Caregiving centenarians: Cross-national comparison in Caregiver-Burden between the United States and Japan

Abstract

Background and Objectives: The personal distress associated with caring for a family member has been well documented; however, questions about the burden of caregiving for centenarians and cross-national differences in the caregiving context, remain unanswered.

Research Design and Methods: This study includes reports by caregivers of 538 near-centenarians and centenarians in the U.S. and Japan: 234 from the Georgia Centenarian Study and 304 from the Tokyo Centenarian Study. Basic descriptive and multivariate regression analyses were conducted. Mean levels of caregiver burden and near-centenarian and centenarians’ characteristics (as predictors) for caregiver burden were compared between the U.S. and Japan. The near-centenarian and centenarians’ functional capacity and personality were assessed as predictors.

Results: Differential predictive patterns in caregiver burden were found in the two groups. In the U.S., near-centenarian and centenarians’ agreeableness and conscientiousness were negatively associated with caregiver burden; whereas the near-centenarian and centenarians’ neuroticism and number of diseases were positively associated with caregiver burden. In Japan, the near-centenarian and centenarians’ activities of daily living, openness, and agreeableness were negatively associated with caregiving burden. Interaction effects between functional capacity and personality, on caregiver burden were observed only in the U.S. In the U.S., higher levels of agreeableness and openness significantly changed the level of caregiver burden associated with vision problems and a greater number of diseases.

Discussion and Implications: Cross-national comparative predictors of caregiving burden between the two countries emphasized that caring for centenarians should be understood in the caregiving context, as well as the social context.

Keywords:

• Centenarians
• caregiver burden
• cross-national comparisons
• cultural context

Acknowledgments

This research was funded by the program for Promoting the Enhancement of Research Universities from Osaka University, Osaka, Japan.

The Georgia Centenarian Study (Leonard W. Poon, PI) was funded by 1P01AG17553 from the National Institute on Aging, a collaboration among the University of Georgia, Tulane University Health Sciences Center, Boston University, University of Kentucky, Emory University, Duke University, Wayne State University, Iowa State University, Temple University, and University of Michigan. Additional authors include S. M. Jazwinski, R. C. Green, M. MacDonald, M. Gearing, W. R. Markesbery (deceased), J. L. Woodard, M. A. Johnson, J. S. Tenover, I. C. Siegler, W. L. Rodgers, D. B. Hausman, C. Rott, A. Davey, and J. Arnold. Authors acknowledge the valuable recruitment and data acquisition effort by M. Burgess, K. Grier, E. Jackson, E. McCarthy, K. Shaw, L. Strong, and S. Reynolds, data acquisition team manager; S. Anderson, E. Cassidy, M. Janke, and J. Savla, data management; M. Poon, project fiscal management.

The Tokyo Centenarian Study was supported in part by a grant from the Japanese Ministry of Health and Welfare for the Scientific Research Project on Longevity, a grant for studying the multidisciplinary approach to centenarians and its international comparison (Principal Investigator, Nobuyoshi Hirose); a grant from the Japanese Ministry of Education, Science, and Culture (No.15730346); and aid for research from the Keio Health Consulting Center. Authors also would like to thank Dr. Hiroki Inagaki for preprocessing cognitive assessment data for the Tokyo Centenarian Study.