Abstract：
BACKGROUND: Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim to analyze whether the association between views of aging and depressive symptoms is influenced by the provision of informal care and its intensity.
METHODS: Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated.
RESULTS: Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age.
CONCLUSIONS: The possibility of reciprocal effects cannot be excluded.
CONCLUSIONS: Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.
METHODS: Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated.
RESULTS: Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age.
CONCLUSIONS: The possibility of reciprocal effects cannot be excluded.
CONCLUSIONS: Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.
摘要：
背景：非正式护理是一种常见的社会支持形式，它的强度可能会有很大的不同。虽然以前对衰老的看法与心理健康有关，我们的目的是分析衰老观点与抑郁症状之间的关联是否受非正式护理的提供及其强度的影响.
方法：使用了美国健康与退休研究的六波数据。该样本包括多达41,058个观察结果，汇集了六波≥50岁的社区居住成年人。抑郁症状采用流行病学研究中心抑郁量表（CESD）和费城老年中心士气量表对自身衰老的态度（ATOA）进行测量（得分越高表示态度积极）；非正式护理（否/是）和护理强度（中度，紧张)进行了调查。具有稳健标准误差的调整后固定效应回归分析，并以护理为调节变量进行计算。
结果：非正式护理与ATOA无关。然而,过渡到强化护理显著缓解了ATOA与抑郁症状之间的关联.较低的抑郁症状与更好的ATOA相关，这种相关性在激烈的护理条件下明显强于非护理条件。在任何形式的护理和主观年龄之间都没有发现明显的交互作用。
结论：不能排除相互影响的可能性。
结论：在提供强化护理的照顾者中，内化年龄歧视和抑郁症状的相关性更强。因此，减少内在化年龄歧视的干预措施尤其对非正式护理人员这一脆弱群体有帮助.
方法：使用了美国健康与退休研究的六波数据。该样本包括多达41,058个观察结果，汇集了六波≥50岁的社区居住成年人。抑郁症状采用流行病学研究中心抑郁量表（CESD）和费城老年中心士气量表对自身衰老的态度（ATOA）进行测量（得分越高表示态度积极）；非正式护理（否/是）和护理强度（中度，紧张)进行了调查。具有稳健标准误差的调整后固定效应回归分析，并以护理为调节变量进行计算。
结果：非正式护理与ATOA无关。然而,过渡到强化护理显著缓解了ATOA与抑郁症状之间的关联.较低的抑郁症状与更好的ATOA相关，这种相关性在激烈的护理条件下明显强于非护理条件。在任何形式的护理和主观年龄之间都没有发现明显的交互作用。
结论：不能排除相互影响的可能性。
结论：在提供强化护理的照顾者中，内化年龄歧视和抑郁症状的相关性更强。因此，减少内在化年龄歧视的干预措施尤其对非正式护理人员这一脆弱群体有帮助.
