Caregiving responsibilities, living alone, and mental health among older women during a time of collective stress

J Gerontol B Psychol Sci Soc Sci. 2026 Mar 14:gbag036. doi: 10.1093/geronb/gbag036. Online ahead of print.

ABSTRACT

OBJECTIVES: The prevailing belief is that during times of heightened collective stress, the adverse effects of experiences such as caregiving and living alone on mental health are exacerbated. Whether this is true and the extent to which modifiable contextual factors still buffer their negative effects remain underexplored. Women are often disproportionately affected by the burdens of caregiving, and older adults face added challenges due to age-related social and health vulnerabilities. We examined prospective associations of caregiving responsibilities and living alone with mental health in a cohort of older women and evaluated the role of caregiving-related stress and social support.

METHODS: Longitudinal data were collected in a subsample of women from the Nurses’ Health Study II (n = 27,646; mean age: 67), across seven time points during the COVID-19 pandemic. Participants self-reported caregiving responsibilities and living arrangements. Participants providing care also reported caregiving-related stress levels and social support levels. Seven mental health measures capturing psychological distress and positive psychological functioning were assessed 1-6 times over one year. Analyses accounted for multiple testing and key confounders.

RESULTS: Compared to non-caregivers, caregivers not reporting stress had better mental health across measures (e.g., Odds Ratioanxiety = 0.8, 95% Confidence Interval = 0.75-0.85). Women living alone did not show worse mental health with adequate social support, relative to women living with others and adequately supported.

DISCUSSION: Effects of caregiving responsibilities and living alone are not uniform, even during times of heightened stress. Caregiving stress and social support matter. Overlooking key contextual factors may lead to missed opportunities for prevention and intervention.

PMID:41830438 | DOI:10.1093/geronb/gbag036