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With sociodemographic changes, men are increasingly taking responsibility for spousal caregiving. Previous studies have described gender differences in the psychological outcomes of caregiving; however, few have focused exclusively on husband caregivers. This study investigates the influence of starting spousal caregiving on the psychological well-being of older husbands in rural areas and examines whether living arrangements can moderate this relationship. A total of 1,167 baseline non-caregiver husbands aged 60 and above in rural areas were taken from the 2011–2015 China Health and Retirement Longitudinal Study (CHARLS). The generalized estimating equation (GEE) was employed to examine the effects of spousal caregiving transitions and living arrangement changes on depressive symptoms over four years. Compared with rural husbands who remained non-caregivers, those transitioning into activities of daily living (ADL) caregiving reported higher depressive symptoms at follow-up (B = 1.67, p < 0.05). Moreover, the increase in depressive symptoms when transitioning into ADL caregiving was significantly lower among participants who changed from living with spouse alone to living with spouse and other family members together (B = − 5.37, p < 0.05). There was an association between transitioning into ADL caregiving and an elevated level of depression over four years among older husbands, which could be alleviated by living with family members. Co-residence with family members could serve as a natural support resource, buffering adverse mental health outcomes when older husbands start a demanding caregiving role. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the joint effects of self and spousal frailty status on functional and mental health in Chinese older adults and determine whether such effects vary by urban versus rural residency. Background: Frailty is a clinical syndrome among old adults and would lead to adverse outcomes. However, studies on the interactive patterns of frailty status between spouses and the joint effects of such patterns on health outcomes are scarce. Design: Data were from the China Health and Retirement Longitudinal Study (CHARLS). A total of 2,581 married seniors who participated both 2011 and 2015 waves of the CHARLS were categorised into four groups: robust self–robust spouse (RR), robust self–frail spouse (RF), frail self–robust spouse (FR) and frail self–frail spouse (FF). Methods: Frailty was measured using the physical frailty phenotype scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Functional health was measured by difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). The generalised estimating equation was used to estimate the effects of concordant frailty on mental and functional outcomes, stratified by rural/urban residency. This study followed the STROBE checklist. Results: The FF group reported higher levels of ADL/IADL difficulties and depressive symptoms at follow‐up than the RR group; urban individuals in the RF group reported higher follow‐up depression than the RR group; and rural individuals from the FR or RF groups reported more follow‐up ADL/IADL difficulties than the RR group. Conclusion: Frailty and subsequent health decline are interdependent in older couples, and the rural/urban context is important for understanding this interdependence in the older Chinese population. Relevance to clinical practice: Couples‐based intervention strategies are needed to tackle situations in which one or both spouses are concurrently facing frailty. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effects of baseline and changes in frailty states on subsequent depressive symptoms, and whether sleep duration would modify these effects. Design Prospective, cohort study. Setting: The 2011 baseline and 2013 follow‐up waves of the China Health and Retirement Longitudinal Study (CHARLS). Participants: Community‐dwelling old adults who were aged 60 or above at baseline and participated in the 2011 and 2013 waves of the CHARLS (N = 5,026). Measurements: Frailty was measured using the physical frailty phenotype (PFP) scale. Levels of depressive symptoms were measured by the 10‐item Center for Epidemiologic Studies Depression Scale (CES‐D). Using the generalized estimating equations (GEE), the effects of baseline and transitions in frailty states were examined on subsequent depressive symptoms, adjusting for a range of confounding variables. Results: Baseline prefrail (b = 0.97, P <.05) and frail states (b = 0.35, P <.05) were associated with higher subsequent level of depressive symptoms 2 years later. Within individuals who were robust at baseline, transitioning into prefrail/frail (b = 3.04, P <.001) was associated with a higher subsequent level of depressive symptoms, and this association was accelerated by short sleep duration. Within individuals who were prefrail at baseline, transitioning into frail (b = 1.76, P <.001) was associated with higher subsequent levels of depressive symptoms, and this association was stronger among those who reported short sleep duration. Conclusion: Baseline and transitions in frailty states were significantly related with higher subsequent levels of subsequent depressive symptoms. Short sleep duration significantly moderated the effects of baseline or transitions of frailty on subsequent depressive symptoms. Targeted interventions could be implemented to improve sleep quality for prefrail and frail older adults. [ABSTRACT FROM AUTHOR]