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Arch Gerontol Geriatr. 2017 Jan - Feb;68:143-148. doi: 10.1016/j.archger.2016.10.003. Epub 2016 Oct 15.

Association of impairments of older persons with caregiver burden among family caregivers: Findings from rural South India.

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Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore. Electronic address:
Department of Community Health, St. John's Medical College, Bangalore, Karnataka, India.
Health Services and Systems Research; Duke-NUS Medical School, Singapore.



In India, owing to cultural norms and a lack of formal long-term care facilities, responsibility for care of the older person falls primarily on the family. Based on the stress process model, we assessed the association of type and number of impairments of older persons (∼primary stressors) with caregiver burden among their family caregivers in rural South India.


All impaired older persons (aged ≥60, with impairment in activities of daily living (ADL) or cognition or vision or hearing) residing in 8 villages in Bangalore district, Karnataka, India, and their primary informal caregivers were interviewed. Caregiver burden was measured using the Zarit Burden Interview (ZBI; higher score indicating greater perceived burden). Linear regression models, adjusting for background characteristics of older persons and caregivers, assessed the association of type of impairment (physical [Yes/No], cognitive [Yes/No], vision [Yes/No] and hearing [Yes/No]) and number (1 or 2 or 3 or 4) of older person impairments with caregiver burden.


A total of 140 caregivers, caring for 149 older persons, were interviewed. The mean (standard deviation) ZBI score was 21.2 (12.9). Of the various older person impairments, ZBI score was associated only with physical impairment (β=6.6; 95% CI: 2.1-11.1). Relative to caregivers of older person with one impairment, those caring for an older person with all 4 impairments had significantly higher ZBI score (β=13.9; CI: 2.5-25.4).


Caregivers of older persons with multiple impairments, especially physical impairment, are vulnerable.


Aged; Caregiver; India; Psychological stress; Rural population

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