prospective studies are needed to assess temporality and causal pathways; the results support enhanced monitoring and development of targeted supports for spousal caregivers, with consideration of sex differences and recipient disability burden.
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