Unmet needs of older spousal caregivers for older adults with chronic obstructive pulmonary disease in the context of dual ageing: a scoping review

Chronic obstructive pulmonary disease (COPD) is highly prevalent in later life and is a major driver of long-term care needs among older adults. In ageing societies, care for older adults with COPD is predominantly provided by spousal caregivers, many of whom are older adults themselves. This situation reflects a context of dual ageing, in which both the care recipient and the caregiver experience age-related vulnerabilities. Despite growing global efforts to promote age-friendly health and social care environments, the unmet needs of older spousal caregivers remain poorly synthesised and are often insufficiently addressed within existing geriatric care models. This scoping review aimed to map and synthesise evidence on the unmet needs of older spousal caregivers of older adults with COPD, with a specific focus on how these needs are shaped within a context of dual ageing. Following Arksey and O’Malley’s framework, we conducted a scoping review of qualitative, quantitative, and mixed-methods studies examining unmet needs among older spousal caregivers of older adults with COPD. A comprehensive search was performed across ten English- and Chinese-language databases, last searched on 30 August 2025. Data were charted and synthesised using a narrative approach, with unmet needs mapped using the International Classification of Functioning, Disability and Health (ICF) framework. Eighteen studies were included. Older spousal caregivers reported multidimensional unmet needs, including psychological and emotional support, role balance, communication with healthcare professionals, information and caregiving skills, gender-specific concerns, and systemic and social support. These needs clustered into six categories across four ICF domains and were shaped by the combined effects of caregiving demands, ageing-related vulnerabilities, and long-term spousal interdependence. Older spousal caregivers of older adults with COPD experience multidimensional unmet needs that are shaped by the context of dual ageing and extend beyond individual caregiving burden to system-level gaps in care. These findings highlight the need for caregiver-inclusive and age-sensitive approaches within age-friendly health and social care environments. The review protocol was registered on the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/RYF3C).