Variations in Mental Distress Among Caregivers of Individuals With Chronic Illnesses and Comorbid Cognitive Impairment.

Abstract

This study was aimed to examine the rates of mentally unhealthy days and frequent mentally unhealthy days among caregivers of patients with cancer, heart disease, mental illness, and Alzheimer's disease and related dementias on the basis of caregiving intensity and how cognitive impairment in non-Alzheimer's disease and related dementias caregiving moderates these relationships. Data from 22,550 caregivers in the 2019-2023 Behavioral Risk Factor Surveillance System were used to explore the relationship between caregiving intensity, mentally unhealthy days, and the presence of cognitive impairment. Zero-inflated negative binomial regressions assessed the associations of caregiving intensity on mentally unhealthy days, and logistic regressions examined the patterns in frequent mentally unhealthy days, controlling for demographics and survey weighting. Caregivers of individuals with mental illness reported the highest frequent mentally unhealthy days (27.53%), followed by caregivers of those with cancer (20.3%), heart disease (18.57%), and Alzheimer's disease and related dementias (17.82%). Increased caregiving intensity correlated with higher mentally unhealthy day rates, particularly among caregivers of patients with cancer, heart disease, and Alzheimer's disease and related dementias. Caregivers of those with cancer showed increased mentally unhealthy days when moderating for cognitive impairment. Higher caregiving intensity was linked to increased frequent mentally unhealthy days in the caregivers of patients with cancer and Alzheimer's disease and related dementias, with cancer caregivers showing more frequent mentally unhealthy days when moderating for cognitive impairment. Caregiving intensity affects mental health outcomes differently across illnesses. Tailored support is needed for caregivers, especially those providing care for individuals with comorbid cognitive impairment.