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.

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.

Effects of caregiving on physical health have received less theoretical and empirical attention than effects on psychological health. This meta-analysis integrates results from 176 studies on correlates of caregiver physical health. Caregiver depressive symptoms had stronger associations with physical health than did objective stressors. Higher levels of care recipient behavior problems were more consistently related to poor caregiver health than were care receiver impairment and intensity of caregiving. Higher age, lower socioeconomic status, and lower levels of informal support were related to poorer health. Predictors of physical health are not identical to predictors of psychological health. Associations of caregiving stressors with health were stronger among older samples, dementia caregivers, and men. In sum, negative effects of caregiving on physical health are most likely to be found in psychologically distressed caregivers facing dementia-related stressors. WHEREAS hundreds of studies have assessed the effects of caregiving on psychological health, much less research is available on the effects of providing care on the physical health of informal caregivers. Poor health of caregivers may be due to (a) the effects of physical exertion that produces muscle strain, skeletal injury, aggravation of chronic illness such as arthritis, or other sources of physical discomfort and pain; (b) negative changes in health-related activities, such as diet and exercise; (c) physiological effects of psychological distress, such as depression, which increase susceptibility to infectious agents; and (d) changes in sympathetic arousal and cardiovascular reactivity that increase the risk for hypertension and cardiovascular disease (e.g., Shaw et al., 1997). In addition to being intrinsically undesirable and incurring increased health care costs, poor health of caregivers has been identified as a risk factor for difficulties in managing the caregiving responsibilities, with potential negative effects on the care recipient (Navaie-Waliser et al., 2002) and for institutionalization of the care recipient (e.g., McCann, Hebert, Bienias, Morris, & Evans, 2004).According to narrative reviews, between 18% and 35% of informal caregivers perceive their health as fair or poor (Schulz, O'Brien, Bookwala, & Fleissner, 1995), and caregivers have frequently been referred to as the ''hidden patients '' (Fengler & Goodrich, 1979). Two meta-analyses have found that informal caregivers have poorer physical health than noncaregivers, measured both by perceived health (Pinquart & Sörensen, 2003a) and by objective health measures, such as stress hormones, antibodies, and medication use (Vitaliano, Zhang, & Scanlan, 2003). However, these studies did not analyze predictors of impaired physical health among caregivers. Understanding which aspects of caregiving contribute to health decrements can help identify caregivers at risk and can contribute to tailored psychosocial and medical interventions. As a result of between-study heterogeneity in sam...

In the present meta-analysis, we integrated findings from 228 studies on the association of six caregiving-related stressors and caregiving uplifts with burden and depressed mood. Care recipients' behavior problems showed stronger associations with caregiver outcomes than other stressors did. The size of the relationships varied by sample characteristics: Amount of care provided and care receivers' physical impairments were less strongly related to burden and depression for dementia caregivers than for caregivers of nondemented older adults. For spouse caregivers, physical impairments and care recipients' behavior problems had a stronger relationship to burden than for adult children. Furthermore, we found evidence that the association of caregiver burden with the number of caregiving tasks, perceived uplifts of caregiving, and the level of physical impairment of the care receiver were stronger in probability samples than in convenience samples.

Caregiver interventions are effective, but some interventions have primarily domain-specific effects rather than global effects. The differences between intervention types and moderators suggest ways of optimizing interventions.

This meta-analysis integrates results from 229 studies on gender differences in caregiver psychological and physical health, caregiving stressors, and social resources. Contrary to common perceptions, gender differences in caregiving variables were small to very small. Women had higher levels of burden and depression, and lower levels of subjective well-being and physical health. They reported that their care recipient had more behavioral problems; they provided more caregiving hours, helped with more caregiving tasks, and assisted with more personal care. Women and men did not differ in the use of informal and formal support. Statistically controlling for gender differences in stressors and resources reduced the size of gender differences in depression and physical health to levels that have been observed in noncaregiving samples. The results support stress-and-coping theories on gender differences in caregiving.

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.

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