Caregiving burden and depressive symptoms among rural caregivers of older adults living with disabilities in China: the role of formal and informal support

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Abstract
Population aging in rural China has increased caregiving demands for older adults living with disabilities, while formal long-term care resources remain limited. Evidence remains insufficient regarding how multidimensional caregiving burden is associated with depressive symptoms and whether formal and informal support buffer these associations. To examine the associations between multidimensional caregiving burden and depressive symptoms among rural caregivers and to investigate the buffering roles of formal and informal support, including heterogeneity by gender and educational attainment. Cross-sectional data from 781 rural caregivers in China were analyzed using multivariable linear regression models. Caregiving burden included overall burden and five dimensions: physical burden, psychological burden, financial burden, time-dependence burden, and social isolation. Formal support was measured by the availability of community care services, and informal support by caregivers' social networks. Stratified analyses were conducted by gender and educational attainment. All dimensions of caregiving burden were significantly associated with higher depressive symptoms. Financial burden and social isolation showed the strongest associations. Informal social support buffered the adverse effects of all burden dimensions, whereas formal community services mainly buffered physical and financial burden. Male caregivers benefited from both forms of support, while female caregivers relied primarily on informal support. Buffering effects were stronger among caregivers with lower educational attainment. Depressive symptoms among rural caregivers are closely associated with multidimensional caregiving burden. Policies should prioritize reducing financial strain and social isolation while strengthening both formal and informal support systems, particularly for women and less educated caregivers.
Funding Information
  • National Social Science Fund of China (22CRK014)

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