Mortality, Morbidity and Health-Related Outcomes in Informal Caregivers Compared to Non-Caregivers: A Systematic Review

Patrick Janson, Kristina Willeke, Lisa Zaibert, Andrea Budnick, Anne Berghöfer, Sarah Kittel-Schneider, Peter U. Heuschmann, Andreas Zapf, Manfred Wildner, Carolin Stupp and Thomas Keil
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Patrick Janson: State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany
Kristina Willeke: State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany
Lisa Zaibert: State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany
Andrea Budnick: Institute of Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, 10098 Berlin, Germany
Anne Berghöfer: Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10098 Berlin, Germany
Sarah Kittel-Schneider: Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital Würzburg, 97080 Würzburg, Germany
Peter U. Heuschmann: Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97080 Würzburg, Germany
Andreas Zapf: Bavarian State Ministry for the Environment and Consumer Protection, 81925 Munich, Germany
Manfred Wildner: State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany
Carolin Stupp: State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany
Thomas Keil: State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany

IJERPH, 2022, vol. 19, issue 10, 1-25

Abstract: A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following PRISMA recommendations, we searched major healthcare databases (CINAHL, MEDLINE and Web of Science) systematically for relevant studies published in the last 10 years (without language restrictions) (PROSPERO registration number: CRD42020200314). We included only observational cross-sectional and cohort studies with low risk of bias (risk scores 0–2 out of max 8) that reported the prevalence, incidence, odds ratio (OR), hazard ratio (HR), mean- or sum-scores for health-related outcomes in informal caregivers and non-caregivers. For a thorough methodological quality assessment, we used a validated checklist. The synthesis of the results was conducted by grouping outcomes. We included 22 studies, which came predominately from the USA and Europe. Informal caregivers had a significantly lower mortality than non-caregivers. Regarding chronic morbidity outcomes, the results from a large longitudinal German health-insurance evaluation showed increased and statistically significant incidences of severe stress, adjustment disorders, depression, diseases of the spine and pain conditions among informal caregivers compared to non-caregivers. In cross-sectional evaluations, informal caregiving seemed to be associated with a higher occurrence of depression and of anxiety (ranging from 4 to 51% and 2 to 38%, respectively), pain, hypertension, diabetes and reduced quality of life. Results from our systematic review suggest that informal caregiving may be associated with several mental and physical disorders. However, these results need to be interpreted with caution, as the cross-sectional studies cannot determine temporal relationships. The lower mortality rates compared to non-caregivers may be due to a healthy-carer bias in longitudinal observational studies; however, these and other potential benefits of informal caregiving deserve further attention by researchers.

Keywords: cohort studies; longitudinal studies; cross-sectional studies; family caregivers; informal caregiving; mental health; physical health; population-based studies; systematic review (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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