title: Depressive symptoms among informal caregivers of older adults: insights from the Singapore Survey on Informal Caregiving.
abstract: BACKGROUND
  This paper determines care recipient and caregiver characteristics and caregiving dimensions - associated with depression among caregivers of older adults, using path analysis and assesses whether the identified path model differs between spousal and adult child caregivers.
  
  
  METHODS
  Data from 1,190 dyads comprising care recipients (community-dwelling adults aged ≥ 75 years with at least one activity of daily living (ADL) limitation) and caregivers (family member/friend most involved in providing care/ensuring provision of care to care recipient), who were interviewed through the Singapore Survey on Informal Caregiving (2010-2011), were used. Using path analysis, we assessed the direct and indirect associations between primary stressors (care recipient's ADL and instrumental ADL status, and memory and behavior problems), caregiver health status, receipt of assistance from a foreign domestic worker/maid, amount of caregiving, negative reaction to caregiving, caregiver's self-esteem, perceived emotional support, and caregiver depressive symptoms.
  
  
  RESULTS
  Our analysis showed that primary stressors, receipt of assistance from a foreign domestic worker/maid, perceived emotional support, and caregiver health status were directly or indirectly associated with caregiver depressive symptoms, and this association was mediated by negative reaction to caregiving. Caregiver self-esteem mediated the relationship between perceived emotional support and negative reaction to caregiving only among adult child caregivers.
  
  
  CONCLUSIONS
  The results provide insights into factors associated with depressive symptoms among spousal and adult child caregivers, and help identify targeted interventions for improving caregiver mood.
authors.affiliation: Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore. chetna.malhotra@duke-nus.edu.sg
authors.forename: Chetna
authors.initials: C
authors.lastname: Malhotra
authors.forename: Rahul
authors.initials: R
authors.lastname: Malhotra
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
authors.forename: David
authors.initials: D
authors.lastname: Matchar
authors.forename: Angelique
authors.initials: A
authors.lastname: Chan
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006306:Health Surveys; D018576:Home Health Aides / Q000523:psychology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000523:psychology; D001523:Mental Disorders / Q000523:psychology; D012649:Self Concept; D012846:Singapore; D013315:Stress, Psychological / Q000150:complications