Implicit attitudes towards older people among paid and unpaid caregivers of older people: a cross-sectional study

Maximiano-Barreto, Madson Alan; Luchesi, Bruna Moretti; Chagas, Marcos Hortes Nisihara

doi:10.1590/1980-5764-DN-2025-0337

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Short Communication • Dement. neuropsychol. 20 • 2026 • https://doi.org/10.1590/1980-5764-DN-2025-0337 linkcopy

Implicit attitudes towards older people among paid and unpaid caregivers of older people: a cross-sectional study

Atitude implícita em relação à pessoa idosa entre cuidadores remunerados e não remunerados de pessoas idosas: um estudo transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

Ageism is a type of prejudice that can be manifested implicitly or explicitly. Implicit ageism has been assessed in different populations (e.g., students and healthcare providers). This form of prejudice can exert an impact on social relationships and the offer of care, as many caregivers (e.g., those of older people) may work with individuals that are not of their interest for various reasons, which can have an impact on both mental health and the quality of care offered to others (e.g., older people).

Objective: To assess implicit attitudes towards older people among paid and unpaid caregivers of older people.

Methods: A cross-sectional study was conducted with 111 paid and unpaid caregivers of older people who reside in the city of São Carlos-SP, Brazil and surrounding region. The caregivers completed data collection instruments addressing implicit attitudes, the impact of providing care, depressive symptoms, sociodemographic characteristics and aspects of the care provided. Based on the score of the implicit attitude test, the caregivers were divided into three groups: “neutral implicit attitudes”, “positive implicit attitudes” and “negative implicit attitudes”.

Results: Women accounted for the vast majority of the sample (91.0%) and age ranged from 19 to 76 years. A total of 63.1% of the paid and unpaid caregivers had negative implicit attitudes towards older people and only 12.6% had positive implicit attitudes.

Conclusion: Caregivers of older people have negative implicit attitudes towards older people. Further studies are needed to investigate the impact of implicit attitudes on the caregiver-recipient relationship.

Keywords:
Brazil; Caregivers; Cross-Sectional Studies; Attitude

Variables		Total (n=111)	Neutral implicit attitudes (n=27)	Positive implicit attitudes (n=14)	Negative implicit attitudes (n=70)	χ²/H	p-value
Sociodemographic
Age (years) ^[IQR]		46 [33-57]	42 [30-57]	44 [34-56]	48 [32-57]	0.34	0.84
Schooling (years) ^[IQR]		12 [12-13]	12 [12-13]	12 [4-12]	12 [11-13]	1.49	0.48
Sex ^{n (%)}	Female	101 (91.0)	24 (88.9)	12 (85.7)	65 (92.9)	0.92	0.63
Sex ^{n (%)}	Male	10 (9.0)	3 (11.1)	2 (14.3)	5 (7.1)	0.92	0.63
Marital status ^{n (%)}	Married	41 (36.9)	15 (55.6)	4 (28.6)	22 (31.4)	5.35	0.07
Marital status ^{n (%)}	Not married	70 (63.1)	12 (44.4)	10 (71.4)	48 (68.6)	5.35	0.07
Skin color ^{n (%)}	White	73 (65.8)	19 (70.4)	10 (71.4)	44 (62.9)	0.72	0.70
Skin color ^{n (%)}	Non-white	38 (34.2)	8 (29.6)	4 (28.6)	26 (37.1)	0.72	0.70
Aspects related to care
Type of caregiver ^{n (%)}	Unpaid	60 (54.1)	14 (51.9)	8 (57.1)	38 (54.3)	0.11	0.95
Type of caregiver ^{n (%)}	Paid	51 (45.9)	13 (48.1)	6 (42.9)	32 (45.7)	0.11	0.95
Resides with care recipient ^{n (%)}	Yes	41 (36.9)	10 (37.0)	6 (42.9)	25 (35.7)	0.26	0.89
Resides with care recipient ^{n (%)}	No	70 (63.1)	17 (63.0)	8 (57.1)	45 (64.3)	0.26	0.89
Duration of care ^[IQR]	Years	3 [1-5]	3 [1-7]	4 [1-5]	3 [0.8-5]	1.61	0.45
	Days per week	6 [4-7]	7 [4-7]	6 [4.75-7]	6 [4-7]	0.02	0.99
	Hours per day	12 [9-16]	12 [8-16]	14 [12-16]	12 [8-16]	0.70	0.71
Clinical
Impact of providing care^a, ^[IQR]		21 [14-30]	21 [15-29]	20 [13-35]	21 [13-31]	0.09	0.96
Depressive symptoms^b, ^[IQR]		6 [2-11]	6 [2-12]	3 [1-13]	6 [2-11]	0.45	0.80
Functional capacity^c, ^[IQR]		29 [19-33]	29 [19-33]	31 [23-33]	28 [19-33]	0.56	0.76
Implicit attitudes^d, ^[IQR]		0.25 [0.01-0.52]	0.01 [-0.04-0.09]†‡	-0.40 [-0.68-0.28]†§	0.43 [0.28-0.61]‡ §	80.62	0.01*

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E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[TFN1] Notes: a: Zarit Burden Inventory (higher scores indicate greater impact of providing care); b: Patient Health Questionnaire (higher scores indicate more depressive symptoms); c: Functional Assessment Questionnaire (higher scores indicate greater dependence); d: Implicit Attitude Test (higher scores indicate greater implicit attitudes); : median; *p≤0.05; IQR: Interquartile range; †‡§: Comparison between groups, Mann-Whitney - U test.