Informal caregiving, chronic physical conditions, and physical multimorbidity in 48 low- And middle-income countries

Louis Jacob, Hans Oh, Jae Il Shin, Josep Maria Haro, Davy Vancampfort, Brendon Stubbs, Sarah E. Jackson, Lee Smith, Ai Koyanagi

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Background: The health of the caregivers is crucial to sustain informal care provision, while multimorbidity is an important health risk concept. However, studies on the association between informal caregiving and physical multimorbidity are currently lacking. Therefore, we investigated this association in adults from 48 low- and middle-income countries (LMICs). Method: Cross-sectional data from 242,952 adults (mean age 38.4 years) participating in the World Health Survey 2002-2004 were analyzed. Informal caregivers were considered those who provided help in the past year to a relative or friend (adult or child) who has a long-term physical or mental illness or disability, or is getting old and weak. Nine physical conditions were assessed. Multivariable logistic regression analyses were conducted to assess associations between informal caregiving and physical multimorbidity, while the between-country heterogeneity in this relationship was studied with country-wise analyses. Results: The overall prevalence of informal caregiving and physical multimorbidity (ie, two or more physical conditions) was 19.2% and 13.2%, respectively. Overall, caregivers had 1.40 (95% confidence interval = 1.29-1.52) times higher odds for physical multimorbidity. This association was particularly pronounced in younger caregivers (eg, 18-44 years: odds ratio = 1.54; 95% confidence interval = 1.37-1.72), whereas this association was not statistically significant among those aged ≥65 and older (odds ratio = 1.19; 95% confidence interval = 0.98-1.44). Country-wise analyses corroborated these findings, and there was a negligible level of between-country heterogeneity (I2 = 24.0%). Conclusions: In LMICs, informal caregivers (especially young caregivers) were more likely to have physical multimorbidity. This should be taken into account in policies that address the health and well-being of informal caregivers.

Original languageEnglish
Pages (from-to)1572-1578
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number8
Publication statusPublished - 2020

Bibliographical note

Funding Information:
A.K.’s work is supported by the PI15/00862 project, integrated into the National R + D + I and funded by the ISCIII–General Branch Evaluation and Promotion of Health Research — and the European Regional Development Fund (ERDF-FEDER). B.S. is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). B.S. is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. Brendon Stubbs is also supported by the Maudsley Charity, King’s College London, and the NIHR South London Collaboration for Leadership in Applied Health Research and Care (CLAHRC) funding.

Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.

All Science Journal Classification (ASJC) codes

  • Ageing
  • Geriatrics and Gerontology


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