Spousal Care Intensity, Socioeconomic Status, and Depression among the Older Caregivers in China: A Study on 2011-2018 CHARLS Panel Data

Using the stress process model and data from the 2011-2018 China Health and Retirement Longitudinal Study (CHARLS), this study examined the effect of spousal caregiving intensity on the depression level of older caregivers in China. The moderating role that socioeconomic status plays in the relationship between spouses was explored by constructing multilevel growth models (MGMs). The care intensity for a spouse was found to relate to significantly increased depression levels in older caregivers, while the degree of disability of the spouse being cared for (B = 0.200, p < 0.001) having a greater effect on depression than the duration of care (B = 0.007, p < 0.01). There was a threshold effect where the provision of more than 10 h of care per week for a spouse (B = 0.931, p < 0.001; B = 0.970; p < 0.01) or caring for a disabled spouse with limited ADLs (B = 0.709, p < 0.01; B = 1.326; p < 0.001; B = 1.469, p < 0.01) increased depression in older caregivers. There were moderating influences, including higher professional prestige before retirement (B = -0.006, p < 0.05) and higher annual family income (B = -0.037, p < 0.10), that increased depression related to the spouse's degree of disability. It was considered that active familism measures should be formulated for older spousal caregivers, especially those with lower socioeconomic status.