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Background <p>It is widely recognized that individuals with disabilities are at a significantly higher risk of mental health issues. However, the mental health status of their spousal caregivers often tends to be overlooked.</p> Objective <p>To investigate the association between caring for a disabled spouse and depressive symptoms among middle-aged and older adults, and to assess whether this association differs by caregiver gender.</p> Methods <p>Cross-sectional data were drawn from the 2020 China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms in respondents were measured by the CESD-10. Associations were estimated using generalized estimating equations (GEE) with a logit link to account for intra-household correlation. Models adjusted for sociodemographic and health-related confounders. We conducted gender-stratified analyses, tested the interaction between gender and caregiving, performed an analysis restricted to caregivers (<i>n</i> = 1,357), and examined the relation between the number/types of recipient disabilities and caregiver depressive symptoms.</p> Results <p>In multivariable GEE models, spousal caregiving was associated with higher odds of depressive symptoms (OR = 1.278, 95% CI 1.127 to 1.449, <i>P</i> &lt; 0.001). Stratified analyses indicated a stronger association among female caregivers (OR = 1.459, 95% CI 1.204 to 1.768, <i>P</i> &lt; 0.001) than male caregivers (OR = 1.207, 95% CI 1.013 to 1.438, <i>P</i> = 0.036); however, the gender × caregiving interaction was not statistically significant (<i>P</i> = 0.271). Within the caregiver subsample, female caregivers had markedly higher odds of depressive symptoms compared with male caregivers (OR = 1.824, 95% CI 1.355 to 2.455). Moreover, a greater number or severity of recipient disabilities was associated with incrementally higher depressive risk among caregivers, suggesting a dose–response relationship.</p> Conclusions <p>Spousal caregiving was associated with elevated odds of depressive symptoms, with larger effect estimates among women. Limitations include cross-sectional design, self-reported measures, and potential residual confounding. Prospective studies are needed to assess temporality and causal pathways; the results support enhanced monitoring and development of targeted supports for spousal caregivers, with consideration of sex differences and recipient disability burden.</p>

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The association between caregiving for disabled spouses and depressive symptoms among middle-aged and older adults in China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月21日

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  • Tingyu Mu,
  • Guiyue Ma,
  • Rixiang Xu

摘要

Background

It is widely recognized that individuals with disabilities are at a significantly higher risk of mental health issues. However, the mental health status of their spousal caregivers often tends to be overlooked.

Objective

To investigate the association between caring for a disabled spouse and depressive symptoms among middle-aged and older adults, and to assess whether this association differs by caregiver gender.

Methods

Cross-sectional data were drawn from the 2020 China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms in respondents were measured by the CESD-10. Associations were estimated using generalized estimating equations (GEE) with a logit link to account for intra-household correlation. Models adjusted for sociodemographic and health-related confounders. We conducted gender-stratified analyses, tested the interaction between gender and caregiving, performed an analysis restricted to caregivers (n = 1,357), and examined the relation between the number/types of recipient disabilities and caregiver depressive symptoms.

Results

In multivariable GEE models, spousal caregiving was associated with higher odds of depressive symptoms (OR = 1.278, 95% CI 1.127 to 1.449, P < 0.001). Stratified analyses indicated a stronger association among female caregivers (OR = 1.459, 95% CI 1.204 to 1.768, P < 0.001) than male caregivers (OR = 1.207, 95% CI 1.013 to 1.438, P = 0.036); however, the gender × caregiving interaction was not statistically significant (P = 0.271). Within the caregiver subsample, female caregivers had markedly higher odds of depressive symptoms compared with male caregivers (OR = 1.824, 95% CI 1.355 to 2.455). Moreover, a greater number or severity of recipient disabilities was associated with incrementally higher depressive risk among caregivers, suggesting a dose–response relationship.

Conclusions

Spousal caregiving was associated with elevated odds of depressive symptoms, with larger effect estimates among women. Limitations include cross-sectional design, self-reported measures, and potential residual confounding. Prospective studies are needed to assess temporality and causal pathways; the results support enhanced monitoring and development of targeted supports for spousal caregivers, with consideration of sex differences and recipient disability burden.