When Missing Out Matters: Associations Between Social Activity Restriction and Caregiver Burden.

Background: Social engagement is crucial for well-being, yet caregivers often face restrictions due to care responsibilities. The caregiver-specific consequences of these restrictions are underexplored.

Methods: We used cross-sectional data from the National Study of Caregiving (2021), a nationally representative study of 1619 unpaid caregivers of adults aged 65 years and older. Caregivers reported if care responsibilities kept them from participating in four social activities (visiting friends/family, attending religious services, going out for enjoyment, and attending group activities). Caregiver burden (emotional, physical, and/or financial) was self-reported. "Any" burden was defined as reporting at least one of the three types of burden. We performed survey-weighted, multivariable logistic regression to determine the adjusted probability of caregiver burden based on social activity participation.

Results: Caregivers were on average 62.5 (SD 22) years old, 65% female, 53% children of the care recipient, and 73% White. 43% reported at least one form of caregiving burden: 35% emotional, 17% physical, and 9% financial. Caregivers had higher adjusted probabilities of "any" caregiving burden (p < 0.001) if they were kept from going out (88% vs. 62%), visiting family/friends (86% vs. 55%), or engaging in group activities (88% vs. 61%). For missed religious activities, caregivers primarily reported higher burden if they rated the missed activities as "important" versus "unimportant" (Any burden: 85% vs. 57%; Emotional burden: 74% vs. 45%; Physical burden: 65% vs. 29%, p < 0.05). Importance was not significant for other activities. There was a step-wise association between the number of missed activities and any reported burden (0 activities missed: 54%, 1 activity: 77%, 2+ activities: 91%, p < 0.01).

Conclusions: Restriction from social activities was associated with higher caregiver burden, with the impact of missing religious activities influenced by its importance to the caregiver. These findings emphasize the need for tailored interventions to help caregivers maintain social engagement despite care responsibilities.