Abstract
ObjectivesMuch is known about the demands of caregiving for persons with dementia (PWD) and its effects on family caregivers, however sex and gender aspects have received less attention. We synthesized the evidence on sex and gender distinctions in: (1) the caregiving burden and (2) the impact of caregiving on the physical and mental health of family caregivers of PWD.DesignSystematic review.Data sourcesMedline, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature between January 2007 and October 2019 were searched.Eligibility criteria for selecting studiesIncluded studies met the following criteria: (1) examine experiences and/or impacts of caregiving among family caregivers of individuals with any form of dementia; (2) report sex and/or gender distribution of study population and/or report results stratified by sex and/or gender, and (3) include both male and female family caregivers.Data extraction and synthesisTwo independent reviewers extracted the data and assessed risk of bias using the Critical Appraisal Skills Program checklist and National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Data were synthesized using a narrative synthesis approach.ResultsA total of 22 studies were included. Caregiving burden was measured using various methods. A majority of studies reported higher burden among females. All studies that did not report a sex and gender difference in caregiving burden accounted for confounders. Findings on sex and gender differences on physical and mental health conditions were inconsistent with most studies failing to account for confounders in their analyses.ConclusionsCurrent evidence on sex and gender differences in caregiving burden, mental and physical health is limited. Findings suggest presence of sex and gender differences in caregiving burden. Given the variety of mental and physical health constructs that were examined, further research is required to substantiate the evidence.PROPSERO Registration Number: CRD 42018070032.
Highlights
Dementia, which refers to a number of conditions that produce acquired cognitive decline [1], is a major global public health concern
All studies that did not report a sex and gender difference in caregiving burden accounted for confounders
Findings on sex and gender differences on physical and mental health conditions were inconsistent with most studies failing to account for confounders in their analyses
Summary
Dementia, which refers to a number of conditions that produce acquired cognitive decline [1], is a major global public health concern. With the rising prevalence of dementia, an increasing number of aging family members are providing care for PWD [6, 7]. To date most research on measures of caregiving burden has been quantitative, providing tools that are adapted within clinical settings [13] and valuable information for evidence-based intervention programs. These measures may fail to capture the breadth of elements that comprise the multi-faceted concept of burden [13]. This review will include qualitative examinations of caregiving burden with the goal of achieving a more comprehensive understanding of caregiving burden in the context of family caregiving and dementia
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