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J Epidemiol. 2016 Dec 5;26(12):622-628. Epub 2016 May 14.

Informal and Formal Social Support and Caregiver Burden: The AGES Caregiver Survey.

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Departments of Health and Social Behavior/Health Education and Health Sociology, School of Public Health, The University of Tokyo.



We examined the associations of informal (eg, family members and friends) and formal (eg, physician and visiting nurses) social support with caregiver's burden in long-term care and the relationship between the number of available sources of social support and caregiver burden.


We conducted a mail-in survey in 2003 and used data of 2998 main caregivers of frail older adults in Aichi, Japan. We used a validated scale to assess caregiver burden.


Multiple linear regression demonstrated that, after controlling for caregivers' sociodemographic and other characteristics, informal social support was significantly associated with lower caregiver burden (β = -1.59, P < 0.0001), while formal support was not (β = -0.30, P = 0.39). Evaluating the associations by specific sources of social support, informal social supports from the caregiver's family living together (β = -0.71, P < 0.0001) and from relatives (β = -0.61, P = 0.001) were associated with lower caregiver burden, whereas formal social support was associated with lower caregiver burden only if it was from family physicians (β = -0.56, P = 0.001). Compared to caregivers without informal support, those who had one support (β = -1.62, P < 0.0001) and two or more supports (β = -1.55, P < 0.0001) had significantly lower burden. This association was not observed for formal support.


Social support from intimate social relationships may positively affect caregivers' psychological wellbeing independent of the receipt of formal social support, resulting in less burden.

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