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      Informal caregivers in Germany – who are they and which risks and resources do they have?

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          Abstract

          Background

          The aim of this study is to describe the social characteristics, the health and living situation and the prevalence of behavioral risk factors of adult informal caregivers compared to non-caregivers in Germany.

          Methods

          We used data from the German Health Update (GEDA 2019/2020-EHIS survey) which is a cross-sectional population-based health interview survey conducted between 04/2019 and 09/2020. The sample comprised 22,646 adults living in private households. Three mutually exclusive groups of providing informal care or assistance were differentiated: intense caregivers (informal care ≥10 h/week), less-intense caregivers (informal care<10 h/week) and non-caregivers. For the three groups weighted prevalences of social characteristics, health status (self-perceived health, health-related activity limitations, chronic diseases, low back disorder or other chronic back defect, depressive symptoms), behavioral risk factors (at-risk drinking, current smoking, insufficient physical activity, non-daily fruit and vegetable consumption, obesity) and social risk factors (single household, low social support) were calculated and stratified by gender. Separate regression analyses adjusted for age-group were conducted to identify significant differences between intense and less-intense caregivers vs. non-caregivers, respectively.

          Results

          Overall, 6.5% were intense caregivers, 15.2% less-intense caregivers and 78.3% non-caregivers. Women provided care more often (23.9%) than men (19.3%). Informal care was most frequently provided in the age group of 45 to 64 years. Intense caregivers reported worse health status, were more often current smokers, physical inactive, obese and lived less often alone than non-caregivers. However, in age-group adjusted regression analyses only few significant differences were seen: Female and male intense caregivers had more often a low back disorder and lived less often alone compared to non-caregivers. In addition, male intense care-givers reported more often worse self-perceived health, health-related activity limitation, and the presence of chronic diseases. In contrast, less-intense caregivers and non-caregivers differed in favor of the less-intense caregivers.

          Discussion

          A substantial proportion of the adult German population provides informal care regularly, especially women. Intense caregivers are a vulnerable group for negative health outcomes, especially men. In particular measures to prevent low back disorder should be provided. As the necessity of providing informal care will probably increase in the future, this will be important for the society and public health.

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          Most cited references36

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          The PHQ-8 as a measure of current depression in the general population.

          The eight-item Patient Health Questionnaire depression scale (PHQ-8) is established as a valid diagnostic and severity measure for depressive disorders in large clinical studies. Our objectives were to assess the PHQ-8 as a depression measure in a large, epidemiological population-based study, and to determine the comparability of depression as defined by the PHQ-8 diagnostic algorithm vs. a PHQ-8 cutpoint > or = 10. Random-digit-dialed telephone survey of 198,678 participants in the 2006 Behavioral Risk Factor Surveillance Survey (BRFSS), a population-based survey in the United States. Current depression as defined by either the DSM-IV based diagnostic algorithm (i.e., major depressive or other depressive disorder) of the PHQ-8 or a PHQ-8 score > or = 10; respondent sociodemographic characteristics; number of days of impairment in the past 30 days in multiple domains of health-related quality of life (HRQoL). The prevalence of current depression was similar whether defined by the diagnostic algorithm or a PHQ-8 score > or = 10 (9.1% vs. 8.6%). Depressed patients had substantially more days of impairment across multiple domains of HRQoL, and the impairment was nearly identical in depressed groups defined by either method. Of the 17,040 respondents with a PHQ-8 score > or = 10, major depressive disorder was present in 49.7%, other depressive disorder in 23.9%, depressed mood or anhedonia in another 22.8%, and no evidence of depressive disorder or depressive symptoms in only 3.5%. The PHQ-8 diagnostic algorithm rather than an independent structured psychiatric interview was used as the criterion standard. The PHQ-8 is a useful depression measure for population-based studies, and either its diagnostic algorithm or a cutpoint > or = 10 can be used for defining current depression.
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            Correlates of Physical Health of Informal Caregivers: A Meta-Analysis

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              Impacts of Informal Caregiving on Caregiver Employment, Health, and Family

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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                16 February 2023
                2023
                : 11
                : 1058517
                Affiliations
                Department of Epidemiology and Health Monitoring, Robert Koch Institute , Berlin, Germany
                Author notes

                Edited by: Andrea Teti, University of Vechta, Germany

                Reviewed by: Brian Beach, University College London, United Kingdom; Jona T. Stahmeyer, AOK Niedersachsen, Germany; Maria Dos Anjos Coelho Rodrigues Dixe, Polytechnic Institute of Leiria, Portugal

                *Correspondence: Judith Fuchs ✉ fuchsj@ 123456rki.de
                Beate Gaertner ✉ gaertnerb@ 123456rki.de

                This article was submitted to Aging and Public Health, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2023.1058517
                9978811
                36875417
                037cf16e-4e07-49f0-8632-8a7eab90d0b8
                Copyright © 2023 Fuchs, Gaertner, Rommel and Starker.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 September 2022
                : 24 January 2023
                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 38, Pages: 11, Words: 7195
                Funding
                Funded by: Bundesministerium für Gesundheit, doi 10.13039/501100003107;
                GEDA 2019/2020-EHIS was funded by the Robert Koch Institute and the German Federal Ministry of Health.
                Categories
                Public Health
                Original Research

                informal care,population-based study,health monitoring,germany,health status,behavioral risk factors,social risk factors

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