title: Subjective burden among spousal and adult-child informal caregivers of older adults: results from a longitudinal cohort study.
abstract: Pressures on informal caregivers are likely to increase due to increasing life expectancy and health care costs, which stresses the importance of prevention of subjective burden. The present study examined the correlates of overall subjective burden and multiple burden dimensions among spousal and adult-child caregivers of Dutch older adults, both cross-sectional and longitudinal (12-months follow-up).
  
  
  
  In 2010 and 2011 baseline and follow-up data was collected in a sample of informal caregivers and care recipients in the Northern provinces of the Netherlands. Subjective burden included 7 burden dimensions and a summary score for overall subjective burden, based on the Care-Related Quality of Life Instrument (CarerQoL-7D). Objective stressors were the time investment in caregiving (hours of household care, personal care, practical care) and the health situation of the care recipient, including multimorbidity, functional limitations (Katz Index of Independence Basic Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), and cognitive functioning problems (EQ-5D + C). Correlates of subjective burden were evaluated with linear and logistic regression analyses.
  
  
  
  The sample consisted of 356 caregivers at baseline (43% spousal, 57% adult-child caregivers), and 158 caregivers at follow-up (45% spousal, 55% adult-child caregivers). At baseline and follow-up, spousal caregivers experienced a higher overall subjective burden, and reported more often mental health problems, physical health problems, and problems with combining daily activities, compared to adult-child caregivers. For spousal caregivers, a poorer health situation of the care recipient was associated with higher subjective burden, while adult-child caregivers reported higher levels of subjective burden when their time investment in caregiving was high. Subjective burden at follow-up was mainly explained by baseline subjective burden.
  
  
  
  These results indicate that for effective caregiver support, it is crucial to take the type of care relationship into account, since the level and correlates of overall subjective burden and burden dimensions varied for spousal and adult-child caregivers. In addition, reducing subjective burden will also positively impact the subjective burden over time.
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands. m.oldenkamp@umcg.nl.
authors.forename: Marloes
authors.initials: M
authors.lastname: Oldenkamp
authors.affiliation: Department of Health Sciences, Health Psychology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Mariët
authors.initials: M
authors.lastname: Hagedoorn
authors.affiliation: Department of Geriatrics, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.|Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA, Leiden, The Netherlands.
authors.forename: Joris
authors.initials: J
authors.lastname: Slaets
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Stolk
authors.affiliation: Department of Sociology, University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands.
authors.forename: Rafael
authors.initials: R
authors.lastname: Wittek
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.|Department of Geriatrics, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Nynke
authors.initials: N
authors.lastname: Smidt
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D032721:Adult Children / Q000523:psychology*; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005192:Family Health / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D012944:Social Support; D018454:Spouses / Q000523:psychology*
keywords: Adult children; Burden; Caregiving; Longitudinal studies; Spouses