Association between care recipient frailty and caregiver burden among community-dwelling older adults: evidence from the National Study of Caregiving

Informal caregiving can impose substantial stress on caregivers when caring for recipients with complex health needs. Despite growing interest in caregiver burden, limited research has examined care recipients' physical frailty as a primary driver of this burden. This study examines the association between care recipient frailty and multiple domains of caregiver burden and provides national estimates of caregivers providing care to older adults with frailty.

We used data from the National Study of Caregiving to generate nationally representative estimates of caregivers providing care to frail community-dwelling older adults. Multivariable logistic regression models were run to estimate the odds, based on care recipient's frailty status, of reporting physical, emotional, and financial difficulty, participation restrictions, and caregiver strain.

In 2022, 21.3 million adults provided care to community-dwelling older adults, of which 4.6 million provided care to frail older adults (21.3%), and 12.8 million provided care to those who are prefrail (60%). In the fully adjusted model, caregiving for frail individuals was significantly associated with greater odds of caregivers experiencing physical difficulty. Specifically, caring for prefrail recipients was associated with a 76% increase in the odds of physical difficulty (OR = 1.76; 95% CI: 1.03-3.00), while caring for frail recipients was associated with a more than twofold increase in odds (OR = 2.30; 95% CI: 1.25-4.26).

Our study highlights the prevalence of unpaid family caregiving for community-dwelling older adults with prefrailty and frailty and shows that frailty is associated with increased caregiver burden, particularly physical difficulty.