Martin Pinquart

Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis.

Providing care for a frail older adult has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. In this meta-analysis, the authors integrated findings from 84 articles on differences between caregivers and noncaregivers in perceived stress, depression, general subjective well-being, physical health, and self-efficacy. The largest differences were found with regard to depression (g = .58), stress (g = .55), self-efficacy (g = .54), and general subjective well-being (g = -.40). Differences in the levels of physical health in favor of noncaregivers were statistically significant, but small (g = .18). However, larger differences were found between dementia caregivers and noncaregivers than between heterogeneous samples of caregivers and noncaregivers. Differences were also influenced by the quality of the study, relationship of caregiver to the care recipient, gender, and mean age of caregivers.

Influences of Socioeconomic Status, Social Network, and Competence on Subjective Well-Being in Later Life: A Meta-Analysis

Meta-analysis is used to synthesize findings from 286 empirical studies on the association of socioeconomic status (SES), social network, and competence with subjective well-being (SWB) in the elderly. All three aspects of life circumstances are positively associated with SWB. Income is correlated more strongly with well-being than is education. The quality of social contacts shows stronger associations with SWB than does the quantity of social contacts. Whereas having contact with friends is more strongly related to SWB than having contact with adult children, there are higher associations between life satisfaction and quality of contact with adult children when compared with quality of friendships. Moderating influences of gender and age on the effects of SES, social network, and competence on SWB are also investigated.

Helping caregivers of persons with dementia: which interventions work and how large are their effects?

BACKGROUND In recent years, many different forms of interventions for caregivers of people with dementia have been developed. However, their results have been, in part, inconclusive. METHODS Meta-analysis was used to integrate the results of 127 intervention studies with dementia caregivers published or presented between 1982 and 2005. RESULTS Interventions had, on average, significant but small effects on burden, depression, subjective well-being, ability/knowledge and symptoms of care recipient. Only multicomponent interventions reduced the risk for institutionalization. Psychoeducational interventions that require active participation of caregivers had the broadest effects. Effects of cognitive-behavioral therapy, support, counseling, daycare, training of care recipient, and multicomponent interventions were domain specific. The effect sizes varied by study characteristics, such as caregiver gender and year of publication. CONCLUSIONS Because most interventions have domain-specific outcomes, clinicians must tailor interventions according to the specific needs of the individual caregivers. Although more recent interventions showed stronger effects, there is room for further improvements in interventions.

Depression and cancer mortality: a meta-analysis.

BACKGROUND The goal of the present study was to analyze associations between depression and mortality of cancer patients and to test whether these associations would vary by study characteristics. METHOD Meta-analysis was used for integrating the results of 105 samples derived from 76 prospective studies. RESULTS Depression diagnosis and higher levels of depressive symptoms predicted elevated mortality. This was true in studies that assessed depression before cancer diagnosis as well as in studies that assessed depression following cancer diagnosis. Associations between depression and mortality persisted after controlling for confounding medical variables. The depression-mortality association was weaker in studies that had longer intervals between assessments of depression and mortality, in younger samples and in studies that used the Beck Depression Inventory as compared with other depression scales. CONCLUSIONS Screening for depression should be routinely conducted in the cancer treatment setting. Referrals to mental health specialists should be considered. Research is needed on whether the treatment of depression could, beyond enhancing quality of life, extend survival of depressed cancer patients.

Spouses, adult children, and children-in-law as caregivers of older adults: a meta-analytic comparison.

The present meta-analysis integrates the results from 168 empirical studies on differences between caregiving spouses, adult children, and children-in-law. Spouses differ from children and children-in-law significantly with regard to sociodemographic variables; also, they provide more support but report fewer care recipient behavior problems. Spouse caregivers report more depression symptoms, greater financial and physical burden, and lower levels of psychological well-being. Higher levels of psychological distress among spouses are explained mostly--but not completely--by higher levels of care provision. Few differences emerge between children and children-in-law, but children-in-law perceive the relationship with the care recipient as less positive and they report fewer uplifts of caregiving.

Correlates of subjective health in older adults: a meta-analysis.

Age-associated changes of subjective health and associations of subjective health with physical health, functional health, and mental health were meta-analyzed in older adults (M age > 60 years). An age-associated decline of subjective health, which was stronger in old-old samples than in young-old samples, was found. Subjective health was correlated with the indicators of objective health, but the association with physical health was stronger than with functional health. Correlations of subjective health with physical health and functional health were lower in the old-old than in the young-old samples, whereas associations of subjective health with mental health were stronger in older samples. Furthermore, the size of the association between subjective and objective health varied by the method of assessment of objective health, showing highest associations with symptom checklists and results of medical examinations due to strict protocols.

Meta-Analysis of Sleep Disturbance and Suicidal Thoughts and Behaviors

OBJECTIVE The potential association of various sleep disturbances to suicidal thoughts and behaviors is the subject of several reviews. The current meta-analysis was conducted to estimate the size of the association generally as well as between more specific relationships. DATA SOURCES Electronic databases for years 1966-2011 were searched to identify candidate studies using PubMed search terms suicide and sleep or sleep initiation/maintenance disorders or dreams or nightmares or sleep disorders/psychology or sleep disorders/epidemiology as well as Ovid search terms suicide and sleep or insomnia or nightmares. The search was supplemented by cross-referencing from identified articles and reviews. STUDY SELECTION Original studies reporting both sleep disturbance and suicide outcomes were identified with 39 of 98 studies (40%) comprising 147,753 subjects selected for inclusion. DATA EXTRACTION Data were extracted by multiple independent observers and verified by a study author. The meta-analysis was performed using random-effects models. The size of associations was calculated for all types of sleep disturbances and suicide outcomes combined and for more specific categories including nightmares, insomnia, and insomnia subtypes and suicidal ideation, suicide attempts, and suicide. Moderator effects were evaluated. RESULTS Overall, sleep disturbance was significantly associated with an increased relative risk for suicidal ideation, suicide attempt, and suicide ranging from 1.95 (95% CI, 1.41-2.69) to a relative risk of 2.95 (95% CI, 2.48-3.50) in unadjusted studies. Associations were smaller, but remained highly significant among adjusted studies. Depression did not moderate the association between sleep and suicide variables. CONCLUSIONS This meta-analysis supports an association between sleep disturbance and suicidal thoughts and behaviors. Sleep disturbances in general, as well as insomnia and nightmares individually, appear to represent a risk factor for suicidal thoughts and behavior. This proposition is further bolstered by the result that depression did not show risk moderation.

Dementia care: mental health effects, intervention strategies, and clinical implications

Caring for elderly people with dementia is associated with well-documented increases in burden, distress, and decrements in mental health and wellbeing. More severe behavioural, cognitive, and functional impairments in a patient are associated with higher levels of burden and distress. Distress increases with care hours per week, number of tasks, and declining coping and support resources. Demographic factors also affect levels of burden and distress. Promising, evidence-based interventions exist, but substantial economic and policy barriers preclude their widespread dissemination. Health-care policy makers should consider addressing these barriers; clinicians and families must campaign for reimbursement; and clinical researchers must develop more potent preventive interventions. In this article we review how dementia care affects the mental health of the carer and identify interventions that might be useful in mitigating carer burden and distress.

Associations of caregiver stressors and uplifts with subjective well-being and depressive mood: a meta-analytic comparison

The present meta-analytic study gives a systematic review of research on depression and the subjective well-being of caregivers. We integrate results from 60 studies on informal caregivers’ subjective well-being (e.g., positive affect, life-satisfaction) and contrast them with the result of studies on caregiver depression. Analyses were based on a two-factor model of subjective well-being that distinguishes between positive and negative dimensions of well-being (e.g., happiness and depression). The strongest effects were domain-specific: uplifts of caregiving were associated with subjective well-being and caregiving stressors were associated with depression. In addition, weaker effects that crossed domains were present: uplifts were weakly associated with depressive symptoms. In addition, lower levels of caregivers’ subjective well-being were weakly related to care receivers’ physical and cognitive impairments, as well as behaviour problems, but not to the amount of caregiving. Type of care recipients’ illness and the measure of well-being moderated, in part, the association between stressors/uplifts and subjective well-being.

Changes of life satisfaction in the transition to retirement : A latent-class approach

Contradictory positions have been advanced as to whether retirement has negative, positive, or no effects on subjective well-being. The authors investigated changes in life satisfaction in 1,456 German retirees. Using latent growth mixture modeling, the authors found 3 groups of people who experienced retirement differently. In Group 1, satisfaction declined at retirement but continued on a stable or increasing trajectory thereafter. Group 2 demonstrated a large increase in satisfaction at retirement but overall declining satisfaction. In Group 3, satisfaction showed a temporary very small increase at retirement. Groups differed by retirement age, gender, socioeconomic status, marital status, health, unemployment before retiring, and region. Thus, retirement is not a uniform transition, and resource-rich individuals are less likely to experience retirement-related change in satisfaction.