Investigation in sociodemographic factors associated with caregiver strain

Background: Caregiver distress is the strain experienced by individuals providing care for people with chronic physical or mental health conditions which limit their self-sufficiency for tasks of daily living. More than 1 in 5 Americans are caretakers of a family member or friend with a long-term disability–a number expected to increase with an aging population.

Methods: We performed a cross-sectional analysis using the 2021 Behavioral Risk Factor Surveillance System (BRFSS) conducted by the Centers for Disease Control and Prevention (CDC) to determine rates of depressive disorders among caregivers and associations between demographic and relational-aspects of the care recipient.

Results: The included sample size for analysis was 32,676, representing 17,274,935 caregivers in the US. Our analysis found caregivers who responded female (6008, 29.71%), earning less than $15,000 a year (837, 41.47%), did not complete high school (555, 31.56%) or had some college with no degree (2904, 29.45%), and American Indians (216, 35.18%) had the highest rates of a depression diagnosis within these categories. Furthermore, the odds for having a diagnosis of a depressive disorder is higher among caregivers if the care recipient has a mental disorder, substance use disorder, asthma, or a chronic respiratory condition compared to caregivers of individuals with infirmity or frailty due to old age. Lastly, we found that compared to individuals providing care for their mother, individuals providing care to their mother-in-law or spouse were less likely to have a diagnosis of depression and those caring for their live-in partner were more likely to have a diagnosis.

Conclusion: Our findings add to previous research showing specific groups of caregivers are at higher risk for caregiver stress which may lead to depression. More specifically, we found that depression is more likely to occur among individuals caring for live-in partners and among care recipients who have mental health or substance use disorders or chronic respiratory conditions such as COPD. This may be due to the need for more closely supervised care, as well as the risk for hostility or impulsivity of the care recipients. In addition to these prevalences and associations, qualitative research may elucidate underlying trauma among caregivers. Analysis into the demographic risk factors for the development of depression amongst caregivers is vital in providing effective therapeutic options for the care recipient and educational opportunities for the caregiver, both at the individual and community level.