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Grandparent caregiving and cognitive functioning among older people: evidence from Korea

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Abstract

Caregiving for grandchildren is becoming common and plays an important role in the childcare system in many countries. This study examines whether caregiving for grandchildren has a causal effect on grandparents’ cognitive functioning, using a longitudinal survey of older Koreans. To assess the causal relationship, we estimate a fixed-effects instrumental variable model by using the presence of a married child and a child aged 31–40 years as instruments. The estimation results reveal that caregiving for grandchildren significantly improves grandparents’ cognitive functioning. Caregiving for grandchildren is predicted to improve global cognitive functioning score by 30.05%, orientation score by 19.85%, delayed recall score by 95.58%, and language ability score by 30.10%. In addition, the effect of grandparent caregiving is salient among females as well as lower-income and less educated groups. Our findings suggest that caregiving for grandchildren, which is one of the most common forms of informal care, may play a complementary role to formal care.

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Notes

  1. We consider some other candidates—the number of children, widowhood status, and divorce status—that are related to family structure in an attempt to find exogenous instruments besides the presence of married children (Z1) and children aged 31 to 40 years (Z2). However, we find that those candidates do not strongly predict the probability of caregiving.

  2. Even though the variable indicating grandparents’ caregiving status is binary, we implement linear regression to estimate the first-stage regression. It has been documented that even when the dependent variable in the first stage regression is binary, employing a linear model specification does not cause serious complications (Angrist and Pischke 2008; Kelejian 1971).

  3. We use the presence of married children instead of the number of married children as an instrumental variable because the probability of caregiving for grandchildren is not a monotonic increasing function of the number of married children. Table 9 shows how the ratio of grandparents who provide caregiving for grandchildren varies by the number of married children. The ratio of caregivers increases by 0.034 when the number of married children increases from 0 to 1. However, it does not significantly increase when the number of married children increases from 1 to 2 and from 4 to 5. Even though the ratios of caregivers significantly decrease when the number of married children increases from 2 to 3 (−0.009) and from 3 to 4 (−0.011), these values are notably smaller than 0.034.

  4. Minimum and maximum scores of each domain are in parentheses.

  5. Among the variables described in Table 1, outcomes (cognitive functioning) and time-varying independent variables (e.g., income, participation in social groups, age) are measured in each survey wave. Time-invariant independent variables are all measured in the first wave except for the working status of women in the year of child’s birth. We included the initial values of ADL/IADL and chronic disease from the first wave due to the possibility that caregiving for grandchildren affects ADL/IADL and chronic disease. Also, respondents’ educational attainment rarely changes, since the KLoSA is a survey of people aged 45 years or older. Therefore, we included respondents’ educational attainment from the first wave.

  6. In the KLoSA, there is another question that is slightly different from the above: “Have you taken care of any of your grandchildren before he/she reached the age of 10 years?” This question does not ask about the timing of caregiving for grandchildren. Once we use responses to this question, the ratio of caregiving for grandchildren increases from 2.4% to 5.1%, whereas the ratio of caregiving for grandchildren among respondents who have at least one grandchild increases from 3.4% to 7.3%. Also, another panel dataset from Korea, the Korean Retirement and Income Study (KReIS), shows that the ratios of caregiving for grandchildren were 4.9% in 2011 and 6% in 2013 among respondents who have at least one grandchild. Even though we found that the ratio of caregiving for grandchildren in the KLoSA is not relatively low compared with those of other surveys, it is quite low in terms of absolute value, thereby requiring caution in interpretation.

  7. The following chronic diseases are included: (1) high blood pressure; (2) diabetes; (3) cancer or malignant tumor; (4) lung disease; (5) liver disease; (6) heart disease; (7) cerebrovascular disease; (8) emotional, nervous, or psychiatric problem; and (9) arthritis or rheumatism.

  8. The Staiger-Stock rule of thumb is applicable when the model has one endogenous regressor and one or two instrumental variables. Stock and Yogo (2002) went into more detail and provided various critical values for the weak instrument tests on the basis of the number of endogenous and instrumental variables. The critical values are smaller than 20 when the number of endogenous variable is one and the number of instrumental variables is two.

  9. The IV estimates from our analysis can be interpreted as the local treatment effect. It is the average treatment effect for individuals whose treatment status are most influenced by the instruments (Imbens and Angrist 1994). In our analysis, IV (FE-IV) estimates substantively capture the effect of grandparent caregiving on respondents who provided care for their grandchildren mainly because they had married children or children aged 31–40 years. Therefore, if the characteristics of individuals whose treatment status is most influenced by instruments are substantially different from other groups, it is possible that IV and FE-IV estimates are quite different from OLS estimates. It turns out that the respondents who have married children or children aged 31–40 years are more likely to be female, old, and retired than the respondents who have neither. Detailed statistics are available upon request.

  10. Lower education level denotes high school or less, and higher education level denotes college or more. We categorized respondents’ education level in this manner because it is well documented that college education induces differences in many respects (Brand and Davis 2011; De Walque 2007; Hout 2012).

  11. Prior to estimating the IV model, we implemented a naïve OLS regression to investigate whether the associations between caregiving for grandchildren and cognitive functioning change substantially by excluding those without grandchildren. As shown in Table 14, the estimation results are not sensitive to the sample selection based on whether the individuals have grandchildren.

  12. The value of the first stage F-statistic from the FE-IV estimation using a single IV is 1.90, which is much smaller compared with the criterion proposed by Staiger and Stock (1997), and the standard errors are very large. The estimation results are available upon request.

  13. Typically, in previous studies, formal care includes daycare centers and kindergartens, and informal care includes personal care such as babysitters, relatives, non-relatives, and siblings (Bernal and Keane 2011; Del Boca et al. 2014; Herbst 2013). We follow this convention herein: i.e., formal care includes daycare centers and kindergartens but does not include personal care such as babysitters.

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Acknowledgements

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2017S1A3A2066494).

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  1. School of Economics, Sogang University, Seoul, Korea

    Taehyun Ahn & Kyong Duk Choi

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Appendix

Appendix

Figure 2 and Tables 7–14

Fig. 2
figure 2

Patterns of cognitive functioning scores with age

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Table 7 Cognitive functioning by domain
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Table 8 Sample mean test: ratio of grandparent caregiving and K-MMSE score by demographic characteristics
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Table 9 Sample mean test: ratio of caregiving for grandchildren by the number of married children
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Table 10 Cognitive functioning and grandparent caregiving: OLS estimates
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Table 11 Grandparents' caregiving decision: first-stage FE-IV regression
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Table 12 Effects of grandparent caregiving for subgroups (FE-IV estimation)
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Table 13 Cognitive functioning and grandparent caregiving (OLS): sample selection
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Table 14 Cognitive functioning and grandparent caregiving (FE-IV): attrition bias
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Ahn, T., Choi, K.D. Grandparent caregiving and cognitive functioning among older people: evidence from Korea. Rev Econ Household 17, 553–586 (2019). https://doi.org/10.1007/s11150-018-9413-5

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