{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T15:05:25Z","timestamp":1776179125051,"version":"3.50.1"},"reference-count":52,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"WHO Centre for Health Development","award":["K18020"],"award-info":[{"award-number":["K18020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Depression is a common geriatric problem globally. It is particularly burdensome in low- and middle-income countries, where care for older people mainly relies on the family in the absence of long-term care facilities. This study aimed to assess the level of caregivers\u2019 burden among family caregivers who are taking care of older persons with depression in the home care setting within the communities of Chiang Mai, Northern Thailand. Materials and Methods: This cross-sectional study investigated 867 pairs of community-dwelling older adults and their family caregivers in Chiang Mai, Thailand. The depression of older people was screened using the 15-item Geriatric Depression Scale. The family caregivers\u2019 burden and quality of life were measured using the Caregiver Burden Inventory (CBI) and the European Quality of Life (EQ) Five Dimension Five Level scales. The analysis applied was multivariable regression. Results: Two-thirds of the family caregivers were female. The mean age was 55.3 \u00b1 13.8 years. The family caregivers caring for older persons with depression experienced significantly higher levels of burden in terms of the CBI total score (Coefficient: 10.60, 95% CI: 8.60, 12.60) and lower quality of life in terms of the EQ visual analogue scale (Coefficient: \u22125.52, 95% CI: \u22128.41, \u22122.62). They were more likely to take sick leave from their jobs (adj. OR 4.00, 95% CI: 1.73, 9.24) and more often to get sick (adjusted OR 7.26, 95% CI: 2.68, 19.64) than the caregivers of older adults without depression. Conclusions: Urgent interventions to prevent depression among older adults and systematic support to relieve family caregiver burden are necessary. The measures to relieve family caregiver burden include care capacity building, psychological support, respite care service, financial support, and other health promotion activities.<\/jats:p>","DOI":"10.3390\/medicina61010050","type":"journal-article","created":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T11:24:19Z","timestamp":1735730659000},"page":"50","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Substantial Impact of Later-Life Depression Among Community Older Adults on the Family Caregivers\u2019 Burden in the Home Care Setting of Chiang Mai, Northern Thailand"],"prefix":"10.3390","volume":"61","author":[{"given":"Keisuke","family":"Shimizu","sequence":"first","affiliation":[{"name":"Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8175-6309","authenticated-orcid":false,"given":"Myo Nyein","family":"Aung","sequence":"additional","affiliation":[{"name":"Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"},{"name":"Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan"},{"name":"Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saiyud","family":"Moolphate","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8030-8026","authenticated-orcid":false,"given":"Thin Nyein Nyein","family":"Aung","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuka","family":"Koyanagi","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo 135-0063, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2286-0568","authenticated-orcid":false,"given":"Siripen","family":"Supakankunti","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2132-7275","authenticated-orcid":false,"given":"Motoyuki","family":"Yuasa","sequence":"additional","affiliation":[{"name":"Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"},{"name":"Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,1]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2017). Depression and Other Common Mental Disorders: Global Health Estimates, World Health Organization."},{"key":"ref_2","unstructured":"Institute for Health Metrics and Evaluation (IHME) (2018). Findings from the Global Burden of Disease Study 2017, IHME."},{"key":"ref_3","unstructured":"World Health Organization (2023, July 17). Depression\u2014Fact Sheets. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/depression."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1370\/afm.1260","article-title":"Severity of depression and magnitude of productivity loss","volume":"9","author":"Beck","year":"2011","journal-title":"Ann. Fam. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.psc.2013.08.008","article-title":"The economic, public health, and caregiver burden of late-life depression","volume":"36","author":"Zivin","year":"2013","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"51","DOI":"10.3329\/bmrcb.v37i2.8434","article-title":"Predictors of depression among older people living in rural areas of Thailand","volume":"37","author":"Haseen","year":"2011","journal-title":"Bangladesh Med. Res. Counc. Bull."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.jad.2023.01.068","article-title":"Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis","volume":"325","author":"Edwards","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref_8","unstructured":"World Health Organization (2010). Mental Health and Development: Targeting People with Mental Health Conditions as a Vulnerable Group, World Health Organization."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1017\/S0033291717003336","article-title":"Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: Results from the WHO World Mental Health (WMH) surveys","volume":"48","author":"Alonso","year":"2018","journal-title":"Psychol. Med."},{"key":"ref_10","unstructured":"Lorthanavanich, D., Nirathron, N., Teerakapibal, S., Rompho, N., Tanvisuth, A., and Komazawa, O. (2021). Population Ageing in Thailand, Economic Research Institute for ASEAN and East Asia (ERIA) and Thammasat University."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1111\/ggi.13804","article-title":"Prevalence and associated factors influencing depression in older adults living in rural Thailand: A cross-sectional study","volume":"19","author":"Charoensakulchai","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Aung, T.N.N., Moolphate, S., Koyanagi, Y., Angkurawaranon, C., Supakankunti, S., Yuasa, M., and Aung, M.N. (2022). Depression and Associated Factors among Community-Dwelling Thai Older Adults in Northern Thailand: The Relationship between History of Fall and Geriatric Depression. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191710574"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Prasartpornsirichoke, J., Pityaratstian, N., Poolvoralaks, C., Sirinimnualkul, N., Ormtavesub, T., Hiranwattana, N., Phonsit, S., and Rungnirundorn, T. (2023). The prevalence and economic burden of treatment-resistant depression in Thailand. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16477-y"},{"key":"ref_14","unstructured":"Knodel, J., Teerawichitchainan, B., Prachuabmoh, V., and Pothisiri, W. (2015). The Situation of Thailands\u2019 Older Population: An Update Based on the 2014 Survey of Older Persons in Thailand, HelpAge International East Asia\/Pacific Regional Office."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"101882","DOI":"10.1016\/j.ejon.2020.101882","article-title":"Caregiving burden, depression, and anxiety in family caregivers of patients with cancer","volume":"50","author":"Unsar","year":"2021","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/21678421.2022.2079993","article-title":"Care burden and related factors among informal caregivers of patients with amyotrophic lateral sclerosis","volume":"24","author":"Tulek","year":"2023","journal-title":"Amyotroph. Lateral Scler. Front. Degener."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e12638","DOI":"10.1097\/MD.0000000000012638","article-title":"Relationship between the anxiety\/depression and care burden of the major caregiver of stroke patients","volume":"97","author":"Hu","year":"2018","journal-title":"Medicine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/bdi.12379","article-title":"Caregiver burden as a predictor of depression among family and friends who provide care for persons with bipolar disorder","volume":"18","author":"Perlick","year":"2016","journal-title":"Bipolar Disord."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4103\/ipj.ipj_228_20","article-title":"A cross-sectional study to assess the caregiver burden and the quality of life of caregivers of the patients suffering with psychiatric illness","volume":"31","author":"Gupta","year":"2022","journal-title":"Ind. Psychiatry J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1111\/jocn.13601","article-title":"Caregiver burden and prevalence of depression, anxiety and sleep disturbances in Alzheimer\u2019s disease caregivers in China","volume":"26","author":"Liu","year":"2017","journal-title":"J. Clin. Nurs."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e057817","DOI":"10.1136\/bmjopen-2021-057817","article-title":"Caregiver burden and its associated factors among family caregivers of persons with dementia in Shanghai, China: A cross-sectional study","volume":"12","author":"Liu","year":"2022","journal-title":"BMJ Open"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/psyg.12141","article-title":"A comparative study of caregiver burden in late-onset depression and Alzheimer\u2019s disease","volume":"16","author":"Kazhungil","year":"2016","journal-title":"Psychogeriatrics"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Balkaran, B.L., Jaffe, D.H., Umuhire, D., Rive, B., and Milz, R.U. (2021). Self-reported burden of caregiver of adults with depression: A cross-sectional study in five Western European countries. BMC Psychiatry, 21.","DOI":"10.1186\/s12888-021-03255-6"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e20196","DOI":"10.2196\/20196","article-title":"Community-Integrated Intermediary Care (CIIC) Service Model to Enhance Family-Based, Long-Term Care for Older People: Protocol for a Cluster Randomized Controlled Trial in Thailand","volume":"10","author":"Aung","year":"2021","journal-title":"JMIR Res. Protoc."},{"key":"ref_25","first-page":"101","article-title":"The Use of GDS-15 in Detecting MDD: A Comparison Between Residents in a Thai Long-Term Care Home and Geriatric Outpatients","volume":"5","author":"Wongpakaran","year":"2013","journal-title":"J. Clin. Med. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s40337-022-00560-7","article-title":"Adaptation and validation of the Caregiver Burden Inventory in eating disorders","volume":"10","author":"Bertelli","year":"2022","journal-title":"J. Eat. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1590\/0104-1169.3357.2534","article-title":"Adaptation and validation of the Caregiver Burden Inventory for use with caregivers of elderly individuals","volume":"23","author":"Valer","year":"2015","journal-title":"Rev. Lat. Am. Enferm."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/1477-7525-5-33","article-title":"Performance of the EQ-5D and the EQ-5D+C in elderly patients with cognitive impairments","volume":"5","author":"Wolfs","year":"2007","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s40258-017-0310-5","article-title":"EQ-5D and the EuroQol Group: Past, Present and Future","volume":"15","author":"Devlin","year":"2017","journal-title":"Appl. Health Econ. Health Policy"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual. Life Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3015","DOI":"10.1007\/s11136-015-1038-z","article-title":"Psychometric properties of the EQ-5D-5L in Thai patients with chronic diseases","volume":"24","author":"Sakthong","year":"2015","journal-title":"Qual. Life Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Cheng, W.L., Chang, C.C., Griffiths, M.D., Yen, C.F., Liu, J.H., Su, J.A., Lin, C.Y., and Pakpour, A.H. (2022). Quality of life and care burden among family caregivers of people with severe mental illness: Mediating effects of self-esteem and psychological distress. BMC Psychiatry, 22.","DOI":"10.1186\/s12888-022-04289-0"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2147\/JMDH.S135372","article-title":"The burden of family caregiving in the United States: Work productivity, health care resource utilization, and mental health among employed adults","volume":"10","author":"Hopps","year":"2017","journal-title":"J. Multidiscip. Healthc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.genhosppsych.2014.08.008","article-title":"Caregiver burden in families of patients with depression attending Obafemi Awolowo University teaching hospitals complex Ile-Ife Nigeria","volume":"36","author":"Olawale","year":"2014","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_35","first-page":"31","article-title":"Prevalence of depression symptoms and associated socio-demographic factors in primary health care patients","volume":"27","author":"Erjavec","year":"2015","journal-title":"Psychiatr. Danub."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s10823-017-9330-8","article-title":"The Impact of Eldercare on Adult Children\u2019s Health and Employment in Transitional China","volume":"32","author":"Pei","year":"2017","journal-title":"J. Cross Cult. Gerontol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.psychres.2008.06.013","article-title":"Caring for people with depression or with schizophrenia: Are the consequences different?","volume":"169","author":"Koeter","year":"2009","journal-title":"Psychiatry Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"239","DOI":"10.4103\/0019-5545.102423","article-title":"A comparative study of caregiver burden in psychiatric illness and chronic medical illness","volume":"54","author":"Ampalam","year":"2012","journal-title":"Indian J. Psychiatry"},{"key":"ref_39","first-page":"724848","article-title":"Stigma and discrimination in people suffering with a mood disorder: A cross-sectional study","volume":"2012","author":"Lazowski","year":"2012","journal-title":"Depress Res. Treat."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/inm.12668","article-title":"Experience of stigma among family members of people with severe mental illness: A qualitative systematic review","volume":"29","author":"Yin","year":"2020","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.2147\/RMHP.S370353","article-title":"Determinants of Health-Related Quality of Life Among Community-Dwelling Thai Older Adults in Chiang Mai, Northern Thailand","volume":"15","author":"Aung","year":"2022","journal-title":"Risk Manag. Healthc. Policy"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/j.psychres.2018.12.005","article-title":"Does improvement in symptoms and quality of life in chronic schizophrenia reduce family caregiver burden?","volume":"271","author":"Rhee","year":"2019","journal-title":"Psychiatry Res."},{"key":"ref_43","first-page":"26","article-title":"Correlates of Quality of Life in Caregivers of Patients with Schizophrenia and Bipolar Affective Disorder: A Study From Southwestern Nigeria","volume":"32","author":"Ukpong","year":"2021","journal-title":"Turk. Psikiyatr. Derg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1176\/appi.ajp.161.5.857","article-title":"Extent and cost of informal caregiving for older Americans with symptoms of depression","volume":"161","author":"Langa","year":"2004","journal-title":"Am. J. Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Aung, T.N.N., Aung, M.N., Moolphate, S., Koyanagi, Y., Supakankunti, S., and Yuasa, M. (2021). Caregiver Burden and Associated Factors for the Respite Care Needs among the Family Caregivers of Community Dwelling Senior Citizens in Chiang Mai, Northern Thailand. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18115873"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s12961-022-00911-5","article-title":"Effectiveness of a community-integrated intermediary care (CIIC) service model to enhance family-based long-term care for Thai older adults in Chiang Mai, Thailand: A cluster-randomized controlled trial TCTR20190412004","volume":"20","author":"Aung","year":"2022","journal-title":"Health Res. Policy Syst."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e12814","DOI":"10.1111\/ecc.12814","article-title":"Underestimated caregiver burden by cancer patients and its association with quality of life, depression and anxiety among caregivers","volume":"27","author":"Shin","year":"2018","journal-title":"Eur. J. Cancer Care"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1177\/0164027504264493","article-title":"Positive Aspects of Caregiving","volume":"26","author":"Tarlow","year":"2016","journal-title":"Res. Aging"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.psychres.2017.12.088","article-title":"Moderating role of positive aspects of caregiving in the relationship between depression in persons with Alzheimer\u2019s disease and caregiver burden","volume":"261","author":"Xue","year":"2018","journal-title":"Psychiatry Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/famp.12032","article-title":"Caregiver attributions for late-life depression and their associations with caregiver burden","volume":"52","author":"Polenick","year":"2013","journal-title":"Fam. Process"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"937","DOI":"10.2147\/CIA.S361071","article-title":"Evaluating the Effectiveness of Community-Based Dementia Caregiver Intervention on Caregiving Burden, Depression, and Attitude Toward Dementia: A Quasi-experimental Study","volume":"17","author":"Lee","year":"2022","journal-title":"Clin. Interv. Aging"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1111\/famp.12684","article-title":"Effect of support groups on caregiver\u2019s quality of life","volume":"61","year":"2022","journal-title":"Fam. Process"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/1\/50\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T15:22:56Z","timestamp":1759850576000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/1\/50"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,1]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["medicina61010050"],"URL":"https:\/\/doi.org\/10.3390\/medicina61010050","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,1]]}}}