An Integrated Analysis of Informal Caregiving and Psychosocial Work Stressors on Mental Health Trajectories in Later Life

Informal caregivers exhibit poorer mental health trajectories compared to non-caregivers.

• Study used longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE), waves 6, 7, 8, and 9
• Sample comprised 13,233 adults aged 50 years and older at baseline from 17 European countries
• Cross-domain latent growth models were employed to evaluate longitudinal associations
• The finding held across the observation period spanning four survey waves

Adults who become caregivers within the household during the study period also show poorer mental health trajectories.

• The analysis distinguished between baseline caregivers and those who became caregivers over the course of the study
• Within-household caregiving onset was specifically associated with declining mental health
• Cross-domain latent growth models captured this transition effect longitudinally
• This suggests that the onset of caregiving, not only sustained caregiving, poses mental health risks

An increase in work efforts is associated with declining mental health among older working adults.

• Psychosocial work stressors were assessed using an effort-reward framework
• Increasing effort over time was longitudinally linked to worsening mental health trajectories
• The association was examined among adults aged 50 and older who were still employed
• These findings were identified using cross-domain latent growth models across four SHARE waves

A reduction in work rewards is associated with declining mental health among older working adults.

• Decreasing rewards at work over time was longitudinally linked to worsening mental health trajectories
• This finding complements the effort finding, consistent with an effort-reward imbalance framework
• The sample included adults from 17 European countries, suggesting cross-national generalizability
• Both effort and reward trajectories were examined simultaneously within the cross-domain latent growth model

Among women, but not men, the combination of informal caregiving and adverse psychosocial working conditions amplifies negative mental health outcomes.

• A sex-specific effect modification was identified in which adverse work conditions and caregiving jointly worsen women's mental health beyond their individual effects
• This combined effect was not observed among men
• The finding points to a gender-differentiated vulnerability to the dual burden of paid work and unpaid caregiving
• The authors conclude that 'an integrated approach to work conditions and care provision may be especially important for protecting women's mental health'

The study was motivated by policy trends in aging societies that simultaneously increase reliance on informal care and extend working lives.

• Concerns about pension system sustainability and rising healthcare expenditure were cited as drivers of these trends
• A growing number of older adults now combine paid work with informal caregiving as a result
• The authors note that a 'joint investigation of informal care and working conditions is needed to account for possible effect modification, but this has rarely been done'
• The study was designed to address this gap in the literature

The authors recommend coordinated policy efforts targeting both psychosocial working conditions and informal caregiver support, particularly for women.

• Policy recommendations stem from the observed amplifying interaction between caregiving and adverse work conditions in women
• The authors call for efforts to 'improve psychosocial working conditions while supporting informal caregivers'
• The integrated approach is highlighted as 'especially important for protecting women's mental health'
• No specific policy instruments are prescribed beyond the principle of coordination and targeting