Impact of caregiver burden on adverse health outcomes in community-dwelling dependent older care recipients

Am J Geriatr Psychiatry. 2011 Apr;19(4):382-91. doi: 10.1097/JGP.0b013e3181e9b98d.


Objective: To determine whether caregiver burden is associated with subsequent all-cause mortality or hospitalization among dependent community-dwelling older care recipients.

Methods: A prospective cohort study of 1,067 pairs of community-dwelling 65-year-old or older care recipients and their informal caregivers was conducted. The 1,067 pairs completed the baseline assessment including caregiver burden assessed by the Zarit Burden Interview and a 3-year follow-up for all-cause mortality and hospitalization.

Results: During the 3-year follow-up, 268 recipients died and 455 were admitted to hospitals. The multivariate Cox proportional hazards model revealed that the recipients with caregivers with a baseline ZBI score in the highest quartile were 1.54 and 1.51 times more likely to show increased risks of all-cause mortality and hospitalization, respectively, in comparison with those with caregivers in the lowest quartile after adjustment for potential confounders. The highest quartile of caregiver burden was associated with all-cause mortality and hospitalization within nonusers of respite services including day-care services, home-help services, and nursing-home respite stay services. No apparent association was observed within the users of these services except for day-care services, for which users showed a statistically significant association between the highest quartile and the risk of hospitalization.

Conclusions: Heavy caregiver burden is associated with mortality and hospitalization among community-dwelling dependent older adults, even after adjusting for potential confounders. The reduction of caregiver burden and improvement of caregiver well-being may not only prevent the deterioration of caregiver health but also reduce adverse health outcomes for care recipients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Caregivers / psychology*
  • Community Health Services / statistics & numerical data*
  • Disabled Persons / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Health Services for the Aged / statistics & numerical data*
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Mortality
  • Proportional Hazards Models