The Effect of Becoming an Intensive Family Caregiver on Cognitive Functioning: a Matched Difference-in-Differences Analysis in Europe

Enrique Alonso-Perez , Charité – Universitätsmedizin Berlin
Ariane Bertogg, University of Konstanz
Gellert Paul, Charité Universitätsmedizin Berlin

Background: With increasing life expectancy, cognitive decline becomes a common experience in later life. At the same time, older adults are increasingly taking up caregiving roles. Previous studies suggest a decline in mental health upon becoming an intensive daily caregiver, but evidence on the links between providing informal care and cognitive functioning is mixed. Filling this gap, we examine the effects of becoming an intensive caregiver on cognitive trajectories using a counterfactual design. Methods: We draw on eight waves (2004-2022) of the Survey of Health, Ageing and Retirement in Europe (SHARE), using longitudinal information on 136,543 observations from 34,257 individuals aged 50+ in 25 countries. Respondents who started intensive (i.e., daily) caregiving (N = 11,419 individuals, the treatment group) are matched with non-caregivers (N = 22,838 individuals, the control group) using Propensity Score Matching. Difference-in-differences models are applied to estimate the effect of caregiving on a composite score of four cognitive tests (memory, verbal fluency and numeracy). Results: About one in three adults aged 50 takes up intensive caregiving. Cognitive functioning decreased for both groups, with caregivers experiencing a steeper decline around the caregiving onset. Stratified analyses show that men with migration background experience the largest decline when becoming caregivers. Conclusions: Our results evidence an acceleration of cognitive decline around the onset of caregiving in later life. Stratified results point at unequal impacts. Our findings highlight the need for policies and support programs targeting individuals at risk of becoming caregivers around the caregiving onset.

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 Presented in Session 104. Flash Session Caregiving Patterns, Determinants and Consequences