Quality of Life Research

, Volume 18, Issue 6, pp 679–688 | Cite as

Family caregiving and emotional strain: associations with quality of life in a large national sample of middle-aged and older adults

  • David L. RothEmail author
  • Martinique Perkins
  • Virginia G. Wadley
  • Ella M. Temple
  • William E. Haley



This study examined the quality of life correlates of family caregiving and caregiving strain in a large national epidemiological sample.


Structured telephone interviews were conducted with 43,099 participants as part of the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Participants completed the 12-item short form health survey (SF-12) and brief measures of depressive symptoms, social contacts, and caregiving strain.


Family caregiving responsibilities were reported by 12% of participants. Caregivers reported more quality of life problems than noncaregivers, but these effects were largely dependent on the perceived level of caregiving strain. High strain caregivers reported more problems with emotional distress, worse physical functioning, and fewer social contacts than noncaregivers. Conversely, caregivers who reported no strain from caregiving reported better quality of life than noncaregivers. Caregiving strain effects were not due to demographic differences or to more objective indicators of caregiving demand.


Psychological and social indices of quality of life indicate prevalent problems among family caregivers who have experienced high strain from their caregiving responsibilities. Public health programs for disabled individuals should include assessments of strain on family caregivers and support services for those who report high levels of caregiving strain.


Caregiving Caregiving strain Family caregivers Psychological health Depressive symptoms Health-related quality of life 



This research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Department of Health and Human Services. Additional funding was provided by an investigator-initiated grant R01 NS045789 from NINDS. The content is solely the responsibility of the authors and does not necessarily represent the official views of NINDS or the National Institutes of Health. Representatives of the funding agency have been involved in the review of the manuscript but not directly involved in the collection, management, analysis or interpretation of the data. The authors acknowledge the participating investigators and institutions of REGARDS for their valuable contributions: The University of Alabama at Birmingham, Birmingham, Alabama (Study PI, Statistical and Data Coordinating Center, Survey Research Unit): George Howard DrPH, Leslie McClure PhD, Virginia Howard PhD, Libby Wagner MA, Virginia Wadley PhD, Rodney Go PhD, Monika Safford MD, Ella Temple PhD, Margaret Stewart MSPH, J. David Rhodes BSN; University of Vermont (Central Laboratory): Mary Cushman MD; Wake Forest University (ECG Reading Center): Ron Prineas MD, PhD; Alabama Neurological Institute (Stroke Validation Center, Medical Monitoring): Camilo Gomez MD, Susana Bowling MD; University of Arkansas for Medical Sciences (Survey Methodology): LeaVonne Pulley PhD; University of Cincinnati (Clinical Neuroepidemiology): Brett Kissela MD, Dawn Kleindorfer MD; Examination Management Services, Incorporated (In-Person Visits): Andra Graham; Medical University of South Carolina (Migration Analysis Center): Daniel Lackland DrPH; Indiana University School of Medicine (Neuropsychology Center): Frederick Unverzagt PhD; National Institute of Neurological Disorders and Stroke, National Institutes of Health (funding agency): Claudia Moy PhD.


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • David L. Roth
    • 1
    Email author
  • Martinique Perkins
    • 1
  • Virginia G. Wadley
    • 2
  • Ella M. Temple
    • 1
  • William E. Haley
    • 3
  1. 1.Department of Biostatistics, School of Public HealthUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Department of Medicine, Division of Gerontology, Geriatrics, and Palliative CareUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.School of Aging StudiesUniversity of South FloridaTampaUSA

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