This review identified the following factors as predictors of poor physical health in informal caregivers: duration and burden of care giving, cognitive impairment in the care recipient, not being a spouse, low level of support, and age of the caregiver. Caregivers with poor physical health cannot provide care effectively. Attention should be broadened to include informal caregivers because they too can become future patients in the health care system. Thus, specific interventions should not only target psychological health but also address physical health such as encouraging healthy living.

Background: The objective of this review was to integrate the available research on associations of physical health of caregivers with the following factors: 1) socio-demographic variables (age, spousal status, and coresidence); 2) caregiver stressors; 3) caregiver resources (socioeconomic status) and social support; and 4) psychological distress. Few studies have examined the physical health of informal caregivers even though they have often been referred to as "hidden patients". Past reviews found that informal caregivers have poorer physical health than non-caregivers. Identification of the aspects of care giving (i.e., the predictors of poor physical health) associated with caregivers at risk can help to initiate tailored psychosocial and medical interventions and subsequently shift the attention given to care recipients to include caregivers.

Methods: The authors searched electronic databases for studies examining variables of physical health in informal caregivers of older adults. In the end, 176 studies on caregiver physical health, published between 1986 and 2006, were analyzed in this review.

Findings: The following factors were associated with poor physical health of caregivers: severity of care recipient behavioural problem and their cognitive impairments; length of time in the caregiver role; coresidence (i.e., living with the care recipient); not being a spousal caregiver; higher caregiver burden and depression; higher caregiver's age; lower socioeconomic status; and lower levels of informal support. For example, caregivers who do not live with the care recipient have better physical health, suggesting that healthrelated habits, such as getting enough sleep and engaging in healthy eating patterns, are impaired when living with the care recipients.

No association was found between physical health and hours of care provision, physical impairments of the care recipients, or use of formal support. Higher care giving demands have a stronger impact on the physical health of older caregivers, dementia caregivers, and men. Performing more care giving tasks was associated with better physical health, suggesting that caregivers with better health are able to provide higher levels of support.

Conclusions: This review identified the following factors as predictors of poor physical health in caregivers: duration and burden of care giving, cognitive impairment in the care recipient, not being a spouse, low level of support, and age of the caregiver. Knowing which caregivers have these risk factors, health care professionals can intervene and allow caregivers to continue their crucial role of providing care. Caregivers with poor physical health cannot provide care effectively. This review illustrates that attention should be broadened to include caregivers because they too can become future patients in the health care system. Thus, specific interventions are required to target caregivers; and should not only target psychological health but also address physical health such as encouraging healthy living.

Reference: Pinquart M, Sorensen S. "Correlates of physical health of informal caregivers: A meta-analysis." Journal of Gerontology: Psychological sciences 2007; 62B(2): 126-137.

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