The Impact of Informal Caregiving on Physical Functioning: A Longitudinal Analysis of Dutch Older Adults

Background and Objectives: Despite a growing body of literature on physical functioning and informal caregiving in later life, few studies have addressed two key issues: 1) how physical functioning changes over time for older caregivers compared with non-caregivers; 2) the role of different types of physical functioning in understanding these changes. This study investigates the association between informal caregiving and changes in physical functioning over time among older adults in the Northern Netherlands. 
Research Design and Methods: We analyzed data from two waves of the Lifelines Cohort Study, using a sample of 9,912 older caregivers and non-caregivers. We examined 11 outcome variables: overall physical functioning and 10 physical functioning types (e.g., vigorous and moderate activities; lifting/carrying groceries; walking various distances). We also controlled for health and demographic characteristics. Associations between changes in physical functioning and caregiving were modeled using generalized estimating equations.
Results: Caregiving moderates physical functioning over time, with caregivers experiencing less decline in overall physical functioning, moderate activities, and lifting/carrying groceries compared with non-caregivers. Despite this, caregivers exhibited higher mental and physical impairments at baseline, contradicting aspects of the healthy caregiver theory. Gender differences were significant, with women showing more limitations in physical functioning than men. Additionally, higher household income and educational attainment were associated with better physical functioning, potentially moderating the negative effects of caregiving and aging.
Discussion and Implications: This research contributes valuable insights into healthy aging, informal care, and disability in later life, suggesting the need for tailored interventions and policies for older caregivers.
Keywords: healthy aging, informal care, physical functioning, longitudinal, generalized estimating equations