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A study of 792 family and unpaid caregivers with cardiovascular conditions found that disrupted sleep, physical limitations, caregiving demands and negative emotions were associated with greater caregiving burden or psychological distress. The findings show associations, not proof that caregiving caused distress, and the researchers say the role of support needs further interpretation.
A study of 792 family and unpaid caregivers with cardiovascular conditions found that disrupted sleep, physical difficulties and caregiving demands were associated with greater burden or psychological distress while caring for older adults living in the community. Published in the Journal of Applied Gerontology, the research highlights caregivers’ own health as a factor providers may need to ask about, but it does not establish that caregiving caused anxiety or depression symptoms.
Led by Kyeung Mi Oh of George Mason University’s College of Public Health, the researchers analyzed data from the National Health and Aging Trends Study and the National Study of Caregiving. Participants reported cardiovascular conditions including hypertension, heart disease or a previous heart attack. Hypertension was reported by 92.3% of the caregivers in the study. Most were 65 or older, 60.9% were women, and nearly half were spouses or partners.
The study assessed perceived caregiving burden and psychological distress, including symptoms of anxiety and depression. Caregivers reporting more disrupted sleep, low energy, reduced leg strength, longer caregiving hours and more negative emotions also reported greater burden. Trouble falling back asleep, breathing problems during sleep and more negative emotions were associated with greater psychological distress.
The authors also reported that caregivers’ own health and well-being appeared more closely tied to burden and distress than the health conditions of the person receiving care. Greater caregiving burden was itself associated with greater distress. The study suggests sustained caregiving strain could be one pathway contributing to distress, but its findings describe associations rather than demonstrating cause and effect.
Caregiver Health Enters the Care Discussion
The findings draw attention to people who may be managing their own cardiovascular conditions while providing regular care to an older relative or partner. Sleep disruption, reduced physical functioning and emotional strain can affect day-to-day well-being; the study indicates these factors travel alongside higher reported burden and distress in this group.
Oh said health care providers should ask about caregiving responsibilities and whether they affect sleep, emotional well-being and the ability to manage cardiovascular conditions. Such questions could help identify caregivers who may need further assessment or support. The study does not test a particular intervention, however, and does not show that screening or support changes cardiovascular outcomes.
The reported link between distress and caregiving burden also matters for families and services supporting older adults: the person providing care may have health needs of their own. The results point to a need to consider caregiver well-being alongside the needs of the person receiving care, without treating the study’s associations as a diagnosis or an individual prediction.
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How the Caregiver Study Was Conducted
The research focused on family and unpaid caregivers who had cardiovascular conditions and were caring for older adults living in the community. It drew on two U.S. studies, the National Health and Aging Trends Study and the National Study of Caregiving, rather than a clinical trial that assigned caregivers to different levels of support or caregiving work.
The paper, by Oh and Y. Song, was published in the Journal of Applied Gerontology in 2026. Its measures included caregivers’ reported sleep, physical functioning, emotions and caregiving demands, as well as perceived burden and psychological distress. The study’s results therefore show which reported factors were associated with burden and distress within this sample; they do not establish that those factors caused the outcomes.
Some associations varied across outcomes. Younger caregivers and women reported greater burden. More negative emotions were associated with greater burden and distress, while more positive emotions were associated with lower levels of both. These are group-level findings and do not mean every younger caregiver or woman will experience greater strain.
“Our findings suggest that caregivers’ sleep, physical functioning, emotional well-being, and caregiving demands are important factors associated with caregiving burden and psychological distress.”
— Kyeung Mi Oh, professor in George Mason University’s School of Nursing
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Cause, Support and Individual Risk
The study does not establish whether caregiving demands led to poorer sleep or distress, whether existing health difficulties made caregiving feel more burdensome, or whether both were influenced by other factors. Its findings are associations, not evidence of causation, and do not predict what an individual caregiver will experience.
One finding needs particular caution: greater reported support for caregivers was associated with greater distress. The authors said this should not be interpreted to mean that support causes distress. Caregivers dealing with more difficult circumstances may be more likely to seek or receive help. The available report does not specify which forms of support were measured or explain this association.
The source material also does not provide detailed effect sizes for the reported associations, or establish whether the findings apply to caregivers outside the study population. The results do not test a specific support program or show whether any intervention reduces psychological distress or cardiovascular risk.
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Questions for Care and Research
Oh’s recommendations point to a practical next step for health care conversations: ask patients with cardiovascular conditions whether they provide care, and whether those duties affect sleep, emotional well-being or management of their own condition. The study calls for attention to caregivers who may need additional assessment and tailored support, but it does not set out a specific screening protocol.
Further research would be needed to clarify how caregiving demands, cardiovascular health and distress influence one another over time, and why reported support was associated with greater distress in this sample. It is also not clear from the source report what follow-up studies are planned. People making decisions about cardiovascular or mental health care should consult a qualified health professional.
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Key Questions
What did the study find?
Among 792 unpaid caregivers with cardiovascular conditions, disrupted sleep, physical difficulties, longer care hours and negative emotions were associated with greater burden or psychological distress. The findings do not show that these factors caused distress.
Who took part in the research?
The study examined family and unpaid caregivers with conditions including hypertension, heart disease or a previous heart attack who cared for older adults living in the community. Most participants were 65 or older, and 60.9% were women.
Does the study show that caregiving causes anxiety or depression?
No. Researchers found associations with measured psychological distress, which included symptoms of anxiety and depression. The study does not establish cause and effect or provide an individual diagnosis.
Did support make caregivers more distressed?
The study reported an association between more reported support and greater distress, but the authors cautioned that this does not mean support caused distress. People facing harder circumstances may be more likely to seek or receive help.
What do the researchers recommend?
Oh said health care providers should ask whether caregiving responsibilities affect a person’s sleep, emotional well-being or ability to manage cardiovascular conditions. The study did not test a particular support program or treatment.
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