Does informal care attenuate the cycle of ADL/IADL disability and depressive symptoms in late life?

Abstract

Prior studies have extensively examined the reciprocal relation between disability and depressive symptoms in late life, but little is known about whether informal care attenuates the reciprocal relation over time. This study examined whether disability and depressive symptoms mobilize informal care and whether informal care, once mobilized, protects older adults against the progression of disability and depressive symptoms. The analysis was based on 6,454 community-dwelling older adults who were interviewed in one or more waves of the Health and Retirement Study between 1998 and 2006. Extending an autoregressive cross-lagged model, we constructed 3 cycles of the relations among disability, depressive symptoms, and informal care. Comparing the relations across 3 cycles informs us about the attenuating effect of informal care on the relation between disability and depressive symptoms over time. Although older adults' disability and depressive symptoms mobilized informal care initially, worsening disability and depressive symptoms often exhausted support. Receipt of care generally increased, rather than decreased, disability and depressive symptoms, and the detrimental effects remained the same over time. We need to better understand the linkage between disability and depressive symptoms and seek effective interventions to reduce caregiver strain and enhance care receivers' well-being.