Cognition in informal caregivers: evidence from an English population study

Abstract

Background and objectives

The relationship between caregiving and cognition remains unclear. We investigate this association comparing four cognitive tasks and exploring the role of potential explanatory pathways such as healthy behaviours (healthy caregiver hypothesis) and depression (stress process model).

Research design and methods

Respondents were from English Longitudinal Study of Ageing (ELSA) (N = 8910). Cognitive tasks included immediate and delayed word recall, verbal fluency and serial 7 subtraction. Series of hierarchical linear regressions were performed. Adjustments included socio-demographics, health related variables, health behaviours and depression.

Results

Being a caregiver was positively associated with immediate and delayed recall, verbal fluency but not with serial 7. For immediate and delayed recall, these associations were partially attenuated when adjusting for health behaviours, and depression. For verbal fluency, associations were partially attenuated when adjusting for depression but fully attenuated when adjusting for health behaviours. No associations were found for serial 7.

Discussion and implications

Our findings show that caregivers have higher level of memory and executive function compared to non-caregivers. For memory, we found that although health behaviours and depression can have a role in this association, they do not fully explain it. However, health behaviours seem to have a clear role in the association with executive function. Public health and policy do not need to target specifically cognitive function but other areas as the promotion of healthy behaviours and psychological adjustment such as preventing depression and promoting physical activity in caregivers.

Keywords:

• Verbal memory
• executive function
• caregiving duration
• older adults

Acknowledgements

The English Longitudinal Study of Ageing was developed by a team of researchers based at the University College London, NatCen Social Research, and the Institute for Fiscal Studies. The data were collected by NatCen Social Research. The funding is currently provided by the National Institute of Aging (R01AG017644), and a consortium of UK government departments coordinated by the National Institute for Health Research.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

RB is funded in part by grant MR/R016372/1 for the King's College London MRC Skills Development Fellowship programme funded by the UK Medical Research Council (MRC, https://mrc.ukri.org) and by grant IS-BRC-1215-20018 for the National Institute for Health Research (NIHR, https://www.nihr.ac.uk) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. RJBD is supported by: 1. Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and Wellcome Trust. 2. The BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement No. 116074. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA; it is chaired by DE Grobbee and SD Anker, partnering with 20 academic and industry partners and ESC. 3. The National Institute for Health Research University College London Hospitals Biomedical Research Centre. 4. National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. MJB was supported by grant PSI2016-78737-P (AEI/FEDER, UE) from the National Research Agency of the Spanish Ministry of Economy, Industry and Competitiveness and the European Regional Development Fund.