Depression linked to physical health decline in cancer caregivers

A new report finds cancer caregivers suffer a steady decline in physical health compared to controls, and that symptoms of depression were the only significant predictor of caregivers' physical health decline. Writing in Cancer, the authors say assessing and addressing depressive symptoms among caregivers early in the cancer survivorship trajectory may help to prevent premature health decline among this important, yet vulnerable population. The study is the longest follow-up to date of caregivers' physical health following providing care to a loved one with cancer. It was funded by the American Cancer Society.

Cancer caregiving has been associated with worsening health among caregivers. To explore possible predictors of this decline, researchers led by Kelly M. Shaffer, Ph.D., of Memorial Sloan Kettering Cancer Center, analyzed survey data from 664 cancer caregivers in the American Cancer Society's National Quality of Life Survey for Caregivers. They examined changes in caregivers' physical health from year two to year eight following a family member's cancer diagnosis to find predictors of declining health.

At two years after diagnosis, caregivers' health was slightly higher than the national mean. But over the following six years that advantage dissipated, as caregivers experienced a small yet notable decline in health. Investigators found having elevated depressive symptoms was the only predictor of the physical health decline; caregivers with high depressive symptoms showed twice the rate of physical health decline of caregivers with an average level of depressive symptoms.

"Adverse effects of depression on physical health have been well-documented in the general population," write the authors. "These findings extend evidence to the cancer caregiving context, known to have many psychosocial stressors and challenges, and highlight the importance of depression specifically to caregivers' premature physical health decline."

The authors say caregiver distress screening could be more widely adopted hand-in-hand with efforts to implement similar screening for patients, including technology-based assessment using brief and straightforward questions to assess whether a caregiver has been experiencing depression.

"Identifying caregivers in need, and connecting these caregivers to effective and accessible psychosocial services, are imperative next steps to improve comprehensive care for families facing cancer," said Dr. Shaffer.