Colorectal cancer is the third most common cancer in the United States, and many colorectal cancer survivors often experience various symptoms significantly influenced by diet. Although it is known that social determinants of health can lead to notable inequities that affect lifestyle and quality of life, limited studies have examined the interplay of social determinants of health and diet on symptom experiences in this population. This scoping review aimed to explore relationships among social determinants of health, diet, and symptom experiences in colorectal cancer survivors.

This study adhered to the Joanna Briggs Institute scoping review methodology, following the framework established by Arksey and O'Malley. Five databases were searched on September 22, 2023, and updated on April 2, 2024, including Medline, CINAHL, Embase, Web of Science, and APA PsycINFO. The review was performed using the PCC (Population, Concept, Context) format to examine symptom experiences in the context of social determinants of health and diet among colorectal cancer survivors.

A total of 21 articles were included. Reported symptoms included gastrointestinal, chemotherapy-related, physical, and psychological symptoms. Social determinants of health at the individual level (age, gender, race/ethnicity, marital status, education, income) and relationship level (social support needs) were identified as influencing symptom experiences. Dietary choices and intake also impacted symptom experiences.

Significant associations exist between social determinants of health, diet, and symptom experiences in colorectal cancer survivors. Further exploration into how these factors influence symptom experiences is necessary to inform future tailored interventions to better support this population.

We examine the mental health trajectories of people who start providing personal care and compare their trajectories with matched controls who remain non-carers. We also investigate whether trajectories vary by gender, financial resources, and supportive long-term care policies.

Using 9 waves of the Survey of Health, Ageing, and Retirement in Europe, collected in 28 European countries from 2004 to 2022, we analyze longitudinal data from 68,075 men and women aged 50 or older. We identify transitions into regular personal care within the household and use depressive symptoms from up to 4 waves before and after transitioning into care to measure mental health trajectories. Financial resources are measured by household wealth, whereas 3 macro indicators assess (1) support for caregivers, (2) support for care recipients, and (3) public care service availability. Propensity score matching, applied separately for men and women, identifies matched noncaregivers from the same country, and we use piecewise growth curve models to examine changes before, during, and after becoming a carer.

Both men and women have a clear increase in depressive symptoms when becoming a regular carer, and this increase even begins before the transition. The increase during the transition is slightly more pronounced for women and those with lower wealth, but we find no systematic differences by policy indicators.

Our study highlights the need for improved support for carers. Although national policies may influence the likelihood of becoming a carer, their effectiveness in mitigating the mental health impact of caring remains unclear.

A growing body of research examines how adult children's education influences older parents' cognitive health. Whereas prior studies tend to focus on educational advantage, this study seeks to understand how various measures of educational disadvantage are associated with parents' dementia likelihood. In addition, we ask how the risks associated with one child's educational disadvantage are shaped by a sibling's educational success.

Using data from the U.S. Health and Retirement Study (2000-2018) and event history analyses, comparisons are made between measures of offspring educational disadvantage and their relationships with parents' risk of dementia onset. In addition, analyses are conducted to understand whether the link between one child's educational disadvantage and parental dementia onset is influenced by a sibling's educational advantage.

Educational disadvantage is associated with an increased risk of parental dementia onset, with a threshold measure for whether a parent had at least one child without a high school education providing the best model fit for the data. Moreover, the heightened risks associated with one child's educational disadvantage are not offset by another sibling's educational success.

Children's educational deficits are a hidden source of health disparities among older parents. Although scholars in recent years have rightly focused on the importance of offspring education, more attention should be paid to conceptualizing how educational disadvantage matters for parents and how the educational attainment of each child shapes parents' cognitive health.

Resilience as a dynamic process plays a significant role in caregivers' mental health. Little is known about gender differences in the resilience process and predictors of resilience in spousal caregivers.

To investigate changes in resilience among wives and husbands of patients with advanced cancer over a 6-month posttreatment period, and identify different predictors of resilience between females and males.

This longitudinal, observational study was conducted from January to December 2022.

Spousal caregivers of patients with newly diagnosed advanced cancer were recruited from five regional tertiary hospitals in China. There were three assessment points at 1, 3, and 6 months post-initial treatment. The dependent variable was resilience, and five independent repeated variables were investigated.

Totally, 179 wife caregivers and 133 husband caregivers were included. Resilience in both wife caregivers and husband caregivers increased over time (Wald χ2 = 29.83, p < 0.001) but husbands had higher levels of resilience than wives (Wald χ2 = 35.59, p < 0.001). However, there was no interaction between time and gender (Wald χ2 = 5.25, p > 0.05). Patient functional status, caregiver burden, social support, coping self-efficacy, and mutuality were predictors of resilience for wife caregivers. Meanwhile, patient functional status, caregiver burden and coping self-efficacy could predict resilience for husband caregivers.

Healthcare providers may develop gender-specific interventions to promote resilience in spousal caregivers of patients with advanced cancer. This would improve mental health for caregivers in the process of palliative care.

As the rates of Alzheimer's disease (AD) and AD and related dementias (ADRD) in the United States steadily rise, so too does the demand for informal caregiving. Research on AD/ADRD caregiving highlights the associated risk of adverse health outcomes and lower quality of life; however, there is a lack of discussion about Black male dementia caregivers, who already face unique health challenges. Through an intersectionality lens, this perspective will raise awareness of the multifaceted burden of Black male informal AD/ADRD caregiving, along with strategies to better support this underserved community. HIGHLIGHTS: The non-Hispanic Black population in the United States is disproportionately affected by Alzheimer's disease (AD) and AD and related dementias (ADRD), which will increase the demand for caregiving. Most dementia informal caregiving research focuses on non-Hispanic White females, with little emphasis on Black men, who represent an at-risk population. By adopting an intersectional approach, clinicians, researchers, and policymakers can better understand and improve the health of informal Black male AD/ADRD caregivers. The increasing prevalence of AD and ADRD in the US Black community can create an added strain on Black male informal caregivers. Examining the unique AD/ADRD caregiving needs of Black men can inform future research to improve the health of similar at-risk communities.

This study aimed to explore the experiences of parents of children with Duchenne Muscular Dystrophy (DMD) in Turkey.

A descriptive phenomenological approach was employed. Ten participants were purposively sampled and interviewed in-depth using semi-structured methods. Data was analyzed thematically. The reporting of this study was informed by the COREQ guidelines.

The data revealed five themes: parental emotional reactions to learning about their child's diagnosis of DMD, parents as medical advocates for their child diagnosed with DMD, parental exhaustion from the day-to-day demands of caring for a child with a diagnosis of DMD, the DMD community as a lifeline for parents whose children have a diagnosis of DMD, barriers to adequate care for children with a diagnosis of DMD.

This study offered multifaceted dimensions of parents' experiences with DMD, providing insights into the distinctive challenges, and coping strategies within the Turkish context. Parents encountered intricate and systemic challenges, and their ability to navigate these complexities varied depending on their support networks.

Nurses can empower parents of children with DMD by addressing their emotional needs, educating them as medical advocates, and connecting them with community resources. Integrating these approaches into nursing practice ensures holistic, empathetic, and effective care, enhancing support and confidence for families navigating the challenges of DMD.

To investigate how changes in frailty affect diabetes risk and whether sex and age influence this relationship.

This prospective cohort study, based on the China Health and Retirement Longitudinal Study (CHARLS), included 11,221 adults aged 45 and over without diabetes before the second survey. The frailty index (FI), with scores ranging from 0 to 1, was administered at baseline (2011) and during the second survey (2013), categorizing participants as robust (FI ≤ 0.10), pre-frail (FI 0.10-0.25), or frail (FI ≥ 0.25). Frailty changes were determined from the two assessments.

The primary outcome was incident diabetes. Cox regression was used to assess the association of frailty changes with diabetes and whether this association differed by sex and age (≤65 years and >65 years).

During a median 7-year follow-up, 1197 developed diabetes. Those remaining pre-frail/frail had nearly double the risk of diabetes (HR 1.99, 95 % CI 1.70-2.33) compared with those remaining robust. Progressing from robust to pre-frail/frail increased risk (HR 1.80, 95 % CI 1.48-2.19), and improving from pre-frail/frail to robust still had an elevated risk (HR 1.32, 95 % CI 1.06-1.66). Higher FI tertile changes were linked to increased diabetes risk (HR 1.44, 95 % CI 1.24-1.67), with a significant trend (P < 0.001). Women were at higher risk (P = 0.004), but age did not significantly modify the association (P = 0.972).

Frailty progression is strongly linked to increased risk of diabetes, especially in women, highlighting the need for targeted frailty management in diabetes prevention.

To test the efficacy of a randomized control trial low-touch mobile health intervention designed to promote care partner self-awareness and self-care.

This randomized controlled trial included a baseline assessment of self-report surveys of health-related quality of life (HRQOL), care partner-specific outcomes, and the functional/mental status of the person with traumatic brain injury (TBI), as well as a 6-month home monitoring period that included 3 daily questions about HRQOL, monthly assessments of 12 HRQOL domains, and the use of a Fitbit to continuously monitor physical activity and sleep. HRQOL surveys were repeated at 3 and 6 months post-home monitoring.

Two academic medical centers.

A total of 254 TBI care partners.

The CareQOL app, a mobile health app designed to promote care partner self-awareness (through self-monitoring) and self-care (through personalized self-care push notifications).

Care partners were randomly assigned to self-monitoring alone (n=128) or self-monitoring plus self-care push notifications (n=126). Although we neither saw improvements in HRQOL outcomes, nor in physical activity or sleep, we found that across all the different measures, approximately 1/3 of the participants showed clinically meaningful improvements, 1/3 stayed the same, and 1/3 got worse; care partners who reported engagement in the intervention were more likely to show improvements than those who were not engaged. There was preliminary support for factors that being male, caring for a person with posttraumatic stress symptoms, living in the same household as the person with TBI, being a spousal care partner, working, and being diagnosed with COVID-19 during the study were associated with increased risk for negative outcomes.

Findings suggest that engagement with the app, even when it is confined to self-monitoring alone, is associated with small improvements in HRQOL.

It is reported that women are more likely to be caregivers than men, experience a higher burden of care and increased emotional health sequelae as a result. Social location (a person's gender, culture, ethnicity, etc.) is known to influence caregiving experiences. However, there is limited work that draws attention to how cultural and linguistic diversity shapes the experiences and expectations of informal caregivers.

The authors aimed to study how to reallocate health and social service resources to better support older adults ageing in place. However, some participants felt strongly about the role of gender. This report addresses the gap for better understanding (1) how gender influences informal caregiving for older adults ageing at home in Ontario, Canada, and (2) how culture may influence gendered caregiving expectations for this population.

A critical social justice paradigm and balance of care framework guided the research. Focus groups (15) and one-one-one interviews (7) were carried out. A collaborative approach to codebook thematic analysis was conducted.

This study was carried out in Peel, a diverse region in Ontario, Canada. 42 individuals participated in the study (14 older adults, 10 caregivers and 18 healthcare providers).

Four themes were found regarding the role of gender in caregiving: (1) women caregivers as catalysts for ageing in place, (2) gender norms, generational standards and the societal expectation for women to be caregivers, (3) the intersection of culture and gender on caregiving for older adults and (4) health service workforce as women-dominant and linguistically diverse.

Service needs not currently met by Canada's healthcare system often become absorbed by women caregivers who facilitate ageing in place. Further research is required to better understand: (1) how a larger breadth of communities experience the intersection of gender and culture in the care of older adults in Ontario, Canada, and (2) how to better harness the diversity within Canada's homecare workforce to allow for cultural, linguistic and/or gender alignment with older adult clients.

Patients and caregivers were research participants; however, the focus groups were co-design sessions, in which participants built and shaped personas and care packages.

The importance of timely integration of palliative care has been confirmed over the past years for any patient suffering from a life-threatening or life-limiting disease. Palliative and supportive care increases quality of life of patients and caregivers in both oncological and non-cancer diseases and should therefore be offered on a needs-based approach and throughout the disease trajectory.

We analyzEd all in-patient consultation requests of the leading university hospital in Switzerland in 2019. Sociodemographics, symptoms, and specific requests as well as provided support offers were retrieved from the electronic patient files. Demographic and clinical data was analyzed by descriptive statistics between groups. Overall survival from diagnosis and time from consultation to death was analyzed by means of Kaplan-Meier estimates and log-rank test.

We identified 507 in-patient consultation requests from 24 oncological and non-oncological departments in 2019. The final analysis cohort comprised 290 patients, of which 133 women (45.9%). Median overall survival of the population from diagnosis was 21.1 months (CI 15.57-26.72). Median survival from palliative care consultation was 29 days (CI 20.89-37.11), independent of primary diagnosis (p = 0.298) or sex (p = 0.079). A total of 38.9% (N = 140) of consultations were requested concurrently to a tumor-targeted treatment. Palliative care consultations provided more support services than requested (p < 0.001).

Our findings underline the persisting late involvement of palliative care services in the disease trajectory, despite being a concurrently consultable and readily available support service to address patient and caregiver needs.

Caregivers of individuals with schizophrenia play a crucial role in providing support, but they frequently experience significant levels of stress and burden due to the demanding nature of caregiving responsibilities.

To estimate the magnitude of caregiver burden in the primary caregivers of patients with schizophrenia; and to find out the association between severity of disability in patients with schizophrenia and caregiver burden.

This was a hospital-based analytical cross-sectional study involving patients diagnosed with Schizophrenia and their primary caregivers (n = 72) attending the Psychiatry, OPD of a tertiary healthcare facility in Puducherry. PANSS, IDEAS, and BAS were used to assess the severity of illness and burden among primary caregivers, respectively.

The mean ages of schizophrenia patients and primary caregivers were 39.2 years and 43.1 years, respectively. The proportion of females among patients was 54.2% and that among primary caregivers was 65.3%. The mean (SD) IDEAS global disability score among people with schizophrenia was 7.1 ± 2.6, while the total PANSS score was 51.8 ± 11.4. The mean (SD) burden assessment schedule scores among caregivers were 72.9 ± 13.2. Caregiver burden was notably higher among those over 40 yrs, living in urban areas, literate, employed, of lower or middle socioeconomic status, and from nuclear families (P < 0.05). However, gender, religion, marital status, and substance use did not affect burden (P > 0.05). Caregivers experiencing burden had patients with higher illness severity and disability, as indicated by elevated PANSS and IDEAS scores (P < 0.05). Moreover, caregiver age (r = 0.147), patient illness severity (r = 0.261), treatment duration (r = 0.351), and various aspects of patient disability (r = 0.383) showed positive correlations with caregiver burden.

The caregiver burden is significantly correlated with patient illness severity, disability, and treatment duration, particularly affecting older caregivers and those from specific socioeconomic backgrounds. The findings underscore the considerable challenges faced by caregivers in supporting individuals with schizophrenia and highlight the need for targeted interventions and support services to reduce caregiver burden and enhance patient outcomes.

Epilepsy imposes substantial challenges on informal caregivers, who play a vital role in supporting individuals with this condition. This review aims to explore the burden experienced by informal caregivers of adults with epilepsy and identify critical factors that influence their overall experience. A literature review was conducted following PRISMA guidelines. PubMed and ScienceDirect were searched for identifying original research articles published in English from January 2005 till the end of February 2024. Studies were critically appraised using the AXIS Critical Appraisal Tool for Cross-Sectional Studies. Data were extracted and a narrative synthesis was performed. Twelve studies involving 1.265 participants were included. Eight studies were rated as high quality, while four were rated as fair quality. Six primary determinants of caregiver burden were identified: care-recipient characteristics, caregiver characteristics, psychological and physical factors, availability of support system, ethnicity and culture, and stigma. The majority of studies reported mild-to-moderate levels of caregiver burden, reflecting the diverse challenges faced by caregivers providing assistance to adults with epilepsy. While this review identifies several factors influencing caregiver burden, prospective longitudinal and qualitative studies are essential to unravel the multidimensional nature of caregiver burden and its variations across diverse cultural settings.

There are still insufficient data on caregiver burden among caregivers of adult people with epilepsy (PWE), particularly in Malaysia. This study aims to explore the level of perceived caregiver burden among the informal caregivers caring for PWE, its predicting factors associated with caregiver burden, and the impact of this caregiver burden on their psychological health.

In this cross-sectional study, caregivers of adult PWE attending the neurology outpatient clinic at Hospital Canselor Tuanku Muhriz (HCTM) completed a comprehensive questionnaire comprising demographic data of participants and care recipients (adult PWE). Epilepsy-related data were obtained from the interview and medical records. Affiliate stigma among caregivers was assessed using Affiliate Stigma Scale (ASS), and psychological impacts were evaluated using Depression Anxiety Stress Scale 21 (DASS-21). The level of caregiver burden was evaluated with Zarit Burden Interview (ZBI).

A total of 119 caregivers participated in the study, and 35.2 % of them reported mild to moderate burden. The factors most strongly associated with higher caregiver burden were female caregivers, needs for assistance in activities of daily living (ADL), frequent seizures, polypharmacy, and affiliate stigma among caregivers. A statistically significant positive correlation was seen between caregiver burden and psychological impacts of depression (r 0.522, p < 0.001), anxiety (r 0.463, p < 0.001), and stress (r 0.598, p < 0.001).

This study demonstrated various degrees of caregiver burden among caregivers of adult PWE. A better understanding on the predictive factors and impacts on psychological health of caregivers are needed to provide suitable interventions including psychoeducation for the caregivers to alleviate their burden and subsequently improve the quality of caregiving.

Research on the influence of heart failure on mortality after Alzheimer's disease diagnosis is limited.

To evaluate the association between comorbid heart failure and mortality following Alzheimer's disease diagnosis, particularly considering sex differences.

We analyzed administrative claims data from Japan, involving 32,363 individuals (11,064 men and 21,299 women) aged 75 or older newly diagnosed with Alzheimer's disease, with 7% having comorbid heart failure. Cox proportional hazard models and population attributable fractions (PAFs) were used to evaluate the association between comorbid heart failure and mortality within one year following Alzheimer's disease diagnosis.

Individuals with Alzheimer's disease and heart failure had a multivariate-adjusted hazard ratio of 1.51 (95% confidence interval [CI], 1.32-1.73) for mortality during the one-year follow-up period compared to those with Alzheimer's disease and without heart failure. Subgroup analysis by sex revealed a higher mortality hazard ratio in women of 1.63 (95% CI, 1.36-1.95) than that in men of 1.39 (95% CI, 1.13-1.71). Further age and sex subgroup analysis indicated that women across all age brackets-75-79, 80-84, and ≥ 85 years-had higher mortality hazard ratios. The PAF for heart failure increased with age in both sexes, with women having higher PAFs than men, and the sex difference in PAF being most pronounced in the 75-79 age category (men: 1.4%, women: 4.0%).

Hazard ratios and PAFs for mortality associated with comorbid heart failure in newly diagnosed Alzheimer's disease are higher in women than in men, which persists across all age subgroups.

We aimed to 1) identify distinct segments within the general population characterized by various combinations of stressors (stressor profiles) and to 2) examine the socio-demographic composition of these segments and their associations with perceived stress levels.

Segmentation was carried out by latent class analysis of nine self-reported stressors in a representative sample of Danish adults (N = 32,417) aged 16+ years. Perceived stress level was measured by the Perceived Stress Scale (PSS).

Seven classes were identified: Class 1 was labeled Low Stressor Burden (64% of the population) and the remaining six classes, which had different stressor combinations, were labeled: 2) Burdened by Financial, Work, and Housing Stressors (10%); 3) Burdened by Disease and Death among Close Relatives (9%); 4) Burdened by Poor Social Support and Strained Relationships (8%); 5) Burdened by Own Disease (6%); 6) Complex Stressor Burden Involving Financial, Work, and Housing Stressors (2%); and 7) Complex Stressor Burden Involving Own Disease and Disease and Death among Close Relatives (2%). Being female notably increased the likelihood of belonging to Classes 2, 3, 5, and 7. Higher age increased the likelihood of belonging to Class 3. Low educational attainment increased the likelihood of belonging to Classes 5 and 6. A significant difference was observed in perceived stress levels between the seven latent classes. Average PSS varied from 9.0 in Class 1 to 24.2 in Class 7 and 25.0 in Class 6.

Latent class analysis allowed us to identify seven population segments with various stressor combinations. Six of the segments had elevated perceived stress levels but differed in terms of socioeconomic composition and stressor combinations. These insights may inform a strategy aimed at improving mental health in the general population by targeting efforts to particular population segments, notably segments experiencing challenging life situations.

informal caregivers of people with dementia are at greater risk of developing physical and mental health problems when compared to the general population: they often experience high levels of stress which can lead to a lowered sense of well-being, feelings of being burdened, depression and compromised physical health. The significant beneficial effects of Psychoeducational Interventions on the critical outcomes of caregiver burden and strain were considered sufficient to warrant a recommendation in favour of the intervention. The emergence of the COVID-19 pandemic has significantly increased the use internet-based interventions: this study describes the effectiveness of support program for informal caregivers of people with dementia internet-based and on-site conditions.

A Psychoeducational Interventions program, consisting of 5 meetings every 2 weeks, has been structured. It aims to provide information and strategies for managing cognitive and psycho-behavioral symptoms in neurodegenerative diseases, as well as to develop effective communication skills and understanding of the caregiver's experience. Intervention formats include slides, video, group discussions and are always led by a psychologist. We assessed in 73 caregivers (33 internet-based and 40 on-site conditions) level of Behavioural and Psychological Symptoms of Dementia management, dementia awareness, social support, find leisure time, harmony with relative, stress, with Visual-Analogue Scale at the beginning of PI and at the end. During the pandemic period the protocol was adapted to be available online and subsequently proposed to caregivers belonging to the Cognitive Disorders and Dementia Centre.

in both modalities, internet-based and on-site condition, a statistically significant improvement was highlighted in all aspects (p < 0.05, for all p-value). Questionnaire on basic dementia knowledge was successfully completed at 100%. Also, participants reported a medium to high level of satisfaction with very limited dropouts (< 3%).

The evidence from this pilot study indicated that caregiver support interventions in both conditions significantly improved several and important outcomes: they showed a significant effect in reducing caregiver strain and improving ability and knowledge. Indeed, Psychoeducational Interventions contribute to effective coping strategies to mitigate caregiver burden so they can continue to provide care for loved ones.

Pain in older adults is an increasing concern in low- and middle-income countries (LMICs), with literature suggesting an association with past traumatic events (TEs) in high-income settings. We aim to investigate this relationship in a population-representative sample of older adults with high burden of TEs in a rural South African community.

The Health and Aging in Africa: A longitudinal Study of an INDEPTH Community in South Africa (HAALSI) study collected data pain intensity, using the Brief Pain Inventory, and TEs with a 16-item questionnaire, from 2411 participants aged 40-79 in 2014-15. We used logistic regression models to test the association between TE exposure and self-reported pain status.

TE experience was near-universal (99.1% experience of at least one), while 9.0% of participants reported current pain, of which 86.6% was moderate/severe. In multivariable regression, increased odds of moderate/severe pain was associated with more TEs of any kind (OR 1.08; 95%CI 1.02-1.15 per additional TE) and with past exposure to disasters, accidents and illnesses (men and women), violence in the community (women only) and social/family environment problems (men only)-but not with childhood or war-related TEs.

TEs were associated with pain even within a rural resource-limited setting where trauma experiences were extremely common. However, associations varied by TE type and sex. Interventions to prevent pain in older adults need to be targeted to block specific mechanisms that vary within even at-risk populations.

Spouses experience conflicting emotions when caring for partners with severe mental illnesses. They can have negative emotions while also regarding caregiving as positive and may develop a better marital relationship through the caregiving process. This study investigated factors affecting the negative and positive emotions of husbands and wives acting as caregivers of their spouses with severe mental illnesses.

An online nationwide survey of 166 spouses caring for partners diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder was conducted. Caregivers' negative and positive emotions, personal and role strains in the care burden, sense of coherence, and patients' disabilities in family communication were assessed. We conducted a series of hierarchical multiple regression analyses to evaluate the effects of these factors on the emotions of husbands and wives separately.

Among the 166 spouses, 112 (67%) were husbands and 54 (33%) were wives. Husbands were caregivers to 1.4 times as many individuals diagnosed with psychotic disorder as were wives. The negative emotions of husbands were linked to personal strain, whereas those of wives were associated with patient disability in family communication. Sense of coherence was the only factor predicting positive emotions for both sexes.

Support for spousal caregivers should be adjusted according to sex. A reduction in husbands' personal strain can alleviate their negative emotions, whereas wives' negative emotions can be relieved by improving communication within their families. Regardless of sex, a higher sense of coherence level has the potential to suppress negative emotions and enhance positive emotions.

Sleep, cognition, and mortality may be interdependent.

We explored paths between sleep, cognition and mortality and potential interactions.

The study examines the relationship among sleep, global mental status, and mortality risk using data from 1364 participants from the Healthy Aging in Neighborhood of Diversity across the Life Span (HANDLS) study. We used Cox proportional hazards models and four-way decomposition models to analyze sleep patterns and global mental status.

After a median time at risk of 8.2 years, 172 deaths occurred, with rate of 16 per 1000 person-years. A 1-unit increase in the Pittsburgh Sleep Quality Index (PSQI) global score was linked to a 7% increase in mortality risk in the reduced model, but this effect was attenuated in the full model. In both reduced and fully adjusted models, the PSQI global score and sleep quality domains interacted with global mental status, with poor sleep generally associated with mortality risk in the group with better global mental status at first-visit. In four-way decomposition models, total effects (TE) of PSQI scores on mortality risk were positive and statistically significant, while being mostly controlled direct effects. However, among women, the inverse TE of global mental status on mortality risk was partially mediated by PSQI sleep latency and the PSQI global.

Poor global mental status is associated with greater mortality risk at better sleep quality levels and vice versa. Further longitudinal studies with multiple sleep and cognitive performance repeats are needed to corroborate these findings.

Informal care partners are essential to the care of people living with dementia, but they often experience significant burden and receive minimal training, support, and resources. This article provides an overview of care partner experiences, factors contributing to burden, and methods for reducing burden of caregiving in dementia.

The US Department of Health and Human Services National Plan to Address Alzheimer's Disease and the World Health Organization Global Action Plan for dementia have identified support for dementia care partners as a top priority for research and policy in recognition of care partners' instrumental but underresourced role in dementia care. The psychological, financial, social, and physical costs of caregiving, particularly without necessary knowledge, skills, and resources, can lead to care partner burden. Reassuringly, multicomponent interventions can mitigate burden and other negative consequences of caregiving, especially when they are theoretically grounded, inclusive, and culturally relevant.

Health care providers play a vital role in the early identification of care partner burden through brief, regular assessments. With earlier identification and subsequent intervention (eg, education, skills-based training, local and national resources), the experience of burden and negative health outcomes can be mitigated and quality of life for people living with dementia and their care partners can be improved.

Quantifying the COVID-19 burden is critical to public health response, resource allocation, and policies to mitigate the pandemic, reduce its impact on health and well-being, and ensure recovery and resilience of affected communities. Though a lot of research has been done worldwide on the issues of caregivers during the pandemic, the information about the Pakistani context is not sufficient. The present study aims to explore and quantify the social burden of family caregivers of COVID-19 patients in Pakistan on scientific grounds, which will be a foundation for the policy, support services, and eventually the improvements in the caregivers well-being who are facing the unrepresentative challenges during the pandemic. The present research is a cross-sectional study of family caregivers in Punjab-Pakistan during the pandemic and quantifies the social burden of COVID-19 on caregivers through a 22-item scale developed on a binary response. The study's findings proposed a model of the social burden of caregivers based on five domains . In addition, the study observed significant associations between social burden and some profile variables, such as gender, age, marital status, occupation, income, living arrangements, and caregiving types. The research quantifies the social burden of COVID-19 on family caregivers in Pakistan and will be helpful for researchers, practitioners, and policymakers to understand the social challenges caregivers face during the COVID-19 pandemic in Pakistan.

A better understanding of the causal relationship between spousal cognitive functioning and depression levels among middle-aged and older adults is vital for effective health policymaking under the globally severe aging challenge. However, the related evidence is often limited by potential omitted-variable bias and reverse causation. This study uses an instrumental variables approach, namely the two-stage least squares (2SLS) method, to examine the impact of spousal cognitive functioning on depression levels among middle-aged and older adults in China. The data were sourced from the China Health and Retirement Longitudinal Study (CHARLS) of 2020, including a total of 3,710 couples aged 45 years and above. Depression levels were measured using the Center for Epidemiologic Studies Depression Scale (CES-D-10), while cognitive functioning was assessed using the Mini-Mental State Examination (MMSE). Spousal social participation was employed as the instrumental variable to address omitted-variable bias and reverse causation. Additionally, an interaction effect test between gender and spousal cognitive functioning was conducted. The results show that for each one-point increase in the spouse's MMSE score, the CES-D-10 score of middle-aged and older adults decreased by 17.1% to 68.2%. The OLS results indicated that women, rural residents, and middle-aged individuals were more sensitive to these changes. The interaction effect test results confirmed that women were more affected by changes in spousal cognitive functioning. However, after a more reliable 2SLS analysis, the results for age groups shifted, showing that middle-aged individuals were more sensitive to these changes, with a decrease in depression levels reaching 70.0%, compared to 60.2% for the elderly group. Nonetheless, given the prevalence of depression among the elderly, the impact of spousal cognitive decline on depression in this group should not be overlooked. Our findings highlight the importance of spousal cognitive health in managing depression among both middle-aged and older adults, with particular attention to women and rural populations.

To investigate the factors influencing medication errors made by informal caregivers while providing care at home.

A cross-sectional study based on an online survey, which included both structured and open-ended questions, was conducted in Spain. The survey comprised 49 questions to collect self-reported avoidable medication errors made by caregivers at home.

A total of 685 caregivers participated in the survey, with 346 considered qualified (having received >20 h of training). On average, 13.5 (SD 38.2, 95% CI 10.5-16.5) errors per caregiver per year were self-reported. Errors were more prevalent among non-qualified caregivers, males, direct relatives of the care recipient, those with external occupations, or those who used external aids.

Errors made by informal caregivers occur more frequently than expected, and recognizing these errors remains a challenge. Training is essential for creating safer care environments by increasing awareness of error sources and the risks associated with medication. Recipients' direct relatives should receive appropriate training, considering differences between male and female caregivers. Associations and companies within the care economy sector should prioritize the creation of safer home care environments as a key objective.

This study aimed to evaluate the association between the sociodemographic characteristics of caregivers and patients with stroke, clinical data on stroke, and disability with caregiver burden, hopelessness, and anxiety.

This cross-sectional study included patients with stroke of either sex, aged >18 years. Data were collected between January 2020 and July 2021. Patient demographic included age, sex, stroke type, severity, etiology, topography, treatment, and stroke recurrence. Stroke disability was assessed using the modified Rankin Scale and Barthel Index at 90 days post-discharge. Additionally, caregiver burden, hopelessness, and anxiety were evaluated during patient consultations using the Zarit Burden Interview (ZBI), Beck Hopelessness Scale (BHS), and Beck Anxiety Inventory (BAI).

We included 104 patients with stroke and their caregivers. Overall caregiver burden was moderate (ZBI: 24 [25]), with mild hopelessness (BHS: 4 [4]) and minimal to mild anxiety (BAI: 8 [13]). The linear regression model presented in Table 3 showed that female caregivers scored up to 11 points higher on the Zarit Burden Interview (p = 0.011). Additionally, increased patient age was associated with a higher caregiver burden (p = 0.002) on the Zarit Burden Interview. Posterior circulation stroke and total anterior circulation stroke were also associated with higher Zarit Burden Interview scores compared to lacunar stroke (p = 0.017). Age was not associated with caregiver burden in the entire sample. However, an association between age and caregiver burden was found only in the female group. Furthermore, women aged 65 years and older experienced a more severe burden than women aged 18 to 64 years (p<0.001). Stroke disability was not associated with caregiver burden.

Older female caregivers were significantly affected when caring for stroke patients. Total anterior circulation stroke and Posterior circulation stroke increased Zarit Burden Interview scores. However, no association was observed between stroke disability and the caregiver burden.

Effective recruitment and retention of participants are prerequisites for high quality physical activity intervention programs and evaluation trials, but this is underreported in the literature making it difficult to identify the most promising strategies. Incorporating stakeholder feedback in the design of program components and recruitment materials can optimise recruitment reach and the engagement of participants throughout programs and trials.

The Active Women over 50 randomised controlled trial is testing a program designed to support women aged 50 + to be more physically active. To optimise program design and recruitment flyers, we conducted one focus group and 17 interviews with diverse purposively sampled women aged 50 + living in New South Wales, Australia. Women were asked to review recruitment flyers and the four proposed program components: (1) health coaching, (2) dedicated website with resources, (3) private Facebook group and (4) motivational email and SMS messages. Data analysis incorporated framework methods, deductive analysis using the Adapted Mobile App Rating Scale for evaluating websites and abductive analysis to critique the underlying program theory.

Five themes were identified in relation to recruitment: I want to see (women like) myself, Keep it real, Readability is for everyone, Why should I do it? and Find us where we live. The four program components were strongly supported as a package, but were valued differently for their relative importance. Results were used to refine the health coaching scheduling; website appearance and content; promotion and moderation of the Facebook group; and the structure, appearance and content of messages. Not all suggestions were actionable due to technological and time constraints, and the desire to keep program costs low enough for delivery at scale during the study and beyond. The program theory was expanded to encompass two emergent concepts.

This consultation resulted in substantial refinements to recruitment flyers and strategies, and all four program components. We anticipate that these refinements will increase the reach and appeal of the trial and optimise future scale-up. Consultation feedback, while specific to this program, may have wider transferability for recruitment and the design of programs with similar components targeting women aged 50+.

Informal caregivers often experience multiple negative consequences as a result of the informal care they provide. Among other factors, employment status, financial resources, and mental health are related to informal caregiving. This analysis examined the association between informal caregivers' employment status and their mental health, as well as the moderating effect of net household income on this relationship.

The research question was addressed with data from the German Socio-Economic Panel (SOEP) survey, comprising 3,053 informal caregivers (1,007 male; 2,046 female). Data were obtained through self-reports, and mental health was measured with the Summary Scale Mental Score. Stepwise adjusted multiple linear regression models were used to examine the association between employment status and mental health. The moderating effects were tested with interaction terms. All analyses were also stratified for gender.

Informal caregivers with full-time jobs reported better mental health than unemployed or marginally employed caregivers (β = 0.077, p < 0.001). The significant interaction term for full-time (β=-0.066, p = 0.001) and part-time workers (β=-0.066, p = 0.003) indicated a moderating effect of net household income on the association between employment status and mental health. This finding was especially evident in women.

Employment appears to be a relevant protective factor for informal caregivers' mental health. However, if informal caregivers are not employed, a low net household income might additionally restrict their mental health. Therefore, welfare policy structures must be created to reduce the negative financial consequences for informal caregivers and enable them to achieve work-life-care balance.

Inter-generational interaction is a carrier of Chinese traditional culture, and it can exert important influence on the depressive symptoms on Chinese older adults. The study aims to analyze gender differences in the association between inter-generational interaction and depressive symptoms among Chinese older adults and explore factors contributing to the differences.

Data from China Family Panel Studies in 2020 were used. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. The latent class analysis was applied to identify patterns of inter-generational interaction of older adults (aged 60 and above). Before the comparison between older man and older woman, we used Coarsened Exact Matching to control confounding factors and improve causal inferences. Multiple linear regression was conducted to explore the association between inter-generational interaction and depression symptoms. Oaxaca-blinder decomposition method was used to analyze the gender difference and the sources.

Our study identified three types of inter-generational interaction: detached, nearby but discordant and two-way tight-knit. Analysis indicated that most of older man (54.39%) and older woman (49.78%) were in the type of nearby but discordant. Older man and older woman who in detached type had higher depression scores than other types, and the depression score of two-way tight-knit type accounted for 12.42 and 13.77 respectively. Our findings demonstrated that two-way tight-knit type (-11.89%) significantly decreased the gender differences in the depression symptoms. Other major contributors also included living without spouse (20.56%), primary school and junior middle school (15.95%), higher middle school and above (9.50%) and no illness for two weeks (47.70%).

Our study highlighted three patterns of inter-generational interaction, and most of older man and older woman were in the pattern of nearby but discordant. In addition, the two-way tight-knit pattern significantly can decrease gender differences in depression symptoms. The contributors should be taken into account in more targeted intervention strategies for narrowing gender differences in the depression symptoms, which could achieve a gender dividend in the era of China's aging population.

To examine the influence of sociodemographic factors on employment changes among adult children following onset of parental Alzheimer's disease and related dementia (ADRD).

We used Health and Retirement Study (2010-2018; N = 20,110) data to examine adult child (ages 50-70) changes in employment and work hours at onset of parental ADRD and potential variation by gender, age, race, ethnicity, and education.

Parental ADRD onset was not associated with changes in adult child employment overall, although associations differed substantially across subpopulations defined by education level. Sons with the lowest education were least likely to cease employment, while daughters with the lowest education were most likely to reduce work hours. Sons at older ages were increasingly likely to reduce work hours or end employment following parental ADRD onset.

The potential impact of parental ADRD on adult child employment is complex and should be considered in the context of sociodemographic factors.

One in five Canadians lives with one or more chronic conditions. Patients with chronic conditions often experience a high treatment burden because of the work associated with managing care. Telehealth is considered a useful solution to reduce the treatment burden among patients with chronic conditions. However, telehealth can also increase the treatment burden by offloading responsibilities on patients. This cross-sectional study conducted in Ontario, Canada examines the association between telehealth utilization and treatment burden among patients with chronic conditions. This study aimed to explore whether and to what extent, telehealth use is associated with treatment burden among patients with chronic conditions. The secondary objective was to explore which sociodemographic variables are associated with patients' treatment burden. An online survey was administered to community-dwelling patients with one or more chronic conditions. The Treatment Burden Questionnaire (TBQ-15) was used to measure the patient's level of treatment burden, and a modified telehealth usage scale was developed and used to measure the frequency of telehealth use. Data was analyzed using descriptive statistics, correlations, analyses of variance, and hierarchical linear regression analysis. A total of 75 patients completed the survey. The participants' mean age was 64 (SD = 18.93) and 79% were female. The average reported treatment burden was 72.15 out of 150 (a higher score indicating a higher level of burden). When adjusted for demographic variables, a higher frequency of telehealth use was associated with experiencing a higher treatment burden, but the association was not statistically significant. Additionally, when adjusted for demographic variables, younger age, and the presence of an unpaid caregiver were positively related to a high treatment burden score. This finding demonstrates that some patient populations are more at risk of experiencing high treatment burden in the context of telehealth use; and hence, may require extra support to utilize telehealth technologies. The study highlights the need for further research to explore how to minimize the treatment burden among individuals with higher healthcare needs.

A great deal of literature documents the significant demands, both physical and psychosocial, that care partners experience when providing care to persons with a range of health conditions. There is, however, far less research available on care partners of adult persons who are d/Deaf or hard of hearing (d/DHH). In response to this gap, the authors developed measures of d/DHH stigma among care partners as part of the work of the Lancet Commission on Hearing Loss' Measures, Models, and Stigma Reduction Subgroup. The measures examined in this article are part of a larger set of parallel measures to enable comparison of stigma measurement across groups.

The present study describes the preliminary validation of five stigma scales specifically tailored for use to assess the prevalence and effect of stigma on the care partners of adult people who are d/DHH in the United States. Care partners in this context are defined broadly and can include spouses, partners, adult children, siblings, and friends of persons who are d/DHH. The scales describe the care partner's own assessment of how the person who is d/DHH experiences and perceives stigma as well as the care partner's own internalized, experienced, and perceived stigma as a result of their association with a person who is d/DHH. This latter set of three scales describes secondary stigma, or the stigma a person experiences related to their association with a member of a stigmatized group. Measures were developed through a process that included a literature review, Delphi groups with people who became d/DHH after they developed spoken language, cognitive interviews, and a pretest. An online, self-administered preliminary validation survey was conducted with 151 care partners.

Results support the internal reliability of each of the five stigma scales (ordinal α's all greater than 0.9) and that each scale is assessing a single factor.

Additional testing is needed to confirm the validity of these measures. After further validation, they can be used to assess the prevalence and effect of stigma on care partners of persons who are d/DHH and to evaluate the success of interventions developed to address stigma and its effects both on the care partner and the person who is d/DHH and receiving the care.

Patients from diverse sociocultural backgrounds and with differing medical conditions may have varying levels of acceptance of advanced care planning and palliative care.

We performed a retrospective analysis of the National Inpatient Sample for patients discharged from January 1, 2016, to December 31, 2019, with conditions associated with frequently terminal conditions. We recorded demographic variables, do not resuscitate (DNR) status, and palliative care (PC) status and analyzed the associations between outcomes, mortality, and length of stay (LOS).

A total of 23,402,637 patient records were included in the study, of which 2% were DNR and PC, 5% were DNR only, and 1% was PC only. From 2016 to 2019, the percentage of patients with PC increased from 2.55% to 3.27% and DNR from 6.31% to 7.7%. Black patients were less likely to have DNR status (odds ratio [OR] 0.72 [0.71-0.72]) but had similar PC rates. Male patients were less likely to have a DNR order in place (OR 0.89 [0.89-0.89]) but more likely to be in PC (OR 1.05 [1.04-1.05]). The diagnoses with the highest association with DNR status were lung cancer (OR 4.1 [4.0-4.5]), pancreatic cancer (OR 4.6 [4.5-4.7]), and sepsis (OR 2.9 [2.9-2.9]) The diagnoses most associated with PC were lung cancer (OR 6.3 [6.2-6.4]), pancreatic cancer (OR 8.1 [7.1-8.3]), colon cancer (OR 4.9 [4.8-5.1]), and senile brain degeneration of the brain OR 6.5 [5.3-7.9]). Mortality and LOS decreased between 2016 and 2019, but hospital charges increased (p < 0.001). Black race and male gender were associated with higher inpatient mortality (OR 1.12 [1.12-1.14]), LOS, and hospital charges.

In the United States, the proportion of hospitalized patients with DNR, PC, and DNR with PC increased from 2016 to 2019. Overall, inpatient mortality and LOS fell, but hospital charges per patient increased. Significant gender and ethnic differences emerged. Black patients and males were less likely to have DNR status and had higher inpatient mortality, LOS, and hospital charges.

This study seeks to assess whether and to what extent caregiver work strain is ameliorated by the presence of additional family caregivers and formal service use. Building on the stress process model and stress-appraisal moderation, we examine how formal and informal support varies in associations with caregiver distress for men and women.

This study utilizes data provided by the National Study of Caregiving, which is linked with care-recipient information from the National Health and Aging Trends Study. Using panel methods for the pooled waves, we estimated caregiver outcomes of emotional well-being on the intersection of experiences of work strain and (a) the number of additional caregivers and (b) utilization of 6 different types of formal support.

Additional informal caregivers for each respective care recipient are associated with lower levels of distress, although utilization of formal services (paid help and Medicaid funding) is positively associated with caregiver distress. Informal support can offset the impact of work strain, but interactions are only evident for women caregivers.

The findings suggest that informal support, exemplified by the number of additional caregivers, corresponds with reduced emotional distress among employed caregivers and can mitigate the negative impacts of work strain. However, positive associations between formal support and male and female caregiver distress suggest that the context of formal services may offer limited or untimely support. This study is expected to broaden our understanding of informal caregiving in later life and provide practical implications on how to sustain informal care.

The long-term symptoms associated with Alzheimer's disease pose significant challenges to the psychological wellbeing of patients. This longitudinal study aims to analyze the effects of socioeconomic factors and physical health factors on the psychological wellbeing of older patients diagnosed with Alzheimer's disease (AD) receiving home care, as well as the moderating role of aging and care support in influencing their psychological wellbeing. Data from the Health and Retirement Study (N = 628 older Alzheimer's patients) were analyzed using pooled ordinary least squares fixed-effects models. Findings suggest that Alzheimer's patients' psychological wellbeing was significantly affected by factors including cohabitation, gender, assistance frequency, age, education, and daily activity challenges, with assistance and increasing age mitigating some daily difficulties. The findings underline the multifactorial nature of psychological wellbeing among older Alzheimer's patients in home care and the critical role of social and physical health determinants in shaping these outcomes.

Podoconiosis is a non-infectious, neglected tropical disease caused by chronic barefoot contact with irritant volcanic soils. It typically presents with lower limb swelling, disfigurement, and chronic disability. Patients and their families experience stigma from their communities. Depression, anxiety, and emotional distress contribute to the total illness burden of podoconiosis. This study used a survey-based comparative cross-sectional quantitative study design involving podoconiosis patients, their family members, and unaffected neighbors. The Depression, Anxiety, and Stress Scale (DASS 21), the WHO Quality of Life Scale (WHO-QOL Brief), and the Tekola clinical staging system were used to collect data. We surveyed 741 participants (33.1% patients, 33.3% family, 33.5% neighbors). Podoconiosis patients exhibited significantly elevated odds of severe depression (19.8x), anxiety (10.7x), and stress symptoms (13.5x) in comparison to unaffected neighbors. Family members of podoconiosis patients displayed 1.5x higher odds of experiencing severe anxiety symptoms compared to unaffected neighbors. Higher clinical stages of podoconiosis were associated with increased severity of depressive symptoms. Podoconiosis patients demonstrated lower median scores across all domains of the WHO QoL Brief in contrast to family members and unaffected neighbors. The burden of depression, anxiety, and stress on podoconiosis patients and their family members is high. Podoconiosis morbidity management programs need to encompass families of patients and integrate continuous mental health support within the broader framework of podoconiosis management.

The prevalence of informal caregiving is increasing as populations across the world age. Caregiving has been found to be associated with poor mental health outcomes including depressive symptoms. The purpose of this study is to examine the mean trajectory of depressive symptomatology in older caregivers in a large European sample over an eight-year period, the effects of time-varying and time-invariant covariates on this trajectory, and the mean trajectory of depressive symptomatology according to pattern of caregiving. The results suggest that depressive symptoms in the full sample of caregivers follow a nonlinear trajectory characterized by an initial decrease which decelerates over time. Caregiver status and depressive symptoms were significantly associated such that depressive symptoms increased as a function of caregiver status. The trajectory in caregivers who report intermittent or consecutive occasions of caregiving remained stable over time. Significant associations were found between sociodemographic, health and caregiving characteristics and the initial levels and rates of change of these trajectories. While these results point to the resilience of caregivers, they also highlight the factors that are related to caregivers' adaptation over time. This can help in identifying individuals who may require greater supports and, in turn, ensuring that caregivers preserve their well-being.

With an intensified aging population and an associated upsurge of informal care need in China, there is an ongoing discussion around what factors influence this need among older adults. Most existing studies are cross-sectional and do not focus on older people living in the community. Conversely, this study empirically explores the factors that affect informal care need of Chinese community-dwelling older individuals based on longitudinal data.

This study constructed panel data using the China Health and Retirement Longitudinal Research Study (CHARLS) from 2011 to 2018 for analysis. Generalized linear mixed models were used to analyze the factors affecting reception of informal care, and linear mixed models were used to analyze the factors affecting informal care sources and intensity.

During the follow-up period, 7542, 6386, 5087, and 4052 older adults were included in 2011-2018, respectively. The proportion receiving informal care increased from 19.92 to 30.78%, and the proportion receiving high-intensity care increased from 6.42 to 8.42% during this period. Disability (estimate = 4.27, P < 0.001) and living arrangement (estimate = 0.42, P < 0.001) were the critical determinants of informal care need. The rural older adults reported a greater tendency to receive informal care (estimate = 0.14, P < 0.001). However, financial support from children did not affect informal care need (P > 0.05).

At present, there is a great demand for the manpower and intensity of informal care, and the cost of informal care is on the rise. There are differences in informal care needs of special older groups, such as the oldest-old, living alone and severely disabled. In the future, the region should promote the balance of urban and rural care service resources, rationally tilt economic support resources to rural areas, reduce the inequality of long-term care resources, improve the informal care support system, and provide a strong community guarantee for the local aging of the older adults.

The aging population and increased disability prevalence in Spain have heightened the demand for long-term care. Informal caregiving, primarily performed by women, plays a crucial role in this scenario. This protocol outlines the CUIDAR-SE study, focusing on the gender-specific impact of informal caregiving on health and quality of life among caregivers in Andalusia and the Basque Country from 2013 to 2024.

This study aims to analyze the gender differences in health and quality of life indicators of informal caregivers residing in 2 Spanish autonomous communities (Granada, Andalusia, and Gipuzkoa; Basque Country) and their evolution over time, in relation to the characteristics of caregivers, the caregiving situation, and support received.

The CUIDAR-SE study uses a longitudinal, multicenter design across 3 phases, tracking health and quality of life indicators among informal caregivers. Using a questionnaire adapted to the Spanish context that uses validated scales and multilevel analysis, the research captures changes in caregivers' experiences amid societal crises, notably the 2008 economic crisis and the COVID-19 pandemic. A multistage randomized cluster sampling technique is used to minimize study design effects.

Funding for the CUIDAR-SE study was in 3 phases starting in January 2013, 2017, and 2021, spanning a 10-year period. Data collection commenced in 2013 and continued annually, except for 2016 and 2020 due to financial and pandemic-related challenges. As of March 2024, a total of 1294 participants have been enrolled, with data collection ongoing for 2023. Initial data analysis focused on gender disparities in caregiver health, quality of life, burden, perceived needs, and received support, with results from phase I published. Currently, analysis is ongoing for phases II and III, as well as longitudinal analysis across all phases.

This protocol aims to provide comprehensive insights into caregiving dynamics and caregivers' experiences over time, as well as understand the role of caregiving on gender inequality in health, considering regional variations. Despite limitations in participant recruitment, focusing on registered caregivers, the study offers a detailed exploration of the health impacts of caregiving in Spain. The incorporation of a gender perspective and the examination of diverse contextual factors enrich the study's depth, contributing significantly to the discourse on caregiving health complexities in Spain.

DERR1-10.2196/58440.

People with Parkinson's disease (PD) have an increased risk of dementia, yet patients and clinicians frequently avoid talking about it due to associated stigma, and the perception that "nothing can be done about it". However, open conversations about PD dementia may allow people with the condition to access treatment and support, and may increase participation in research aimed at understanding PD dementia.

To co-produce information resources for patients and healthcare professionals to improve conversations about PD dementia.

We worked with people with PD, engagement experts, artists, and a PD charity to open up these conversations. 34 participants (16 PD; 6 PD dementia; 1 Parkinsonism, 11 caregivers) attended creative workshops to examine fears about PD dementia and develop information resources. 25 PD experts contributed to the resources.

While most people with PD (70%) and caregivers (81%) shared worries about cognitive changes prior to the workshops, only 38% and 30%, respectively, had raised these concerns with a healthcare professional. 91% of people with PD and 73% of caregivers agreed that PD clinicians should ask about cognitive changes routinely through direct questions and perform cognitive tests at clinic appointments. We used insights from the creative workshops, and input from a network of PD experts to co-develop two open-access resources: one for people with PD and their families, and one for healthcare professionals.

Using artistic and creative workshops, co-learning and striving for diverse voices, we co-produced relevant resources for a wider audience to improve conversations about PD dementia.

Given the escalating demand for care services, understanding the impact of informal caregiving, providing unpaid care for family members, on own health is essential. This study longitudinally analyzed the association of caregiving (and different caregiver types) with mental, physical, and self-rated health. Urban-rural, gender, and employment heterogeneity were further investigated.

Based on three-wave data (2011, 2013, and 2018) from the China Health and Retirement Longitudinal Study, we used growth curve models to assess the impact of informal caregiving (providing care to family members) and caregiver types (caregivers to grandchildren, parents, spouses, or multiple family members) on three health outcomes (depressive symptoms, self-rated health, and activities of daily living limitations).

Our study included 13,377 individuals. Results showed a negative correlation of caregiving with mental, physical, and self-rated health. Compared to noncaregivers, spousal caregivers and multiple caregivers were both associated with worsening mental, self-rated, and physical health. In contrast, adult child caregivers were only negatively associated with mental health, and grandparent caregiving did not significantly affect any health outcomes. Further heterogeneity analysis showed that gender did not moderate the relationship between caregiving and health, whereas the negative association between caregiving and health was more pronounced among the rural population and those employed in agriculture.

Findings from the present study suggest that caregiving is detrimental to health, and recommend considering caregiver type when examining caregiving and health. These findings have vital implications for policymakers in addressing the challenges of structuring and implementing a sustainable informal care system.

Two out of three family caregivers are female. However, current trends show that men are more likely to undertake caregiving duties, yet female caregivers report a higher burden. This paper analyzed data from long-term family caregivers to determine whether, under similar circumstances, gender differences in caregiving persist. We examined whether the observed gender gap affects caregivers' satisfaction with their health and quality of life.

We analyze cross-sectional data from family caregivers of persons with spinal cord injury (SCI) in Switzerland. The data provides comprehensive information about the time and type of weekly tasks family caregivers undertake. To determine differences in caregiving related to gender, we balanced the characteristics of the caregiver and the cared-for person using a propensity score kernel matching. With the balanced sample, we estimated how the observed differences in caregiving varied across cohorts using a Poisson regression.

Under similar circumstances, male and female caregivers invest similar time in caregiving. This result holds for 21 caregiving tasks, except for household chores, where women spent, on average, four more hours per week than male caregivers. Despite these differences, female caregivers report a quality of life and satisfaction with their health that is similar to that of male caregivers.

Gender differences in caregiving narrow over time, except for household chores, where female caregivers continue to spend significantly more hours than male caregivers. Measures designed for family caregivers must consider these gender differences, as the support needs of female caregivers can differ greatly from those of male caregivers.