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Gender differences in spousal caregiver strain and paid service use among dementia caregivers in rural Appalachia
Jyoti Tina Savla, Karen A. Roberto, Leslie A. Fontaine. Frontiers in Public Health, 2025-08-13
Topic: Risk, prevention and care in population studies
Spousal caregivers of persons living with dementia (PLwD) often experience high overload and loneliness due to the intensive and ongoing nature of caregiving for their partner. Paid in-home services, such as assistance with daily household tasks, respite care, or personal care, might help ease caregivers' physical strain; however, it is unclear if these in-home services effectively address loneliness and overload and whether their benefits differ by gender. Guided by the Stress Process Model, we analyzed structured interview data from 61 spousal caregivers living in rural Appalachia. Although husbands reported significantly lower loneliness and overload than wives, the overall use of paid services was similar across husbands and wives. Among those experiencing high stress, however, a higher percentage of husbands used in-home paid services than wives. Logistic regression analyses revealed that greater emotional strain (overload and loneliness) and higher functional impairment of the PLwD were independently associated with increased likelihood of paid service use. Our findings underscore the need for programs and policies to acknowledge emotional strain as a legitimate criterion for eligibility for paid services.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Savla, J. T., Roberto, K. A., & Fontaine, L. A. (2025). Gender differences in spousal caregiver strain and paid service use among dementia caregivers in rural Appalachia. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2025.1620744
Vancouver
Savla JT, Roberto KA, Fontaine LA. Gender differences in spousal caregiver strain and paid service use among dementia caregivers in rural Appalachia. Frontiers in Public Health. 2025. doi:10.3389/fpubh.2025.1620744. PMID: 40880915.
BibTeX
@article{savla2025-40880915,
author = {Savla, Jyoti Tina and Roberto, Karen A. and Fontaine, Leslie A.},
title = {{Gender differences in spousal caregiver strain and paid service use among dementia caregivers in rural Appalachia}},
journal = {Frontiers in Public Health},
year = {2025},
doi = {10.3389/fpubh.2025.1620744},
pmid = {40880915},
url = {https://doi.org/10.3389/fpubh.2025.1620744}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Although husbands reported significantly lower loneliness and overload than wives, the overall use of paid services was similar across husbands and wives.
- Logistic regression analyses revealed that greater emotional strain (overload and loneliness) and higher functional impairment of the PLwD were independently associated with increased likelihood of paid service use.
- Our findings underscore the need for programs and policies to acknowledge emotional strain as a legitimate criterion for eligibility for paid services.
Why it matters
Among 61 spousal caregivers in rural Appalachia, husbands reported lower loneliness and overload than wives, while overall use of paid services was similar. Greater emotional strain and worse functional impairment in the person with dementia were linked to more paid service use.
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Study details
- Evidence strengthLow
How this study scored 39/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 37 of the 96 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Frontiers in Public Health) |
| Journal's citation record | 2 / 4 | Frontiers in Public Health: journal h-index 174 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 5 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Leslie A. Fontaine holds only 2 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 1 / 3 | Virginia Tech: institution h-index 834 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40880915) |
| Free to read | 2 / 2 | Free to read |
| Points | 37 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 37 of the 96 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.3389/fpubh.2025.1620744
- PubMed: 40880915
- Original source →
- Free full text: Frontiers in Public Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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