Continuous participation in social activities as a protective factor against depressive symptoms among older adults who started high-intensity spousal caregiving: findings from the China health and retirement longitudinal survey

Abstract

OBJECTIVES: Previous studies documented that caregiving affects the mental health of spousal caregivers, and social participation is a favorable contributor to late-life well-being. However, it remains unclear whether changing social participation influences caregivers' mental health during their transition into spousal caregiving. The present study investigated the influence of transitioning into spousal caregiving, continuity and changes in social participation, and their interactions on older adults' depressive symptoms over time. METHOD: Information on caregiving transitions and social participation for 2,436 baseline noncaregivers was drawn from the 2011‒2015 China Health and Retirement Longitudinal Survey. Generalized estimating equations were used for estimating the effects of caregiving transitions (transition into low-intensity caregiving, transition into high-intensity caregiving versus no caregiving) and changing social participation (increased participation, decreased participation, continuous participation versus no participation) on follow-up depressive symptoms. RESULTS: Individuals who transitioned into spousal care provision over a four-year period reported more elevated depressive symptoms than those who remained noncaregivers. Individuals who continued or increased social participation reported fewer depressive symptoms than those who reported no participation over the four-year period. Increases in depressive symptoms were less severe among individuals who maintained continuous or increased social participation when transitioning into high-intensity care provision than among their counterparts who were not continuously involved in social participation during the transition. CONCLUSIONS: Continuous social participation protected against adverse psychological consequences during the transition into high-intensity spousal caregiving. Clinical attention should be directed at supporting spousal caregivers who meet difficulties in maintaining social participation when starting a demanding caregiving role.