Social Participation as a Moderator for Caregivers’ Psychological Distress: a Dynamic Panel Data Model Analysis in Japan

The adverse impact of caregiving on caregivers’ mental health and the positive impact of social participation (SP) on health are both well understood. This study examined the moderating effect of SP on the association between family caregiving and caregivers’ psychological distress (PD). We used longitudinal data from 27,869 individuals born between 1946 and 1955 collected from a 14-wave nationwide survey, which was conducted from 2005 to 2018. We estimated dynamic panel data models, which could control for an individual’s time-invariant attributes in a dynamic framework, to examine how SP moderated the association between informal caregiving and a caregiver’s PD (defined by a Kessler score of 13 or higher). We observed that the onset of caregiving increased the probability of PD by 2.1% (95% confidence interval [CI]: 1.5%–2.6%) and 1.0% (95% CI: 0.5%–1.6%) for women and men, respectively, compared to 3.4% and 2.8% as the prevalence of PD for women and men, respectively. SP moderated the association between caregiving and a caregiver’s PD by 55.8% (95% CI: 31.9%–79.8%) and 73.5% (95% CI: 36.1%–110.9%) for women and men, respectively. In addition, the moderating effect of SP on a caregiver’s PD increased as the caregiver’s age advanced especially in women. These results suggest the need to keep family caregivers from being socially isolated, especially as they get older.