The scoping review reveals that the studies examining older caregivers’ health are rather scant. Even so, there is a growing scientific interest in this topic, as shown by most of the studies reviewed having been published in the last five years of the studied period. The characteristics of the theoretical background, the methodological approaches, and the synthesis of findings are presented below.

Theoretical Background

More than half of the studies do not take any specific theoretical model as a starting point, while the rest are grounded in theoretical models pertaining to the field of psychology, which could be gathered under the umbrella of the caregiver-stress process framework (Bacon et al., 2016; Baik et al., 2022; Ninomiya et al., 2019; Phetsitong et al., 2022; Polenick et al., 2020). The caregiver-stress process framework postulates that the caregiver’s socioeconomic characteristics, caregiving context and experience, and personal and social resources join to form a process that influences the caregiver’s mental and physical health. The rationale of these studies to justify the relevance of approaching the older caregivers’ health refers to so-called “double jeopardy”: the older caregivers must manage their own health problems while remaining exposed to the negative effects of demanding caregiving on health.

At a conceptual level, the definition and operationalization of care and caregiving was very ambiguous in most studies, even non-existent in some cases. For instance, caregiver was defined as “a helper who provided health-related assistance” (Polenick et al., 2020: 163), “who provided daily support” (Koyama et al., 2017: 109) or “caregivers were (1) serving care recipients for more than 6 months, (2) serving care at home” (Ninomiya et al., 2019). None of the studies detail the specific tasks for which care was provided. All the studies conceptualize caregiving in a practical sense, as assistance in carrying out daily routines, support in personal care, or help with household tasks.

Methodological Approaches

In the research on older caregivers’ health, quantitative methodological approaches predominate: nine of the twelve selected studies perform a quantitative analysis, using both cross-sectional and longitudinal data (Bacon et al., 2016; Barbosa et al., 2021; Koyama et al., 2017; Muñoz-Bermejo et al., 2019; Ninomiya et al., 2019; Phetsitong et al., 2022; Polenick et al., 2020; Potier et al., 2018a, b). These studies use multivariable statistical techniques, namely logistic regression models. The remaining studies use qualitative methods (Alcañiz-Garrán et al., 2021), mixed methods (Baik et al., 2022), and a synthesis review (Morgan et al., 2020). Case studies of countries and regions of the Global North are predominant: the USA (Bacon et al., 2016; Baik et al., 2022; Polenick et al., 2020), Belgium (Potier et al., 2018a, b), Taiwan and Japan (Koyama et al., 2017; Ninomiya et al., 2019), Spain (Alcañiz-Garrán et al., 2021; Muñoz-Bermejo et al., 2019), and a European comparative analysis (Barbosa et al., 2021). The unique exception is one study focusing on the health of older caregivers in low- and middle-income countries in South America and Asia (Phetsitonge et al., 2022).

A large part of the knowledge regarding the health of older caregivers has been generated by exploring the support from cohabiting spouses and partners, mainly triggered by a cognitive problem such as Alzheimer’s disease or dementia diagnosed in one member of the couple (Barbosa et al., 2021; Morgan et al., 2020; Polenick et al., 2020; Potier et al., 2018a, b). However, the selected studies also capture other patterns of support provision in which older people are caring as children aged 65 and over providing care to their long-lived parents or parents in-law, or older people caring for their siblings (Bacon et al., 2016; Baik et al., 2022; Muñoz-Bermejo et al., 2019). The scoping review also reveals that the knowledge about older caregivers’ health has followed two main analytical axes: 1) comparing older caregivers and non-caregivers (Bacon et al., 2016; Barbosa et al., 2021; Polenick et al., 2020; Potier et al., 2018a, b), and 2) comparing older caregivers (≥ 65) and younger caregivers (< 65) (Koyama et al., 2017; Ninomiya et al., 2019; Phetsitong et al., 2022). In turn, some studies also display analyses under a dyadic perspective, considering simultaneously the health of caregivers and the health of the care receivers.

The Characteristics of the Older Caregivers

The selected studies do not thoroughly examine the characteristics of older caregivers. However, it is possible to outline some of their main sociodemographic characteristics through the control variables included in the analyses. Characteristics such as sex and age appear in all the studies, showing that the average age is around 70 years. Most older caregivers are women, although there is a significant narrowing of the gender gap compared to younger caregivers. Additionally, most older caregivers are spouses or partners, which contrasts with a higher percentage of children among younger caregivers.

Other sociodemographic features such as race (Bacon et al., 2016; Baik et al. 2022), educational attainment (Bacon et al., 2016; Barbosa et al., 2021; Phetsitong et al., 2022; Polenick et al., 2020) or financial status (Baik et al., 2022; Barbosa et al., 2021; Potier et al., 2018a) have not been systematically included in the analyses. Even so, results highlight that older caregivers present lower educational level and lower income compared to younger caregivers and older non-caregivers.

Synthesis of the Findings

The selected studies explore different dimensions of health: physical, mental, or emotional health, or a combination of them. There are three main themes: 1) the negative impact of caring on physical, mental, and emotional health; 2) the positive impact of caring on physical, mental, and emotional health; and 3) the mediating factors of the impact of caring on health.

Negative Impact of Caring on Health

Most of the studies highlight the negative impact of caregiving on the health of the older caregivers. Regarding the physical dimension, older caregivers have higher levels of frailty and unintentional weight loss and are less physically active than non-carers (Barbosa et al., 2021; Potier et al., 2018a). It is also found that the risk of malnutrition in older caregivers increases with time (Potier et al., 2018b), and their strength to conduct caregiving tasks decreases with time (Muñoz-Bermejo et al., 2019). The study by Polenick et al. (2020), which focused on older caregivers with multiple chronic illnesses, found that these caregivers had more difficulties to perform physical activities than carers without multi-morbidities. This relationship was also observed for women separately: Women with discordant morbiditiesFootnote 1 tended to have more difficulties in physical functioning. Another study (Barbosa et al., 2021), focusing on the effect of caring on chronic pain, found a stronger association between caring and chronic pain in older caregivers than in non-caregivers. This association was especially visible in countries in the south and the east of Europe, compared to those in the north and the west of the continent. The study by Polenick et al. (2020), which analyzed spousal care in old age, found that older persons with chronic illnesses perceive less benefit from caring for their spouse than those who have no chronic illnesses.

The impact of caring on older caregivers’ mental health is a major topic in the literature. The older caregivers present low levels of life satisfaction (Barbosa et al., 2021), experience feelings of unhappiness more frequently (Alcañiz-Garrán et al., 2021), and are at greater risk of depression (Koyama et al., 2017; Potier et al., 2018a). Older caregivers also present high consumption of medication, especially anti-depressants, and tranquilizers (Potier et al., 2018a), which increases along with the increase of time required for caring, especially in men (Potier et al., 2018b). Older caregivers with multiple illnesses also have more emotional problems (Polenick et al., 2020), while the negative impact of caring on the emotional state is higher in those who suffer from physical conditions. However, older caregiving women had more depressive symptoms than non-caregivers but also fewer ADL/IADL limitations (Bacon et al., 2016). There are insights about the strategies that older caregivers use to manage the impact of physical, psychological, and social distress, such as family support, team effort, and willingness to fully accept their caregiver role (Baik et al., 2022). The sense of coherence (SOC) also buffers the damage care can do to mental health (Ninomiya et al., 2019). One of the situations in which the negative impact of caregiving on mental health increases for older carers is when the activity is intensified, such as when providing end-of-life care to one’s spouse or partner (Morgan et al., 2020). In that case, the negative impact of caregiving on mental health continues after the death of the person cared for.

Positive Impact of Caring on Health

Evidence also showed that caregiving does not harm the health of the older caregivers but rather maintains and improves their capacities and wellbeing. The study by Polenick et al. (2020), which analyzed spousal care in old age, found that carrying out many tasks was related to positive emotions and feelings, such as the satisfaction of covering the needs of the person cared for, the love derived from caring for a loved one, and the belief that one is the best person to provide for the wellbeing of the person cared for.

Explanatory Factors of the Impact of Caring on Older Carers’ Health

The scoping review showed that the relationship between caregiving and older carers’ health is conditioned by individual factors, such as the sociodemographic characteristics of the older caregivers and the illness of the person cared for. For instance, Polenick et al. (2020) found indications that educational qualifications are related to the impact of caring and that those with higher qualifications show a greater negative impact from caring. Also, cohabitation with the person cared for appears as one of the key factors behind the negative impact, since it facilitates the provision of a demanding care (Barbosa et al., 2021). Caring for a person with limited abilities for instrumental activities of daily living (IADL) or activities of daily living (ADL) increases the likelihood of presenting mental health problems such as stress or depression, while the longer the time dedicated to caring, the greater the negative impact of caring on health.