Views of aging and mental health - The role of informal care provision: Longitudinal findings of the health and retirement study in the US.

BACKGROUND: Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim to analyze whether the association between views of aging and depressive symptoms is influenced by the provision of informal care and its intensity. METHODS: Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated. RESULTS: Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age. LIMITATIONS: The possibility of reciprocal effects cannot be excluded. CONCLUSION: Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.

Validation of the German version of the 25-item hikikomori questionnaire 25.

OBJECTIVES: The 25-item Hikikomori Questionnaire (HQ-25) is an instrument developed to measure a condition characterized by extreme social withdrawal that was first described in Japan. This study aimed to translate the HQ-25 into German and validate the German version (HQ-25-G). METHODS: Translation was conducted according to established guidelines. Validation was based on data from a quota sample of individuals living in Germany, ranging from 18 to 74 years old (representing the distribution of age, sex and federal state, n = 5000). Data collection occurred during August and September 2023. We tested reliability, construct validity and concurrent validity. Moreover, HQ-25 scores for key sociodemographic group were reported. RESULTS: Internal reliability for the HQ-25-G was excellent (Cronbach's alpha = 0.93). We confirmed the original three-factor model. Moreover, higher hikikomori levels were significantly associated with more depressive symptoms (r = 0.50), more anxiety symptoms (r = 0.45), higher loneliness levels (r = 0.56), higher levels of objective social isolation (r = -0.47), higher levels of perceived social isolation (r = 0.59) and a higher preference for solitude (r = 0.45). CONCLUSIONS: In a large population-based sample (including younger adults, middle-aged adults and older adults), the HQ-25-G version proves to be a psychometrically robust instrument, which is useful for further exploring the phenomenon of hikikomori within the German-speaking population.

Caregiving intensity and its association with subjective views of ageing among informal caregivers with different sociodemographic background: a longitudinal analysis from Germany.

We analysed whether care time, burden and range of caregiving tasks were associated with informal caregivers' subjective views of ageing (measured as attitudes towards own age (ATOA), subjective age (SA), and onset of old age (OOA)), and whether these associations differed as a function of the caregivers' age and gender. Adjusted cluster-robust fixed effects regression analyses were conducted with gender and age as moderators using data of informal caregivers (≥ 40 years) of the population-based German Ageing Survey (2014, 2017). All three aspect of care intensity were associated with changes in subjective views of ageing and this pattern was a function of the caregiver's age and gender. Care time was significantly associated with higher SA. Care tasks were significantly associated with more positive ATOA and earlier OOA. Age moderated the association between burden and ATOA, with older adults reporting more positive ATOA. Gender moderated the association between care time and ATOA; women reported less positive ATOA than men with increasing care time, but also felt subjectively younger than men with a broader range of care tasks. Age- and gender-stratified analysis indicated further differences. Our findings suggest to reduce care time, especially among older and female caregivers, to prevent a worsening of views of ageing, while being involved in a broad range of care tasks seems to (only) benefit female caregivers.

The Potential of Informal Care for Self-Perceptions of Aging Among Older Community-Dwelling Adults: Longitudinal Findings From the Health and Retirement Study.

OBJECTIVES: This is the first study to analyze, whether receipt of (informal) care with (instrumental) activities of daily living (IADL/ADL) is associated with (positive and negative) self-perceptions of aging among community-dwelling older adults; and whether chronological age moderates these associations, using a longitudinal design. METHODS: Longitudinal data of the Health and Retirement Study in the United States was used. The sample was composed of up to 9,198 observations of community-dwelling adults aged ≥50 years pooled over 6 waves (2008-2018). Receiving care at all and the amount of care received with (I)ADL were analyzed in association with positive and negative attitudes towards own aging (ATOA; 8-item modified Philadelphia Geriatric Center Morale Scale, positive and negative subscore). Adjusted fixed effects regression analyses with robust standard errors were calculated. RESULTS: Transitioning into receipt of care with any (I)ADL was associated with lower positive ATOA but not with any change in negative ATOA. Chronological age moderated the association between receipt of informal care, primarily with IADL, and negative ATOA. More negative ATOA was found among care recipients between 50 and 64 years but less among care recipients aged ≥80 years. DISCUSSION: Receiving any form of informal care was associated with an increase in internalized ageism, in particular among adults aged 50 to 64 years, but a decrease among those aged ≥80 years. Psycho-educative measures are recommended for adults with care needs to prevent a loss of positive self-perceptions of aging, and reduce the danger to their healthy aging, with the receipt of care.

Changes in Network Size, Quality, and Composition among Informal Caregivers in Different Welfare Clusters: Longitudinal Analyses Based on a Pan-European Survey (SHARE).

INTRODUCTION: This study analyzed the association between transitions into informal caregiving, inside and outside their own household, and changes in network size, quality, and composition among older adults (≥50 years) in four different welfare systems in Europe. METHODS: Data from waves 4, 6, and 8 of the Survey of Health, Ageing and Retirement in Europe was used and included up to 110,823 participants (aged ≥50 years) from 12 countries. Participants were asked about informal caregiving inside and outside the household and their network size, quality (emotional closeness, contact frequency), and composition (family, friends, men, women). Adjusted linear and Poisson fixed effects regression analyses were conducted. RESULTS: Participants transitioning into any caregiving (inside or outside the household) had a larger network. More women and family members were found among all those transitioning into caregiving, but only outside caregiving was associated with more men and friends in the network. Transitioning into caregiving outside was associated with reduced network closeness and contact. Changes among caregivers outside were similar in all welfare states but were more pronounced among caregivers inside the household of Eastern Europe. CONCLUSION: Different patterns of changes in network size, quality, and composition were found among adults transitioning into caregiving inside and outside the household. All parameters changed among caregivers outside the household. However, the welfare system played a key role in the network changes among inside household caregivers. Thus, the micro as well as the macro context of caregiving is important for the support network of informal caregivers.

Religious affiliation and oral health-related quality of life: a cross-sectional study based on a nationally representative survey in Germany.

BACKGROUND: Studies have shown an association between a person's religiosity, and physical as well as psychological, health status. However, results differ between certain religious affiliations. While good oral health is important for our overall health and wellbeing, research on religious affiliation and oral health status, specifically oral health-related quality of life (OHRQoL), is lacking. Thus, our aim was to investigate the association between religious affiliation and OHRQoL. METHODS: A nationally representative online survey (n = 3,075 individuals) was conducted in August/September 2021. The mean age was 44.5 years (SD: 14.8 years, 18 to 70 years) and 51.1% of the individuals were female. OHRQoL was measured using the Oral Health Impact Profile (OHIP-G5). Religious affiliation served as key explanatory variable. Several covariates were included in regression analyses. RESULTS: Regressions revealed that compared to individuals with no religious affiliation, individuals belonging to Christianity had poorer OHRQoL (ß = 0.31, p < 0.01), individuals belonging to Islam had poorer OHRQoL (ß = 2.62, p < 0.01) and individuals belonging to another religious affiliation also had poorer OHRQoL (ß = 1.89, p < 0.01). CONCLUSION: Our study demonstrated an association between religious affiliation and OHRQoL. Individuals with specific religious affiliations should be addressed to avoid low OHRQoL.

Wishing for an end? Longitudinal analysis of suicidal ideation among informal caregivers inside and outside their household in different welfare systems of Europe.

OBJECTIVE: This study examines whether transition to caregiving within or outside the household is associated with changes in suicidal ideation and whether this depends on the type of caregiver relationship, the age or gender of the caregiver, or the welfare system. DESIGN: Longitudinal study. SETTING: Ten European countries. PARTICIPANTS: Data from the Survey of Health, Ageing, and Retirement in Europe were used (waves 1, 2, 4, 5, and 6) including participants aged ≥40 years (pooled Observations = 171,848). MEASUREMENTS: Suicidal ideation was measured using the Euro-D scale. Caregiving was measured as care inside and outside the household, and for different recipients. Fixed effects logistic regression analyses, adjusted for health and sociodemographic factors, were used. RESULTS: Transitioning into caregiving inside the household was associated with higher odds of suicidal ideation, in particular if they transitioned into care for partners or parents and within Southern and Bismarckian welfare systems. Transitioning into caregiving outside the household was not associated with suicidal ideation, except among those transitioning into caregiving for non-relatives (higher odds of suicidal ideation), and among male and older caregivers (lower odds of suicidal ideation). Suicide ideation was higher among caregivers in Southern compared to Bismarckian or Scandinavian welfare systems. CONCLUSION: Informal caregiving is associated with suicidal ideation among caregivers inside but not among all caregivers outside the household. The caregiver's characteristics, the care relationship, and the welfare system play an important role. Preventing suicidal ideation requires interventions that focus on informal caregivers and consider their individual and contextual factors.

Mental health, social integration and support of informal caregivers during the second wave of the COVID-19 pandemic: A population-based representative study from Germany.

INTRODUCTION: The study analyzed mental health, social integration and social support of informal caregivers of individuals aged ≥60 years compared to non-caregivers during the second wave of the COVID-19 pandemic. METHODS: A quantitative, cross-sectional study was conducted with a sample drawn randomly from the nationally representative online panel forsa.omninet in Germany between March 4th and 19th 2021. In total, 3022 adults aged ≥40 years from Germany were questioned, including 489 adults providing informal care for adults aged ≥60 years between December 2020 and March 2021. Depressive (PHQ-9) and anxiety symptoms (GAD-7), loneliness (De Jong Gierveld Scale), social exclusion (Bude & Lantermann Scale) and social network support (Lubben's Social Network Scale) were measured. Adjusted OLS regression analyses and additional moderator analyses (moderators: perceived restrictions and danger of infection due to the COVID-19 pandemic) were conducted. RESULTS: Significant higher levels of depressive and anxiety symptoms and more social support were found among informal caregivers compared to non-caregivers. Loneliness and social exclusion did not differ between both groups. Perceived restrictions by the pandemic significantly moderated the association between informal caregiving and social support - social support was stronger among caregivers with higher levels of perceived restrictions by the pandemic. CONCLUSION: Informal caregivers are faced with worse mental health than non-caregivers during the pandemic, although their social support was stronger, in particular in dependence of higher levels of perceived restrictions by the pandemic. Thus, results indicate a need for an informal-care-specific policy and more professional support for informal caregivers during a health crisis.

Prevalence and determinants of loneliness among the oldest old living in institutionalized settings : Study findings from a representative survey.

BACKGROUND: There is very limited knowledge regarding the prevalence and determinants of loneliness in oldest old residents of nursing or old age homes. OBJECTIVE: To examine the prevalence and determinants of loneliness among the oldest old living in institutionalized settings in Germany. MATERIAL AND METHODS: Data were taken from the representative survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+) including individuals ≥ 80 years living in North Rhine-Westphalia. The study focused on individuals living in institutionalized settings. Sociodemographic, lifestyle-related, and health-related determinants were included in multiple linear regression models. RESULTS: Approximately 56.6% of the individuals were not lonely, 25.7% and 17.8% of the individuals were moderately and severely lonely, respectively. Regression analyses showed that higher loneliness was associated with being married (ß = 0.48, p < 0.05), high education (compared to low education, ß = 0.46, p < 0.05), having a small social network size (ß = -0.02, p < 0.05), having poor self-rated health (ß = -0.25, p < 0.05), and more depressive symptoms (ß = 0.25, p < 0.001). CONCLUSION: A significant proportion of the institutionalized oldest old individuals reported moderate or severe loneliness, which underpins the relevance of this topic. Understanding the determinants of loneliness may help to address institutionalized adults aged 80 years and over at risk of loneliness.

Oral health, anxiety symptoms and depressive symptoms: findings from the survey of health, ageing and retirement in Europe.

BACKGROUND: There is limited knowledge regarding the association between oral health and mental health in terms of depressive symptoms and particularly anxiety symptoms. Therefore, our aim was to close this gap in knowledge. METHODS: Cross-sectional data were used from wave 5 of the pan-European Survey of Health Ageing, and Retirement in Europe (SHARE) (n = 62 358 observations). The Beck Anxiety Inventory was used to quantify anxiety symptoms and the Euro-D was used to measure depressive symptoms. Oral health was quantified based on the presence of missing natural teeth, the number of missing natural teeth and the extent of replaced teeth. It was adjusted for several covariates in regression analysis. RESULTS: Multiple linear regressions revealed that the presence of missing natural teeth was associated with higher anxiety symptoms (ß = 0.11, P < 0.001) and higher depressive symptoms (ß = 0.22, P < 0.001) among the total sample. Among individuals with at least one missing natural tooth, the number of missing natural teeth was positively associated with higher anxiety symptoms (ß = 0.02, P < 0.001) and higher depressive symptoms (ß = 0.02, P < 0.001) - and fully replaced teeth (compared to not at all replaced teeth) were associated with lower anxiety symptoms (ß = -0.35, P < 0.001) and lower depressive symptoms (ß = -0.36, P < 0.001). CONCLUSION: Our study stresses the association between lower oral health and lower mental health among older adults in Europe. Future studies based on longitudinal data are required.

Neighbourhood cohesion, loneliness and perceived social isolation prior and during the COVID-19 pandemic. Longitudinal evidence from the German Ageing Survey.

PURPOSE: To investigate the longitudinal association between neighbourhood cohesion and loneliness as well as perceived social isolation prior and during the COVID-19 pandemic (stratified by sex). METHODS: Longitudinal data were taken from a nationally representative sample (German Ageing Survey) of inhabitants aged 40 years and over in Germany prior (wave 6: year 2017) and during the COVID-19 pandemic (wave 8: November 2020 until February 2021; n = 6688 observations, mean age was 67.4 years). The De Jong Gierveld tool was used to measure loneliness and the Bude and Lantermann tool was used to measure perceived social isolation. Neighbourhood cohesion was assessed based on different items. RESULTS: FE regressions showed that decreases in closeness of contact with neighbours were associated with increases in loneliness and perceived social isolation levels among men, but not women. In contrast, decreases in different indicators of involvement in neighbourhood activities were associated with increases in loneliness and perceived social isolation levels among women, but not men. CONCLUSION: Changes in neighbourhood factors are differently associated with loneliness and perceived social isolation among middle-aged and older women and men. Gender-specific efforts to avoid loneliness and social isolation are, therefore, needed.

Personal human values, informal caregiving and the relevance of gender and age: Findings from the population-based German Aging Survey.

OBJECTIVES: This study analyzed if personal human values and provision of informal care were associated and if this differed as a function of gender or age. METHOD: Data from the German Aging Survey were used (wave 2008, N=6,089), which included 748 informal caregivers. Human values were measured with the Human Values Scale from Schwartz (self-enhancement, self-transcendence, conservation, openness to change). Adjusted logistic regression analyses (with gender and age as additional moderators) were conducted. RESULTS: Placing higher importance on conservation and self-enhancement values was associated with lower odds for caregiving, while a higher appreciation of self-transcendence was associated with higher odds of caregiving. With older age, a higher score in conservation values was associated with even lower odds for caregiving. Gender did not moderate these associations, still, lower odds of caregiving were found only among men with higher scores in openness to change, and only among women with higher scores in conservation values. Self-transcendence was associated with higher odds of caregiving among both, men and women. DISCUSSION: In brief, personal values were significantly associated with informal caregiving and may act as motivators or barriers. The same motivators were found among men and women but different values were associated with lower odds of providing care. When aiming to foster informal care and a gender-equal distribution of caregiving, it could be helpful to take these values into account.

Gender Differences in Mental Health, Quality of Life, and Caregiver Burden among Informal Caregivers during the Second Wave of the COVID-19 Pandemic in Germany: A Representative, Population-Based Study.

INTRODUCTION: This study aimed to compare the mental health, quality of life, and caregiving burden between male and female informal caregivers of older adults (≥60 years) during the second wave of the COVID-19 pandemic in Germany. METHODS: The sample consisted of 301 female and 188 male informal caregivers of older adults in need of care (≥60 years). Data were used from a cross-sectional study in March 2021 that questioned a representative sample of adults aged 40 years and older from Germany. Information on informal care provision, mental health (depressive and anxiety symptoms), caregiving burden, and quality of life was assessed for the period between December 2020 and March 2021. Regression analyses, adjusted for (1) the sociodemographic background and health of the caregivers, (2) the caregiving time and caregiving tasks, and (3) the perception of impairment and danger posed by the pandemic, were conducted. RESULTS: Findings of the fully adjusted model indicated a higher level of anxiety and lower quality of life among female caregivers, compared to male caregivers. Gender differences in depression and caregiver burden were not significant in analyses that controlled for care tasks and time. Moderator analyses indicated that gender differences in caregiver's anxiety levels were influenced by the danger perceived to be posed by the pandemic: among men the danger to the care recipient, and among women the danger to themselves, increased anxiety. CONCLUSION: Female informal caregivers were more negatively affected than male informal caregivers during the pandemic, as indicated by higher levels of anxiety and lower quality of life. Gender differences in anxiety depended on the perceived danger posed by the pandemic. Thus, policy and pandemic measures should focus on gender-specific support of female caregivers who seem to be particularly vulnerable during the pandemic. More caregiver-specific support and information around protecting themselves and their care recipients are recommended. Also, further research on gender differences in care performance and their relation to psychosocial health outcomes is recommended.

Are informal caregivers more likely to believe in conspiracy theories during the COVID-19 pandemic?: Findings of a representative study from Germany.

OBJECTIVES: This study analyzed the conspiracy mentality of informal caregivers for older persons compared to non-caregivers and whether this association was dependent on age. METHODS: The sample was collected randomly from a population-based online panel (forsa.omninet) and represents individuals aged ≥40 years from Germany. In total, 3022 participants were questioned about conspiracy mentality (Conspiracy Mentality Questionnaire), informal care provision (N = 489 informal caregivers of older adults), and sociodemographic background. Data assessment took place between 4th and 19th March 2021 and the questions referred to the time between December 2020 and March 2021. RESULTS: No significant differences were found between informal caregivers and non-caregivers. A significant interaction effect was found, indicating a decrease of conspiracy mentality among non-caregivers and an increase among informal caregivers with higher age. After stratifying by gender, this effect was found only among female informal caregivers. CONCLUSION: Middle-aged informal caregivers had a lower, and older-aged a higher, susceptibility to conspiracy theories during the COVID-19 pandemic compared to non-caregivers. The results indicate that providing care could be protective among middle-aged individuals, whereas older informal caregivers may benefit from interventions to reduce susceptibility to conspiracy theories and the associated risks for health and wellbeing.

Can Informal Caregiving be Perceived as Rejuvenating? Changes in Perceptions of Ageing at Onset and End of Informal Caregiving during Different Stages of Life.

INTRODUCTION: Perceptions of ageing are a central predictor of health, wellbeing, and longevity. This study analyses the association between the onset and end of informal caregiving and perceptions of ageing in different stages of life. METHODS: Data from the German Aging Survey (2014, 2017) were used; a longitudinal dataset that is representative of community-dwelling individuals aged ≥40 years in Germany. Adjusted asymmetric fixed effects regression analyses were conducted to analyse the associations in three age groups (40 to <60, 60 to <80, and ≥80). Perceptions of ageing were measured in terms of attitude towards one's own ageing (Philadelphia Geriatric Centre Morale Scale), subjective age (felt age), and onset of old age (when someone is considered to be old). RESULTS: Significant changes in the perceptions of ageing were found only among individuals aged ≥80 years. In this group, the onset of informal caregiving was significantly associated with improved attitude towards one's own ageing and the end of informal caregiving was significantly associated with increased subjective age and earlier onset of old age. CONCLUSION: The perceptions of ageing improved with the onset and worsened with end of caregiving - but only among oldest old individuals. Thus, informal caregiving seems to be a significant predictor for perceptions of ageing in old age.

Social Support for Informal Caregivers of Spouses and Parents(-in-Law) Aged 60 Years and Older During the COVID-19 Pandemic: Findings From a Representative German Online Survey.

OBJECTIVES: We analyzed whether spousal and adult child caregivers of older adults differed from each other and from noncaregivers in terms of the social support available to them during the coronavirus disease 2019 pandemic, whether available support differed by gender, and whether the perception of pandemic restrictions moderated these differences. METHODS: Participants (≥40 years) were randomly drawn from the population-based German online panel forsa.omninet. Between March 4 and 19, 2021, 2,520 noncaregivers, 337 adult child caregivers, and 55 spousal caregivers were questioned about social support, perception of pandemic restrictions, health, and sociodemographic information. Adjusted regression analyses and moderator analyses were conducted. RESULTS: Adult child caregivers had higher social support from family and friends than noncaregivers, and more support from friends than spousal caregivers. Spousal caregivers had less social support from friends compared to both groups. The perceived restrictions of the pandemic moderated the differences in support from family and friends between spousal caregivers and noncaregivers, and the differences between spousal and adult child caregivers in support from friends. Gender moderated the difference in support by friends between caregiving and noncaregiving wives and sons(-in-law). DISCUSSION: Informal caregivers seemed to have a supportive informal network during the pandemic. However, spousal caregivers only had similar levels of support as adult child caregivers if they strongly perceived restrictions of the pandemic, and had the lowest support level of all 3 groups-in particular from friends. Thus, spousal caregivers may benefit most from support actions, and these should focus on their wider social network.

Does Oral Health-Related Quality of Life Differ by Income Group? Findings from a Nationally Representative Survey.

OBJECTIVES: Clarify the association between income group and oral health-related quality of life. METHODS: Data were used from a nationally representative online survey with n = 3075 individuals. It was conducted in late Summer 2021. The established Oral Health Impact Profile (OHIP-G5) was used to measure oral health-related quality of life. The income group (household net income) was used as key independent variable. It was adjusted for several covariates. Full-information maximum likelihood was used to address missing values. RESULTS: Individuals in the lowest income decile had a lower oral health-related quality of life (Cohen's d = -0.34) compared to individuals in the second to ninth income deciles. Individuals in the highest income decile had a higher oral health-related quality of life (Cohen's d = 0.20) compared to individuals in the second to ninth income deciles. Consequently, there was a medium difference (Cohen's d = 0.53) between individuals in the lowest income decile and individuals in the highest income decile. Additionally, multiple linear regressions showed significant differences between individuals in the lowest income decile and individuals in the second to ninth income deciles (ß = 0.72, p < 0.01). In contrast, only marginal significant differences were identified between individuals in the second to ninth income deciles and individuals in the highest income decile (ß = -0.28, p < 0.10). CONCLUSIONS: The current study particularly stressed the association between low income and low oral health-related quality of life in the general adult population. Increasing oral health-related quality of life in individuals with low income is a major issue which should be targeted.

Association between migration and oral health-related quality of life: results from a nationally representative online survey.

PURPOSE: To analyze the link between individuals with and without migration background and oral health-related quality of life (also stratified by sex). METHODS: Data in this cross-sectional study were taken from a nationally representative survey (n = 3075, August/September 2021). The Oral Health Impact Profile (OHIP-G5) was used to measure oral health-related quality of life. Two-part models were calculated, adjusting for various covariates. RESULTS: Individuals with migration background had lower oral health-related quality of life (total sample, Cohen's d = - 0.30; in men, d =- 0.44; in women, d =- 0.22). Two-part models also revealed that the migration background was associated with a higher likelihood of OHIP-G5 scores of one or higher (total sample and in both sexes). Moreover, migration background was positively associated with the extent of oral health-related quality of life (conditional on OHIP-G5 scores of one or higher; total sample and in men). Furthermore, regressions showed that migration background was associated with lower oral health-related quality of life (total sample and in both sexes). CONCLUSIONS: Our study emphasized the link between having a migration background and lower oral health-related quality of life among both women and men. Maintaining oral health among individuals with a migration background is a key challenge. Culturally and socially sensitive actions should provide easy accessible oral health information and preventive measures in order to lower access barriers in dental care for individuals with migration background.

Conspiracy mentality among informal caregivers as a risk factor for caregiver burden, mental health, perceived loneliness and social isolation during the COVID-19 pandemic: findings of a representative online study from Germany.

PURPOSE: This study aims to analyze if and how conspiracy mentality is associated with mental health, burden and perceived social isolation and loneliness of informal caregivers of older individuals with care needs. METHODS: A quantitative, cross-sectional study was conducted. Participants had to be at least 40 years of age and were drawn randomly from the German online panel forsa.omninet and questioned between the 4th and 19th of March 2021. A sample of 489 informal caregivers (relatives and non-relatives supporting individuals aged ≥ 60 years) was questioned. Conspiracy mentality, depressive symptoms, loneliness and social exclusion were measured with validated instruments (e.g., The Conspiracy Mentality Questionnaire). Questions referred to the last three months prior to assessment. Multiple linear regression analyses, adjusted for sociodemographic, economic and health factors and indicators of the pandemic, were conducted. RESULTS: Findings indicate a significant positive association between conspiracy mentality and caregiver burden, loneliness, social exclusion, and depressive symptoms. No gender differences were found for any outcome. CONCLUSIONS: The results indicate that conspiracy mentality could be a risk factor for mental health, perceived social isolation and loneliness, and contribute to increased caregiver burden among informal caregivers of older care recipients during the COVID-19 pandemic. Accordingly, informal caregivers could benefit from actions focused on reducing conspiracy mentality during a health crisis, which could improve psychosocial health and wellbeing in this vulnerable group.

Perceived autonomy of informal care recipients and the relevance of self-esteem.

This study aimed to analyze the longitudinal associations between receipt of (spousal and adult child) care and perceived autonomy, and their moderation by self-esteem. Data from the population-based longitudinal German Ageing Survey (2014, 2017) were used. Perceived autonomy was assessed using Schwarzer's perceived autonomy in old age scale and self-esteem was assessed using Rosenberg's global self-esteem scale. Adjusted fixed effects regression analyses indicated a significant association between both forms of care and reduced autonomy. A significant interaction effect between receipt of care from adult children and self-esteem was found. Recipients of care from adult children with lower levels of self-esteem perceived less autonomy once receiving care, while those with high self-esteem did not perceive a difference. The study's findings indicate that the receipt of informal care was perceived to reduce the care recipient's autonomy, when received from either a spouse or adult children. However, self-esteem was indicated to be either a risk (in the case of low self-esteem) or prevention factor (in the case of high self-esteem) among recipients of care from adult children. This was found irrespective of the care recipient's age. Thus, autonomy should be supported among all informal care recipients and additional actions are recommended to identify and foster self-esteem among recipients of care from adult children in particular. (PsycInfo Database Record (c) 2022 APA, all rights reserved).