Caregiving, volunteering, and loneliness in middle-aged and older adults: a systematic review

Figures & data

Figure 1. PRISMA flow-diagram of study selection.

This figure shows a PRISMA flow diagram of included and excluded studies. Of the 5,929 articles identified by the search strategy, 2,062 duplicate records were removed, resulting in 3,230 titles and abstracts being screened by two independent reviewers. 116 full texts were assessed for inclusion, according to the eligibility criteria. In total, 27 were selected and one additional study was identified by forward- and backward-citation searches.

Table 1. Characteristics of included articles (N = 28) and study participants (N = 191,652).

Study Reference	Country/Panel	Data collection period (follow-up)	Sample size, % female	Baseline age	Loneliness measure	Contribution measure
Cross-sectional studies (N = 13)
Adams, 2008	USA	1993–2003	617 (52.8%)	70.64 (M)	Single item from CES-D	Caregiving to spouse with AD
Beeson, 2003	USA	N.A.	101 (58.4%)	73.96 (M)	20-item UCLA Loneliness Scale	Caregiving to spouse with AD
Curvers et al., 2018	Netherlands	2012	16,291 (52.5%)	>55	11-item De Jong Gierveld Loneliness Scale	Informal care in the last 12 months; Volunteering
Drennan et al., 2008	Ireland	2004	683 (60.9%)	73.5 (M)	15-item SELSA-S	Caregiving to relative at home
Ekwall et al., 2004	Sweden	2000	3,531 (60.5%)	83.6 (M)	3 items on loneliness	8 caregiving activities
Fokkema & Naderi, 2013	Germany	2005–2006	3,742 (51.2%)	62.62 (M)	6-item De Jong Gierveld Loneliness Scale	Informal support provision; Caregiving to grandchild
De Jong Gierveld & Dykstra, 2008	Netherlands/ Netherlands Kinship Panel Study	2002–2004	727 (60.7%)	54.1 (M)	11-item De Jong Gierveld Loneliness Scale	Support exchanges with parents, siblings, and children
Lakomý, 2020	Europe (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Italy, Germany, Luxembourg, Netherlands, Slovenia, Spain, Sweden, and Switzerland)/SHARE	2013	40,748 (58.5%)	67 (M)	Singe item on frequency of loneliness	Caregiving to relatives, non-relatives and friends at least weekly
Neville et al., 2018	New Zealand/Health, Work, and Retirement Study	2013	614 (0%)	>60	11-item De Jong Gierveld Loneliness Scale	12-item volunteering scale
Quirke et al., 2019	Germany/DEAS	2014	3,849 (51.2%)	69.44 (M)	6-item De Jong Gierveld Loneliness Scale	Caregiving to grandchild/child of relatives, friends, or acquaintances
Tang et al., 2016	USA/PINE	2011–2013	2,365 (58%)	72.8 (M)	3-item R-UCLA Loneliness Scale	Caregiving to grandchild
Wagner & Brandt, 2018	Europe (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, Luxembourg, Spain, Switzerland)/SHARE	2013	29,458 (50.4%)	64.71 (M)	3-item R-UCLA Loneliness Scale	Caregiving to household member in the past year
Yang et al., 2018	China/SUNS	2015–2017	2,770 (51.2%)	69.72 (M)	6-item De Jong Gierveld Loneliness Scale	Volunteering in the past year
Longitudinal studies (N = 15)
Carr et al., 2018	USA/HRS	2006–2014 (6 years)	5,882 (53.2%)	>51	3 items R-UCLA Loneliness Scale	Formal volunteer engagement
Hajek & König, 2019	Germany/DEAS	2002–2014 (12 years)	21,762 (49.6%)	63.2 (M)	6-item De Jong Gierveld Loneliness Scale	Informal caregiving to people with health problems
Hansen et al., 2013; Hansen & Slagsvold, 2013†	Norway/NorLAG	2002–2008 (5 years)	2,553 (46%); 1,344 (47.2%)	40–79	3-item modified De Jong Gierveld Loneliness Scale	Caregiving to co-habitating partner; Caregiving to non-resident parent (in law) during the past year
Hawkley et al., 2020	USA/NSHAP	2010–2015 (5 years)	1,176 (50%)	57–85	3-item R-UCLA Loneliness Scale	Begin caregiving to spouse
Kim et al., 2020	USA/HRS	2006–2016 (4 years)	12,998 (59%)	66 (M)	3-item R-UCLA Loneliness Scale	Volunteering in the past year
Matthews & Nazroo, 2021	UK/ELSA	2016–2018 (2 years)	3,740 (58.31%)	73.5 (M)	5-item UCLA Loneliness Scale	Volunteering at least monthly; Number of formal volunteering and informal caregiving activities
Quirke et al., 2021	Germany/DEAS	2008–2014 (6 years)	8,678 (49.7%)	69.13 (M)	6-item De Jong Gierveld Loneliness Scale	Continuation of caregiving to grandchild/child of relatives, friends, or acquaintances
Robinson-Whelen et al., 2001	USA	N.A. (4 years)	143 (64%)	69.25 (M)	3-item New York University Loneliness Scale	Caregiving to spouse with dementia > 5 h per week; former caregivers (death of spouse)
Saadi et al., 2021	UK/ELSA	2006–2015 (5 years)	4,672 (51.2%)	67.68 (M)	3-item R-UCLA Loneliness Scale	Caregiving to partner with dementia, (I)ADL needs, or other conditions during the past week
Smith et al., 2020	UK/ELSA	2002–2011 (8 years)	4,125 (62.3%)	61.67 (M)	5-item UCLA Loneliness Scale	Informal caregiving for people with (I)ADL needs
Szabó et al., 2021	New Zealand/Health, Work, and Retirement Study	2010–2012 (2 years)	2,653 (55%)	64 (M)	6-item De Jong Gierveld Loneliness Scale	Caregiving to grandchildren or non-kin children
Tsai, 2016; Tsai et al., 2013*	Taiwan/Study of Health and Living Status of the Middle-Aged and Elderly in Taiwan	1993–2007 (14 years); 2003–2007 (4 years)	4,998 (46.71%); 2,930 (54.6%)	>60; >50	Single item from CES-D	Caregiving to grandchildren; Continuation of caregiving to grandchildren
Zwar et al., 2020	Germany/DEAS	2014–2017 (3 years)	8,602 (54.48%)	65.85 (M)	6-item De Jong Gierveld Loneliness Scale	Begin informal caregiving to a person with poor health

Note. Study characteristics are presented separately for cross-sectional (N = 13) and longitudinal (N = 15) studies. Some study information could not be retrieved from the articles, even after authors were contacted. N.A. indicates missing information.

^† In two cases, two studies (Hansen et al., 2013; Hansen & Slagsvold, 2013; Tsai, 2016; Tsai et al., 2013) used the same sample and are thus jointly presented in one row.

M = Mean; SHARE, Survey of Health, Aging, and Retirement Europe; DEAS, German Ageing Survey; PINE, Population-based Study of Chinese Elderly; SUNS, Shanghai Urban Neighborhood Survey; HRS, Health and Retirement Study; NorLAG, Norwegian Life Course, Aging, and Generations Panel Study; ELSA, English Longitudinal Study of Ageing; CES-D, Center for Epidemiologic Studies Depression Scale; SELSA-S, Social and Emotional Loneliness Scale for Adults Short Version; NSHAP, National Social Life, Health, and Aging Project; (I)ADL, (Independent) activities of daily living.

Table 2. Results of articles assessing the association between loneliness and caregiving (general, grandchild, and spousal) (N = 24).

Study Reference/Design	Statistical analysis	Covariates	Exposure (Ref. no caregiving†)	Results unadjusted	Results adjusted	Significance‡
General caregiving (N = 10)
Curvers et al., 2018/Cross-sectional	Logistic Regression	age, gender, marital status, SES, mental and physical health status, transportation usage	Informal caregiving in the past year	/	OR (95% CI): Moderate loneliness: 1.10, (0.0945, 1.279); Severe loneliness: 0.98 (0.771–1.240)	/
Drennan et al., 2008/Cross-sectional	Linear Regression	age, gender, SES, residence, marital status, health, social isolation, transportation access, church attendance, community group involvement	Caring for relative at home	/	ß (R^2): Social loneliness: 0.006 (0.53);	/
					Family loneliness: 0.120 (0.23)*;	+
					Romantic loneliness: 0.027, 0.56	/
Ekwall et al., 2005/Cross-sectional	$\mathrm{\chi }$^2-test	/	Weekly hours of caregiving to another person	p < 0.001*	/	–
Fokkema & Naderi, 2013/Cross-sectional	Linear Regression	age, gender, ethnicity, health, SES, partner status, social isolation, grandchild caregiving	Providing (i) emotional support and (ii) personal care	/	ß: 0.03 0.00	/
De Jong Gierveld & Dykstra, 2008/Cross-sectional	Linear Regression	age, gender, partner status, SES, self-rated health, social isolation, social support	Providing financial, emotional, and instrumental support to (i) parents, (ii) siblings, and (iii) children	/	ß: 0.02 −0.13* 0.07*	/ – +
Hansen et al., 2013/Longitudinal	Linear Regression	age, partner status, SES	Providing personal care to non-resident parent (in law) during past year	/	B: Men: 0.01 Women: −0.13	/
Hajek & König, 2019/Longitudinal	Fixed Effect Regression	age, marital status, health, employment, retirement	Providing informal care to people with poor health	/	ß (SE): −0.00 (0.00)	/
Lakomý, 2020/Cross-sectional	Multilevel Logistic Regression	age, gender, health, SES, partner status, number of family members, social services	Number of (i) weekly or (ii) daily caregiving activities	/	ß: (i) 1: −0.083*; 2: −0.196*; 3: −0.321*; >4: 0.373;	–
					(ii) 1: −0.010; 2: −0.093; 3: −0.331	/
Smith et al., 2020/Cross-sectional	Logistic Regression	age, gender, ethnicity, partner status, education, holidays, church attendance, charity member, cognition, well-being	Caregiving to people with (I)ADL needs	p = 0.06	OR (95% CI): 0.26 (0.01–0.51)*;	–
Zwar et al., 2020/Longitudinal	Fixed Effect Regression	age, employment, marital status, health	Begin caregiving to person with poor health	/	B (SE): 0.03 (0.02)	/
Grandchild caregiving (N = 7)
Fokkema & Naderi, 2013/Cross-sectional	Linear Regression	age, gender, ethnicity, health, SES, marital status, social isolation, social support exchange	Caregiving to grandchildren at least (i) weekly, (ii) monthly, (iii) less than monthly, (iv) never§	/	ß: (i) −0.09*** (ii) −0.04* (iii) −0.04* (iv) −0.02	–
Quirke et al., 2021/Longitudinal	Fixed Effect Regression	age, marital status, SES, self-rated health, BMI, physical activity, depressive symptoms	Begin caregiving to grandchild/other child	/	ß (SE): 0.03 (0.02)	/
Quirke et al., 2019/Cross-sectional	Linear Regression	age, gender, marital status, income, BMI, physical activity, self-rated health, depressive symptoms	Caregiving to (i) grandchild and (ii) other child	/	ß (SE): (i) −0.05 (0.02)* (ii) −0.06 (0.02)*	–
Szabó et al., 2019/Longitudinal	ANOVA, Path Analysis	previous loneliness, age, gender, ethnicity, SES, self-rated health	Caregiving to (i) grandchild, (ii) other children, or (iii) both	Social loneliness: p < 0.001*	ß: Social loneliness: −0.16* −0.25* −0.15	–
				Emotional loneliness: p = 0.016*	Emotional loneliness: −0.02 0.11 −0.04	/
Tang et al., 2016/Cross-sectional	t-test, Binomial Regression	age, gender, SES, marital status, number of grand-/children, years living in the US, self-rated health, positive support, negative strain	Caregiving to grandchild	p < 0.001*	IRR (95% CI): 0.63 (0.5–0.77)*	–
Tsai et al., 2013/Longitudinal	Logistic Regression	age, gender, SES, ethnicity, living place, self-reported health	Caregiving to grandchild	/	OR (95% CI): 0.69 (0.55–0.88)*	–
Tsai, 2016/Longitudinal	ANOVA	/	Caregiving to grandchild	p < 0.0001*	/	–
Spousal caregiving (N = 7)
Adams, 2008/Cross-sectional	MANCOVA	age, gender, education, ethnicity, income, self-rated health	Caregiving to spouse with AD	/	p < 0.001*	+
Beeson, 2003/Cross-sectional	t-test	/	Caregiving to spouse with AD	p < 0.05*	/	+
Hansen & Slagsvold, 2013/Longitudinal	Linear Regression	age, SES, health, well-being	Non-caregiving spouse with (i) non-disabled partner, with (ii) disabled partner, Ref: Caregiving to partner	/	B: Men: (i) 0.33*; (ii) 0.24*;	+
					Women: (i) 0.00; (ii) −0.10	/
Hawkley et al., 2020/Longitudinal	Chi-square test/SEM	age, gender, health, SES, ethnicity	Begin caregiving to spouse	p > 0.05	ß (SE): Men: −0.215 (0.205); Women: 0.238 (0.162)	/
Saadi et al., 2021/Longitudinal	Logistic Regression, Mediation Analysis	gender, age, marital status, ethnicity, SES, longstanding illness, self-rated health	(i) Caregiving to partner with dementia, (ii) with other conditions	/	ß (95%CI): 0.31 (0.15, 0.47)*; −0.004 (−0.07, 0.06)	+
Robinson-Whelen et al., 2001/Longitudinal	ANOVA	age (results not reported)	(i) Caregiving to spouse with dementia, (ii) Former caregivers due to death of spouse	p = 0.001*	/	+
Wagner & Brandt, 2018/Cross-sectional	t-test, Multilevel model	gender, age, SES, making ends meet, living situation, health, religiosity, public services	Caregiving in the past year	p < 0.01*	ß0 (SE): 0.20 (0.026)*	+

Note. * p < 0.05, General caregiving includes studies that do not specify the care recipient.

^† The reference group for all studies is ‘no caregiving’, except for the article Hansen and Slagsvold (2013), where the reference group is caregiving to spouse with ADL needs.

^‡ +, caregiving is significantly associated with higher loneliness; –, caregiving is significantly associated with lower loneliness;/, no significant association between caregiving and loneliness.

^§ The reference group is ‘no grandchildren’.

SES (socio-economic-status) refers to covariates such as education, income, and employment. SEM, structural equation model; OR, odds ratio; CI, confidence interval; SE, standard error; ß, standardised regression coefficient; B, unstandardised regression coefficient; IRR, incidence rate ratio.

Table 3. Results of articles assessing the association between loneliness and volunteering (N = 6).

Study Reference/Design	Statistical Analysis	Covariates	Exposure (Ref. no volunteering)	Results unadjusted	Results adjusted	Significance†
Carr et al., 2018/Longitudinal	Linear Regression	age, gender, ethnicity, SES, widowhood, social isolation, church attendance, self-rated health, personality, spouse’s health and memory	Volunteering hours per year (interaction: start volunteering > 100 h x became widowed)	/	ß (SE): 1–99 h: −0.010 (0.067); >100 h: −0.067 (0.129);	/
					Interaction, ß (SE): −0.608 (0.299)*	–
Curvers et al., 2018/Cross-sectional	Logistic Regression	age, gender, marital status, SES, mental and physical health status, transportation usage	Volunteering	/	OR (95%CI): Moderate loneliness: 0.83 (0.730–0.950) Severe Loneliness: 0.72 (0.562, 0.909)*	–
Kim et al., 2020/Longitudinal	Linear Regression	demographics, previous abuse, religious attendance, diseases, depression, mastery, optimism, social isolation, personality	Volunteering hours in the past year	/	ß (95%CI): 1–49 h: 0.00 (−0.05, 0.04); 50–99 h: −0.06 (−0.12, 0.00); >100 h: −0.06 (−0.13, −0.00)*	–
Matthews & Nazroo, 2021/ Longitudinal	Linear Regression	age, gender, marital status, wealth, self-rated health, paid work, caregiving	Monthly volunteering	ß (SE): −0.162, (0.06)*	ß (SE): −0.084 (0.07)	–
Neville et al., 2018/Cross-sectional	Logistic Regression	ethnicity, employment, and urban living status	(i) Occasional and (ii) at least monthly volunteering	/	OR (95%CI): 0.90 (0.56–1.35); 0.78 (0.54–1.14)	/
Yang et al., 2018/Cross-sectional	Linear Regression	age, gender, marital status, education, living arrangement and area, self-rated health, participating in social activities, media use	Volunteering in the past year	/	ß (SE): −0.86 (0.33)*	–

Note. * p < 0.05.

^† +, volunteering is significantly associated with higher loneliness; –, volunteering is significantly associated with lower loneliness; /, no significant association between volunteering and loneliness.

SES (socio-economic-status) refers to covariates such as education, income, and employment. OR, Odds ratio; CI, Confidence interval; SE, Standard error; ß, standardised regression coefficient; B, unstandardised regression coefficient.

Table 4. Detailed quality assessment of all included articles using the Newcastle-Ottawa Scale (NOS).

Cohort studies^† (N = 14)	1	2	3	4	5	6	7	8
Carr et al., 2018	*	*	*		**	*	*	*
Hajek & König, 2019	*	*	*		**	*	*	*
Hansen & Slagsvold, 2013	*	*	*		**	*	*
Hansen et al., 2013	*	*	*		**	*	*
Hawkley et al., 2020	*	*	*	*	**	*	*	*
Kim et al., 2020	*	*	*	*	**	*	*	*
Matthews & Nazroo, 2021	*	*	*	*	**	*	*	*
Quirke et al., 2021	*	*	*		**	*	*	*
Saadi et al., 2021	*	*	*		**	*	*	*
Szabó et al., 2021	*	*	*		**	*	*	*
Robinson-Whelen et al., 2001	*	*	*	*	*	*	*	*
Tsai et al., 2013	*	*	*		**	*	*	*
Tsai, 2016	*	*	*	*		*	*	*
Zwar et al., 2020	*	*	*	*	**	*	*	*
Case control studies^‡ (N = 6)	1	2	3	4	5	6	7	8
Adams, 2008	*	*	*	*	**	*	*
Beeson, 2003			*			*	*
Ekwall et al., 2004		*	*		*		*	*
Smith et al., 2020	*	*	*		*	*	*
Tang et al., 2016	*	*	*		**	*	*	*
Wagner & Brandt, 2018	*	*	*	*	**	*	*
Cross-sectional studies^§ (N = 8)	1	2	3	4	5	6	7
Curvers et al., 2018	*	*	*	*	**	*	*
Drennan et al., 2008	*	*	*	*	**	*	*
Fokkema & Naderi, 2013	*	*		*	*	*	*
De Jong Gierveld & Dykstra, 2008	*	*	*	*	**	*	*
Lakomý, 2020	*	*	*	*	**		*
Quirke et al., 2019	*	*		*	**	*	*
Yang et al., 2018	*	*	*	*	**	*	*
Neville et al., 2018	*	*	*	*	**	*	*

Note. Three versions of the NOS were used for cohort, case-control, and cross- sectional studies. A study can be awarded a maximum of one star for each numbered item within the ‘Selection’ and ‘Outcome’/’Exposure’ categories; a maximum of two stars can be given for ‘Comparability’ (one star for including age, two stars for adding other covariates). For ascertainment of exposure, one star was given when caregiving status was assessed as self-report; no star was given when the description was missing. For the assessment of the outcome (i.e. loneliness), one star was given for a self-report on a validated scale (including the single-item from the CES-D); no star was given for (single or multiple) items from unvalidated scales. Follow-up was defined as long enough when it was >1 year; no star was given for shorter periods or no description.

^† The NOS for cohort studies include the following criteria: 1, Representativeness of the exposed cohort; 2, Selection of non-exposed cohort; 3, Ascertainment of exposure; 4, Demonstration that the outcome of interest was not present at the start of the study; 5, Comparability of cohorts on the basis of the design or analysis; 6, Assessment of outcome; 7, Followed-up long enough for outcomes to occur; 8, Adequacy of follow-up of cohorts.

^‡ The NOS for case control studies include the following criteria: 1, Adequate case definition; 2, Representativeness of the cases; 3, Selection of controls; 4, Definition of controls; 5, Comparability of cases and controls on the basis of the design or analysis; 6, Ascertainment of exposure; 7, Same method of ascertainment for cases and controls; 8, Non-response rate.

^§ The NOS for cross-sectional studies include the following criteria: 1, Representativeness of the sample; 2, Sample size; 3, Non-respondents; 4, Ascertainment of the exposure; 5, Comparability of cohorts on the basis of the design or analysis; 6, Assessment of outcome; 7, Statistical test.

Adams, K. B. (2008). Specific effects of caring for a spouse with dementia: Differences in depressive symptoms between caregiver and non-caregiver spouses. International Psychogeriatrics, 20(03), 508–520. https://doi.org/10.1017/S1041610207006278

 Google Scholar

Beeson, R. A. (2003). Loneliness and depression in spousal caregivers of those with Alzheimer’s disease versus non-caregiving spouses. Archives of Psychiatric Nursing, 17(3), 135–143. https://doi.org/10.1016/S0883-9417(03)00057-8

 PubMed Web of Science ®Google Scholar

Curvers, N., Pavlova, M., Hajema, K., Groot, W., & Angeli, F. (2018). Social participation among older adults (55+): Results of a survey in the region of South Limburg in the Netherlands. Health & Social Care in the Community, 26(1), e85–e93. https://doi.org/10.1111/hsc.12480

 PubMed Web of Science ®Google Scholar

Drennan, J., Treacy, M., Butler, M., Byrne, A., Fealy, G., Frazer, K., & Irving, K. (2008). The experience of social and emotional loneliness among older people in Ireland. Ageing and Society, 28(8), 1113–1132. https://doi.org/10.1017/S0144686X08007526

 Web of Science ®Google Scholar

Ekwall, A. K., Sivberg, B., & Hallberg, I. R. (2004). Loneliness as a predictor of quality of life among older caregivers. Journal of Advanced Nursing, 49(1), 23–32. https://doi.org/10.1111/j.1365-2648.2004.03260.x

 Web of Science ®Google Scholar

Fokkema, T., & Naderi, R. (2013). Differences in late-life loneliness: A comparison between Turkish and native-born older adults in Germany. European Journal of Ageing, 10(4), 289–300. https://doi.org/10.1007/s10433-013-0267-7

 PubMed Web of Science ®Google Scholar

De Jong Gierveld, J., & Dykstra, P. A. (2008). Virtue is its own reward? Support-giving in the family and loneliness in middle and old age. Ageing and Society, 28(2), 271–287. https://doi.org/10.1017/S0144686X07006629

 Google Scholar

Lakomý, M. (2020). Is providing informal care a path to meaningful and satisfying ageing? European Societies, 22(1), 101–121. https://doi.org/10.1080/14616696.2018.1547838

 Web of Science ®Google Scholar

Neville, S., Adams, J., Montayre, J., Larmer, P., Garrett, N., Stephens, C., & Alpass, F. (2018). Loneliness in men 60 years and over: The association with purpose in life. American Journal of Men’s Health, 12(4), 730–739. https://doi.org/10.1177/1557988318758807

 PubMed Web of Science ®Google Scholar

Quirke, E., König, H.-H., & Hajek, A. (2019). Association between caring for grandchildren and feelings of loneliness, social isolation and social network size: A cross-sectional study of community dwelling adults in Germany. BMJ Open, 9(12), e029605. https://doi.org/10.1136/bmjopen-2019-029605

 PubMed Web of Science ®Google Scholar

Tang, F., Xu, L., Chi, I., & Dong, X. (2016). Psychological well-being of older Chinese-American grandparents caring for grandchildren. Journal of the American Geriatrics Society, 64(11), 2356–2361. https://doi.org/10.1111/jgs.14455

 PubMed Web of Science ®Google Scholar

Wagner, M., & Brandt, M. (2018). Long-term care provision and the well-being of spousal caregivers: An analysis of 138 European regions. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 73(4), e24–e34. https://doi.org/10.1093/geronb/gbx133

 PubMed Web of Science ®Google Scholar

Yang, F., Zhang, J., & Wang, J. (2018). Correlates of loneliness in older adults in Shanghai, China: Does age matter? BMC Geriatrics, 18(1), 300. https://doi.org/10.1186/s12877-018-0994-x

 PubMed Web of Science ®Google Scholar

Carr, D. C., Kail, B. L., Matz-Costa, C., & Shavit, Y. Z. (2018). Does becoming a volunteer attenuate loneliness among recently widowed older adults? The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 73(3), 501–510. https://doi.org/10.1093/geronb/gbx092

 PubMed Web of Science ®Google Scholar

Hajek, A., & König, H.-H. (2019). Impact of informal caregiving on loneliness and satisfaction with leisure-time activities. Findings of a population-based longitudinal study in Germany. Aging & Mental Health, 23(11), 1539–1545. https://doi.org/10.1080/13607863.2018.1506739

 PubMed Web of Science ®Google Scholar

Hansen, T., Slagsvold, B., & Ingebretsen, R. (2013). The strains and gains of caregiving: An examination of the effects of providing personal care to a parent on a range of indicators of psychological well-being. Social Indicators Research, 114(2), 323–343. https://doi.org/10.1007/s11205-012-0148-z

 Web of Science ®Google Scholar

Hansen, T., & Slagsvold, B. (2013). The psychological effects of providing personal care to a partner: A multidimensional perspective. Health Psychology Research, 1(2), e25.

 PubMedGoogle Scholar

Hawkley, L., Zheng, B., Hedberg, E. C., Huisingh-Scheetz, M., & Waite, L. (2020). Cognitive limitations in older adults receiving care reduces well-being among spouse caregivers. Psychology and Aging, 35(1), 28–40. https://doi.org/10.1037/pag0000406

 PubMed Web of Science ®Google Scholar

Kim, E. S., Whillans, A. V., Lee, M. T., Chen, Y., & VanderWeele, T. J. (2020). Volunteering and subsequent health and well-being in older adults: An outcome-wide longitudinal approach. American Journal of Preventive Medicine, 59(2), 176–186. https://doi.org/10.1016/j.amepre.2020.03.004

 PubMed Web of Science ®Google Scholar

Matthews, K., & Nazroo, J. (2021). The impact of volunteering and its characteristics on well-being after state pension age: Longitudinal evidence from The English Longitudinal Study of Ageing. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 76(3), 632–641. https://doi.org/10.1093/geronb/gbaa146

 PubMed Web of Science ®Google Scholar

Quirke, E., König, H.-H., & Hajek, A. (2021). What are the social consequences of beginning or ceasing to care for grandchildren? Evidence from an asymmetric fixed effects analysis of community dwelling adults in Germany. Aging & Mental Health, 25(5), 969–975. https://doi.org/10.1080/13607863.2020.1727846

 PubMed Web of Science ®Google Scholar

Robinson-Whelen, S., Tada, Y., MacCallum, R. C., McGuire, L., & Kiecolt-Glaser, J. K. (2001). Long-term caregiving: What happens when it ends? Journal of Abnormal Psychology, 110(4), 573–584. https://doi.org/10.1037/0021-843X.110.4.573

 PubMed Web of Science ®Google Scholar

Saadi, J. P., Carr, E., Fleischmann, M., Murray, E., Head, J., Steptoe, A., Hackett, R. A., Xue, B., & Cadar, D. (2021). The role of loneliness in the development of depressive symptoms among partnered dementia caregivers: Evidence from the English Longitudinal Study of Aging. European Psychiatry, 64(1), e28. https://doi.org/10.1192/j.eurpsy.2021.20

 PubMed Web of Science ®Google Scholar

Smith, T., Saunders, A., & Heard, J. (2020). Trajectory of psychosocial measures amongst informal caregivers: Case-controlled study of 1375 informal caregivers from the English Longitudinal Study of Ageing. Geriatrics, 5(2), 26. https://doi.org/10.3390/geriatrics5020026

 PubMed Web of Science ®Google Scholar

Szabó, Á., Neely, E., & Stephens, C. (2021). The psychosocial benefits of providing non-kin childcare in older adults: A longitudinal study with older New Zealanders. Journal of Health Psychology, 26(11), 1926–1938. https://doi.org/10.1177/1359105319893011

 Google Scholar

Tsai, F.-J. (2016). The maintaining and improving effect of grandchild care provision on elders’ mental health—Evidence from longitudinal study in Taiwan. Archives of Gerontology and Geriatrics, 64, 59–65. https://doi.org/10.1016/j.archger.2016.01.009

 PubMed Web of Science ®Google Scholar

Tsai, F.-J., Motamed, S., & Rougemont, A. (2013). The protective effect of taking care of grandchildren on elders’ mental health? Associations between changing patterns of intergenerational exchanges and the reduction of elders’ loneliness and depression between 1993 and 2007 in Taiwan. BMC Public Health, 13(1), 567. https://doi.org/10.1186/1471-2458-13-567

 PubMed Web of Science ®Google Scholar

Zwar, L., König, H.-H., & Hajek, A. (2020). Psychosocial consequences of transitioning into informal caregiving in male and female caregivers: Findings from a population-based panel study. Social Science & Medicine, 264, 113281. https://doi.org/10.1016/j.socscimed.2020.113281

 PubMed Web of Science ®Google Scholar