Care network types and depression among people with cognitive impairment: A latent class analysis

Depression is a common neuropsychiatric symptom in people with cognitive impairment. Although care networks, defined as groups of caregivers supporting an individual with cognitive impairment, may influence depression, evidence regarding this relationship remains limited. The purpose of this study was to identify the care network types among people with cognitive impairment and assess their association with depression. Using a nationally representative sample of older adults, 537 people with cognitive impairment who required assistance with activities of daily living were analyzed. Latent class analysis was employed to identify care network types according to the composition of six categories of care providers: spouses, children, extended family members, distant relatives/friends/neighbors, privately paid caregivers, and public caregivers. Multiple linear regression was then used to examine the associations between care network types and depression after adjusting for covariates. Five care network types were identified: Child-centered (n = 175, 32.6%), Spouse-centered (n = 101, 18.8%), Friends and Neighbors-centered (n = 43, 8.0%), Public-centered (n = 97, 18.1%), and Mixed (n = 121, 22.5%). Compared with the Child-centered Care Network, the Public-centered Care Network (β = 0.09, p = 0.041) and the Mixed Care Network (β = 0.14, p = 0.002) were associated with higher depression scores. In pairwise comparisons, the Public-centered and Mixed Care Networks also had significantly higher depression scores than the Child-centered, Spouse-centered, and Friends and Neighbors-centered Care Networks. These findings suggest that the overall configuration of caregivers may be relevant to depression among people with cognitive impairment and highlight the importance of considering care network composition when assessing their psychological well-being.