Residential Proximity and Symptoms of Depression and Anxiety Among Adult Children Caring for Aging Parents

TL;DR

This study examines how living close or far from aging parents affects adult children's mental health, finding that distance has little impact compared to personal health and employment.

Contribution

The study is among the first to analyze mental health outcomes of long-distance caregivers using nationally representative data.

Findings

Residential proximity was not significantly linked to depression or anxiety symptoms in caregivers.

Poor health and employment status were stronger predictors of anxiety and depression than proximity.

Distance caregivers are often overlooked despite providing similar levels of care as local caregivers.

Abstract

Long-distance caregivers are an understudied subgroup of family caregivers. This study characterizes adult-child caregivers based on residential proximity to their older-adult parent, and explores associations of proximity with caregiver symptoms of depression and anxiety. Data from the 2021 National Health and Aging Trends Study Round 11 was linked with National Study of Caregiving IV. The sample included adult-child caregivers of Medicare beneficiaries aged 71 and older. Bivariate and multivariable Poisson regression models (stratified by education attainment) analyzed associations between proximity categories, caregiver demographics, care activities, and symptoms of depression and anxiety. The sample included 932 caregivers, representing a population of 9,171,811. In weighted analysis, 26.3% of caregivers coreside, 47.4% live 1–20 minutes away, 13.1% live 21–59 minutes away, and 13.2% live ≥1 hour away. Residential proximity to their aging parent was not a significant predictor of depression, and only marginally significant for anxiety in those with some college education. Poor/fair health predicted anxiety across all education groups; employment reduced the risk of depression for those with some college education. While adult-children provide varying types of caregiving assistance regardless of residential proximity, depression and anxiety are largely associated with caregivers’ health and financial status rather than residential proximity. Findings highlight the need for policies, services and programs that support the needs of distance caregivers, given that their needs are relatively overlooked compared to proximate/local caregivers.