Sex, Perceived Social Support, and Physical Activity as Correlates of Depressive Symptoms in Informal Caregivers: A Cross-Sectional Analysis of the Spanish National Health Survey 2023

Abstract

Highlights What are the main findings? More than one-third of the informal caregivers in this sample reported depressive symptoms, with a higher prevalence among women than men. Perceived social support and physical activity frequency were independently associated with depressive symptoms. What are the implications of the main findings? Poor perceived social support combined with physical inactivity was associated with the highest probability of depressive symptoms. Abstract Background/Objectives: Informal caregivers are at an increased risk of developing depressive symptoms; however, the combined role of sex, perceived social support (PSS), and physical activity (PA) in this population remains insufficiently characterized. This study aimed to describe the prevalence of depressive symptoms among informal caregivers in a national health survey sample and to identify the biopsychosocial factors independently associated with them. Methods: This cross-sectional study used data from the Spanish National Health Survey 2023 (ESdE 2023). Informal caregivers (n = 2072) were identified using the caregiving status item. Depressive symptoms were assessed using the Patient Health Questionnaire-8 (PHQ-8; score ≥5), a screening measure that does not establish a clinical diagnosis of depression. Backward Wald logistic regression identified the independently associated factors, and predicted probabilities were estimated using PA frequency (PAF) and PSS, stratified by sex. Survey weights and complex sample procedures were not applied. Results: Depressive symptoms were reported by 34.5% of caregivers, and were higher among women than men (37.2% vs. 30.7%). Being female (OR = 1.34) and never or occasionally engaging in PA (OR = 1.82 and 1.54, respectively; reference: very frequently) were associated with higher odds of depressive symptoms, whereas each one-point increase in PSS was associated with lower odds (OR = 0.79). The predicted probabilities were highest among caregivers with poor PSS and no PA and lowest among those with strong PSS and frequent PA. Conclusions: Female sex, lower PSS, and infrequent PA were independently associated with depressive symptoms in this sample of informal caregivers.