Table 4.
Cross-sectional evaluations: disease burden outcomes comparing informal caregivers (IC) and non-caregivers (NC).
| First Author, Publication Year [Reference] |
Outcomes and Assessment Tools | Results: Informal Caregivers (IC) vs. Non-Caregivers (NC) (Numbers in Bold Were Reported to Be Stat. Significant Results) |
|---|---|---|
|
Luckett, 2019 [25] |
Quality of Life (SF-12, range 0 = worst, 100 = best) |
Physical component summary (PCS): mean (SD): 49.1 (10.2) vs. 50.4 (10.0),p = 0.020
Mental component summary (MCS): mean (SD): 49.8 (9.8) vs. 51.1 (9.5),p = 0.020 |
|
Roth, 2018 [17] |
1. Depressive Symptoms (CES-D, range 0 = best, 12 = worst, cut-off for depression ≥4) | 1. Depressive symptoms, mean (SD): 1.4 (2.3) vs. 1.0 (1.9),p < 0.001 |
| 2. Stress (Cohen’s Perceived Stress Scale 4-items, range 0 = best, 16 = worst) | 2. Perceived stress levels, mean (SD): 3.6 (3.1) vs. 3.2 (2.9),p < 0.001 | |
| 3. Hypertension (self reported) | 3. Hypertension: 57% vs. 58%, p = 0.467 | |
| 4. Diabetes (self-reported) | 4. Diabetes: 21% vs. 22%, p = 0.141 | |
| 5. Cardiovascular disease (self-reported) | 5. Cardiovascular diseases: 18.7% vs. 23.2%,p < 0.001 | |
|
Trevino, 2018 [26] |
Major depressive episode ([MDE] DSM-IV) Generalized anxiety disorder ([GAD] DSM-IV) |
Odds ratio [OR], (95% confidence interval) Past MDE, n (%): 85 (16%) vs. 1607 (17%), OR: 0.9 (0.7–1.1), p = 0.348 Current MDE, n (%): 22 (4.1%) vs. 239 (2.6%), OR: 1.6 (1.0–2.5),p = 0.037 Current GAD, n (%): 21 (3.9%) vs. 125 (1.3%), OR: 3.0 (1.9–4.8),p < 0.001 Current Comorbid MDE and GAD, n (%): 6 (1.1%) vs. 42 (0.5%), OR: 2.5 (1.1–5.9),p = 0.038 IC without past MDE: OR: 7.7 (3.5–17.0),p < 0.001 IC with past MDE: OR: 1.1 (0.6–2.1), p = 0.662 Past MDE and NC: OR: 60.3 (38.0–95.6),p < 0.001 Past MDE and IC: OR: 8.9 (3.7–21.7),p < 0.001 |
|
Hong, 2017 [27] |
Self-reported diagnoses (depression, insomnia, hypertension, pain, diabetes) |
Prevalences of self-reported diagnoses (after matching for age, sex, education etc.): Depression, % (n): 4.9 (192) vs. 3.5 (138),p < 0.001 Hypertension, % (n): 33.2 (1287) vs. 32.3 (1252), p = 0.39 Diabetes, % (n): 13.8 (535) vs. 13.2 (511), p = 0.42 Dyslipidaemia, % (n): 14.2 (551) vs. 13.7 (531), p = 0.51 Angina pectoris, % (n): 3.2 (126) vs. 2.9 (114), p = 0.43 Heart attack, % (n): 2.4 (95) vs. 2.0 (80), p = 0.25 Arthritis, % (n): 20.5 (794) vs. 19.8 (767), p = 0.44 Osteoporosis, % (n): 12.6 (490) vs. 11.8 (459), p = 0.28 Cataract, % (n): 16.7 (648) vs. 16.7 (648), p = 1.0 |
|
Goren, 2016 [28] |
1. Depressive symptoms (PHQ-9, range 0 = best, 27 = worst, cut-off for depression ≥ 10) |
1. PHQ-9 mean [SD]: 4.4 [5.5] vs. 3.2 [4.8],p < 0.05 1. PHQ-9 ≥ 10 (MDD) % (n): 14.2 (185) vs. 8.9 (4801),p < 0.05 |
| 2. Self-reported diagnoses (depression, insomnia, hypertension, pain, diabetes) | 2. Depression: diagnosed % (n): 6.2 (81) vs. 3.3 (1778),p < 0.05 2. Insomnia: diagnosed % (n): 9.8 (128) vs. 4.4 (2361),p < 0.05 2. Anxiety: diagnosed % (n): 2.0 (26) vs. 0.8 (448),p < 0.05 2. Hypertension: diagnosed % (n): 17.5 (228) vs. 11.7 (6290),p < 0.05 2. Pain: diagnosed % (n): 15.5 (202) vs. 7.9 (4269),p < 0.05 2. Diabetes: diagnosed % (n): 6.1 (79) vs. 3.7 (1981), p < 0.05 |
|
|
3. Quality of Life (SF-36v2: mental and physical component summary [MCS, PCS], range 0 = worst, 100 = best. SF-6D: range 0.29 = worst, 1 = best) |
3. PCS mean [SD]: 51.6 [6.6] vs. 53.6 [6.1],p < 0.05 3. MCS mean [SD]: 46.0 [10.7) vs. 48.0 [9.6],p < 0.05 3. SF-6D: mean [SD]: 0.7 [0.1] vs. 0.8 [0.1], p < 0.05 |
|
| 4. Productivity impairment (WPAI) | 4. Absenteeism: % work missed mean [SD): 5.8 (15.8) vs. 2.9 (12.4),p < 0.05 4. Presenteeism: % impairment at work mean [SD): 22.8 (25.4) vs. 18.6 (23.2),p < 0.05 4. Overall work impairment in hours mean (SD): 25.7 (28.2) vs. 20.3 (25.2),p < 0.05 4. Activity impairment in hours mean (SD): 25.4 (25.8) vs. 20.7 (24.4), p < 0.05 |
|
| 5. Self-reported healthcare resource utilization | 5. Emergency room visits (past 6 months) mean (SD): 0.3 (1.8) vs. 0.1 (0.9),p < 0.05 5. Hospitalizations, past 6 months mean (SD): 0.8 (5.2) vs. 0.5 (4.1),p < 0.05 5. Healthcare provider visits, past 6 months mean (SD):7.7 (18.5) vs. 4.4 (7.7), p < 0.05 |
|
|
Laks, 2016 [29] |
1.Depressive symptoms (PHQ-9, range 0 = best, 27 = worst, cut-off for depression ≥10) |
1. PHQ-9 mean (SD): 7.3 (7.0) vs. 5.5 (6.0),p < 0.05 1. PHQ-9 ≥ 10 (MDD) % (n): 28.7 (60) vs. 20.4 (2176),p < 0.05 |
| 2. Self-reported diagnose (depression, insomnia, hypertension, pain, diabetes) | 2. Depression: diagnosed (OR:2.0) % (n): 23.0 (48) vs. 10.9 (1157),p < 0.05 2. Insomnia: diagnosed (OR:1.6) % (n): 26.8 (56) vs. 15.4 (1635),p = 0.003 2. Anxiety: diagnosed (OR:1.7) % (n): 30.6 (64) vs. 17.6 (1878),p = 0.001 2. Hypertension: diagnosed (OR: 1.6) % (n): 23.4 (49) vs. 14.5 (1547),p = 0.009 2. Pain: diagnosed (OR:1.7) % (n): 31.1 (65) vs. 19.0 (2020),p = 0.001 2. Diabetes: diagnosed (OR:2.1) % (n): 12.0 (25) vs. 4.9 (526),p = 0.004 |
|
|
3. Quality of Life (SF-36v2: mental and physical component summary [MCS, PCS], range 0 = worst, 100 = best. SF-6D, range 0.29 = worst, 1 = best) |
3. PCS mean (SD): 51.0 (7.8) vs. 52.2 (7.7),p < 0.05 3. MCS mean (SD): 44.8 (12.24) vs. 47.2 (11.14),p < 0.05 3. SF-6D mean (SD): 0.68 (0.139) vs. 0.72 (0.137),p < 0.05 |
|
| 4. Productivity impairment (WPAI) | 4. Absenteeism: % work missed mean (SD): 10.1 (19.55) vs. 6.1 (16.88),p < 0.05 4. Presenteeism: % impairment mean (SD): 26.6 (31.60) vs. 16.8 (25.26),p < 0.05 4. Overall work impairment (hours) mean (SD): 30.8 (33.47) vs. 20.3 (28.66),p < 0.05 4. Activity impairment in hours mean (SD): 26.8 (29.85) vs. 20.9 (27.84),p < 0.05 |
|
| 5. Self-reported healthcare resource utilization | 5. Emergency room visits, past 6 months mean (SD): 0.8 (1.93) vs. 0.5 (1.74),p < 0.05 5. Hospitalizations, past 6 months mean (SD): 0.4 (2.24) vs. 0.2 (0.94),p < 0.05 5. Healthcare provider visits, past 6 months mean (SD): 6.6 (8.30) vs. 4.6 (6.54), p < 0.05 |
|
|
Berglund, 2015 [30] |
1. Self-reported long-term illness (“Do you have any long-term illness, problems following an accident, any disability or other long-term health problem?”) | 1. Yes 42.9% vs. 36.4%,p ≤ 0.01 |
|
2. Self-rated health (“How do you rate your general state of health?”) |
2. Poor/very poor: 7.3% vs. 5.8%,p ≤ 0.01 2. Neither good nor poor: 27.3% vs. 22.5%,p ≤ 0.01 2. Good/very good: 65.5% vs. 71.7%,p ≤ 0.01 |
|
| 3. Health-related quality of life (CDC HRQOL-4) | 3. Days with poor physical health (last 30 days) mean (SD): 7.3 (9.4) vs. 6.4 (9.4),p ≤ 0.01 3. Days with poor mental health (last 30 days) mean (SD): 6.3 (9.0) vs. 5.3 (8.3),p ≤ 0.01 3. Days without work capacity (last 30 days) mean (SD): 4.8 (8.9) vs. 4.1 (8.4),p ≤ 0.01 |
|
|
4. Psychological wellbeing (GHQ-12: range 0 = best, 36 = worst, cut-off ≥ 12) |
4. GHQ12 MD mean (SD): 9.1 (5.3) vs. 8.9 (4.8),p ≤ 0.01 4. Good psychological wellbeing: 78.2% vs. 82.4%,p ≤ 0.01 4. Poor psychological wellbeing: 21.8% vs. 17.6 %, p ≤ 0.01 |
|
|
Gupta, 2015 [31] |
1. Quality of Life (SF-36v2: MCS, PCS: range 0 = worst, 100 = best. SF-6D: range 0.29 = worst, 1 = best) |
1. MCS mean (SD): 40.3 (10.8) vs. 45.9 (10.9),p < 0.001 1. PCS mean (SD): 46.8 (10.2) vs. 49.0 (9.8),p < 0.001 1. SF-6D mean (SD): 0.6 (0.1) vs. 0.7 (0.1),p < 0.001 |
|
2. Depressive Symptoms (PHQ-9: 0–4 = minimal, 5–9 = mild, 10–14 = moderate, 15–19 = moderately severe, 20–27 = severe) |
2. Minimal (%): 19.9 vs. 38.6,p < 0.001 2. Mild (%): 21.1 vs. 17.2,p < 0.001 2. Moderate (%): 11.8 vs. 7.4,p < 0.001 2. Moderately severe (%):6.5 vs. 3.8,p < 0.001 2. Severe (%): 6.5 vs. 1.6, p < 0.001 |
|
| 3. Self-reported current medication use for depression | 3. Medication use (%): 17.6 vs. 8.2, p < 0.001 | |
|
4. Self-reported comorbidities (“Have you experienced the following in the past twelve months”) |
4. Narcolepsy (%): 1.2 vs. 0.5, p = 0.072 4. Insomnia (%): 32.4 vs. 18.5, p < 0.001 4. Sleep difficulties (%): 42.7 vs. 28.5, p < 0.001 4. Pain (%): 39.7 vs. 30.4, p = 0.001 4. Anxiety (%):37.9 vs. 23.6, p < 0.001 4. Depression (%): 29.4 vs. 19.4, p < 0.001 4. Heartburn (%): 31.7 vs. 22.9, p = 0.001 4. Migraines (%): 26.6 vs. 22.4, p = 0.102 4. Headaches (%):48.0 vs. 42.0, p = 0.048 |
|
|
Rosso, 2015 [20] |
1. Self-reported diagnosis (chronic disorders) | High- (≥3 x/wk) vs. Low-Frequency IC (≤2 x/wk) vs. NC: 1. Diabetes % (n): 7.0 (53) vs. 2.5 (35) vs. 6.9 (241), p < 0.001 (comparing high vs. low/NC) 1. Asthma % (n): 11.0 (82) vs. 5.4 (73) vs. 6.7 (231), p < 0.001 (comparing high vs. low/NC) 1. Osteoporosis, % (n): 7.8 (58) vs. 7.0 (95) vs. 10.3 (353), p < 0.001 (comparing high vs. low/NC) |
| 2. BMI (calculated by measured height and weight, >29.9 = obese) | 2. Obese % (n):40.4 (303) vs. 28.9 (395) vs. 27.5 (957), p < 0.001 (comparing high vs. low/NC) | |
|
Tuithof, 2015 [32] |
1. Self-reported chronic physical disorders (standard checklist assessed presence of 17 chronic physical disorders) | 1. 45.5% vs. 37.1%, OR: 1.09, 95% CI: 0.93–1.28 |
| 2. Emotional Disorder (12-month prevalence) (DSM-IV) | 2. 7.5% vs. 8.8%, OR: 0.86, 95% CI: 0.66–1.11, p = 0.15 When informal caregiving was defined more strictly: caregiving for >8 h/wk: OR = 0.92, 95% CI: 0.64–1.31 longer than 1 year: OR = 1.22, 95% CI: 0.92–1.63 caregiving for >8 h/wk and longer than 1 year: OR = 1.17, 95% CI: 0.73–1.87 |
|
|
Verbakel, 2014 [33] |
Subjective well-being (self-reported happiness on a scale from 0 to 10) |
Unadjusted mean (SD): 7.69 (1.71) vs. 7.66 (1.77), not statistically significant. IC had on average a slightly lower level of well-being compared to NC (−0.11, SD 0.16) that was stat. sign. after adjusting for age, sex, educational level, partner, children, co-residing parents aged 65+ and religiosity. This Well-being-difference varied across countries: in most European countries, IC reported lower levels of well-being than NC did, whereas in Scandinavia they were slightly higher in IC vs. NC. Resources of formal long-term care reduced this gap, services directed at psychosocial support, facilitating the combination of work and care and financial support did not reduce negative effects of informal caregiving. |
|
Chan, 2013 [34] |
1. Depressive symptoms (CES-D-11, range 0 = best, 19 = worst, cut-off for depression ≥ 7) | 1. CES-D, mean (SD): 3.8 (3.2) vs. 2.9 (2.6),p < 0.0001 1. Clinically significant depressive symptoms (CESD ≥ 7): 18.2% vs. 7.9%, p < 0.0001 OR: 2.36, 95% CI: 1.44–3.86 |
| 2. Self-rated health (“In general would you say your health is—excellent/very good/good/fair/poor?”) | 2. Poor: 3.0%, fair: 21.5%, good: 57.5 %, very good: 14.7%, excellent: 3.4%
vs poor: 1.3%, fair: 15.1%, good: 64.2%, very good: 17.0 %, excellent: 2.5%, p = 0.02 IC were significantly more likely to have poorer SRH OR: 2.45, 95% CI: 1.84–3.26 |
|
| 3. Outpatient visits (assessed by asking if they had seen a doctor in a clinic in the last month and the number of visits) | 3. No outpatient visits in the last month: 62.9% vs. 58.5%, p = 0.15 3. Mean number (SD) of outpatient visits (last month): 1.2 (0.8) vs. 1.2 (0.5), p = 0.42 |
|
|
Herrera, 2013 [35] |
Depressive symptoms (CES-D, range 0 = best, 60 = worst, cut-off for depression ≥ 16) |
Depressive symptoms: CES-D, mean (SD): 8.0 (0.87) vs. 8.3 (0.22) CES-D ≥ 16: 14.1% vs. not reported |
|
Ramsay, 2013 [23] |
Limiting long-term illness (self-reported health problems or disability including problems that are due to age) |
Limiting long-term illness: heavy caregiver (≥20 h/week): 32.1% light caregiver (1–19 h/week): 19.0% non-caregiver: 18.9% |
|
Hernandez, 2010 [36] |
1. Depressive symptoms (CES-D, range 0= best, 60= worst, cut-off for depression ≥ 16) |
1. CES-D, mean (SD): 10.32 (10.60) vs. 6.13 (6.77), p = 0.014 1. CES-D ≥16: 24% vs. 7%, p = 0.004 |
|
2. Self-reported health (“How would you rate your overall health? 1 (excellent) to 4 (poor)”) |
2. Mean (SD): 2.68 (0.76) vs. 2.70 (0.75) | |
|
Butterworth, 2010 [37] |
1. Anxiety and Depression (Goldberg anxiety and depression scale) |
1. Anxiety, clinically significant: 25.9% vs. 17.5%, p = 0.003 OR: 1.57, 95% CI: 1.11–2.20 1. Depression, clinically significant: 50.5% vs. 39.3%, p = 0.002 OR: 1.52, 95% CI: 1.15–2.03 |
|
2. Physical impairment (range 0 = worst, 100 = best) |
2. SF-12 RAND scoring method with scores < 40: 23.3% vs. 17.5%, p = 0.038 |
aHR = adjusted hazard ratio; vs. = versus; wk = week; SD = standard deviation; SF-12 (or 36) = Short Form Survey 12 (or 36) Item; SF-6D = Short-Form Six-Dimension; SD = standard deviation; CES-D = Center for Epidemiologic Studies Depression Scale; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, by the American Psychiatric Association; PHQ-9 = Patient Health Questionnaire 9-item; CDC HRQOL-4 = The Centers for Disease Control and Prevention’s health-related quality of life 4-item; GHQ-12 = General Health Questionnaire 12-item; MCS and PCS = Mental Component Scale and Physical Component Scale; BMI = body mass index.