Never Too Late - November/December 2023

Healthy Minds for Life A Message from Lee Ryan, Professor and Head of the Psychology Department at the University of Arizona

The “Silver Lining” of Caregiving I am a caregiver. My husband’s 92 year- old mother lives full time in our home. Cognitively, she is as sharp as a tack, but she needs considerable help with meals, cleaning, shopping, organizing doctor’s visits, and the like. So when I was planning my column this month, I took it as an opportunity to learn about the most recent research on caregiving and its impact on health. I was expecting to read studies highlighting the negatives that are often associated with being a caregiver – increased risk for depression, chronic illness, disrupted sleep, social isolation, and declining memory and other cognitive functions. But it turns out that’s not the whole story. In fact, recent studies of caregivers paint a much more positive picture that highlights the potential benefit – the silver lining – of being a caregiver. Let’s start with some facts. Caregiving is simply defined as a person who tends to the needs of another person – family or friend – with limitations due to illness, injury or disability. This often includes assistance with a person’s daily needs, managing a disease or disability, and providing social and emotional support. The Centers for Disease Control reports that one in four adults over the age of 45 are caregivers. Women are more likely to be caregivers than men. More than a third of all caregivers themselves have chronic illnesses or disabilities. Caregiving is often associated with health risks that negatively impact emotional, mental, and physical well-being. Caregiving can interfere with our ability to work, engage in social interactions and relationships, or maintain good

physical and mental health. Nearly all caregivers report increased daily stress ranging from mild to severe. More than half of caregivers report symptoms of depression, with approximately one quarter of caregivers meeting the diagnostic criteria for major depression. One in four caregivers report getting insufficient sleep. Caregiving may also negatively impact brain health, leading to increased risk for age-related cognitive impairment and dementia. Multiple studies have found that caregivers have poorer learning, memory, and inhibitory control compared to non-caregivers, and that cognitive scores decline more rapidly over a 2 to 4 year period compared to non-caregivers. But here’s the surprise. Other studies have reported that caregivers have better cognition compared to non- caregivers. In a major recent study on this topic, researchers from the University of South Florida followed more than 3,000 caregivers and another carefully matched 3,000 non-caregivers over a fourteen-year period. The results were impressive. Compared to non-caregivers, caregivers had better scores on measures of global cognitive functioning, memory, verbal abilities, and cognitive control. Even though caregivers reported higher levels of stress and depressive symptoms, they were not at higher risk for cognitive decline over a 14 year period. And, they lived longer, not shorter lives. What could account for these positive findings? In the South Florida study, caregivers reported psychological benefits of caregiving including emotional satisfaction, increased connectedness, increased meaning and purpose in life,

and opportunities for personal growth. It is entirely possible that these positive attributes – a psychological silver lining – balance the stress of caregiving, and may even provide benefits to brain health. The truth is probably somewhat more mixed. There is no question that caregiving may be overwhelming for some individuals and lead to negative health outcomes. But, clearly, researchers are telling us that it isn’t that way for everyone. We don’t yet understand why some, and not other, caregivers experience positive or negative outcomes. Is it related to availability of financial resources, access to adequate health care, or social support? It is critically important that we understand the circumstances that enhance caregiver health. If you are a caregiver and feel that you could benefit from support, please reach out to advocacy groups like Pima Council on Aging or the Alzheimer’s Association. They can help connect you with the resources you need to stay healthy and strong while you care for others. Lee Ryan is a Professor and Head of the Psychology Department at the University of Arizona. She is a researcher studying aging and Alzheimer’s disease, and is a member of the Precision Aging Network. To learn more about the Precision Aging Network, visit our website at https:// precisionagingnetwork.org/ .

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Pima Council on Aging

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