Incremental Health Care Expenditures of the Spouses of Older Adults With Alzheimer's Diseases and Related Dementias (ADRD)

Chu, Jun; Benjenk, Ivy; Chen, Jie

doi:10.1016/j.jagp.2020.09.020

Cited by 11 publications

(12 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Abundant evidence documents higher rates of and multifactorial contributors to depression among dementia caregivers 6,9,25. Here, 35.1% of all LBD caregivers reported depression—more than triple the rate seen in general Medicare beneficiaries—rising to 54.5% in the 45- to 54-year-old age group, more than double that of some ADAD cohorts 10,13,15. This aligns with Liu’s findings that LBD caregivers had more severe depression than their ADAD counterparts.…”

Section: Discussionsupporting

confidence: 79%

“…Chu et al 13 compared cross-sectional survey data of 849 ADAD spouses and 25,707 controls in the Medicare Expenditure Panel Survey 2003-2017, including selfreported comorbidities and mental health. Self-reported hypertension was higher in the ADAD spousal caregivers than in controls (29.4% vs. 23.0%, P = 0.03), and still higher in our LBD caregivers (38.2%).…”

Section: Hypertensionmentioning

confidence: 99%

“…As a proxy measure of depression, Chu et al 13 found that 46.0% of ADAD spouses and 37.1% of controls rated their mental health as either fair or poor (P <0.01) and Suehs et al 10 reported that ADAD caregivers had a higher prevalence of mood disorders compared with controls (24.2% vs. 15.9%, P < 0.001). Using the Patient Health Questionnaire-9 to measure depression in both DLB and AD caregivers, Liu and colleagues found that DLB caregivers scored worse than AD caregivers (PHQ-9: 3.69 ± 3.79 vs. 1.62 ± 2.06, P < 0.001).…”

Section: Depressionmentioning

confidence: 99%

See 2 more Smart Citations

Family Caregiver Comorbidities in Lewy Body Dementia Versus Alzheimer Disease and Associated Disorders

Fleisher

Moshkovich

Levin

et al. 2022

Alzheimer Disease &Amp; Associated Disorders

View full text Add to dashboard Cite

Background: Family caregivers of people living with dementia have high caregiver strain and poor health consequences. Limited research exists on Lewy body dementia (LBD) caregivers and their specific comorbidities. This study aimed to (1) identify the prevalence of self-reported comorbidities among LBD caregivers and (2) contextualize these findings with historical data on caregivers of persons living with Alzheimer disease and associated disorders (ADADs). Methods: In a national, online survey, LBD family caregivers completed the Self-Administered Comorbidity Questionnaire and we compared these findings with extant literature on ADAD caregiver comorbidities. Results: Among 217 LBD caregivers, 84.3% were female, 39.1% were 64 years old or younger, and 66.8% had >2 years of caregiving experience. Caregivers self-identified as current (83.9%) or former (16.1%) caregivers. The most frequent comorbidities were hypertension (38.2%), depression (35.0%), back pain (34.1%), and arthritis (27.7%). LBD caregivers, particularly younger caregivers, had a higher prevalence of depression compared with ADAD caregivers and older adult populations, and back pain prevalence nearly equivalent to spinal cord injury caregivers. Conclusions: Our study is the first to illustrate and contextualize specific comorbidities among LBD caregivers. Understanding the causality and impact of these conditions will be critical in designing effective interventions to improve the lives of families affected by LBD.

show abstract

Section: Discussionsupporting

confidence: 79%

Section: Hypertensionmentioning

confidence: 99%

Section: Depressionmentioning

confidence: 99%

See 1 more Smart Citation

Family Caregiver Comorbidities in Lewy Body Dementia Versus Alzheimer Disease and Associated Disorders

Fleisher

Moshkovich

Levin

et al. 2022

Alzheimer Disease &Amp; Associated Disorders

View full text Add to dashboard Cite

show abstract

“…Caregivers of a spouse with dementia indicate higher home health care expenditures but lower outpatient expenditures than those who do not have a spouse with dementia, which suggests a possible "substitution" effect and greater referrals to home health care by providers for patients with dementia. 512,513 contributors (a friend or relative who paid for dementia expenses and/or provided care for someone with dementia at least once a month in the prior year), 48% cut back on other spending and 43% cut back on savings due to the out-of-pocket costs of providing help to someone with dementia. 452 Due to care responsibilities in the year prior to the survey, close to 4 in 10 care contributors indicated that the "food they bought just didn't last, and they didn't have money to get more," and 3 in 10 ate less because of care-related costs.…”

Section: Caregiver Employment and Financesmentioning

confidence: 99%

“…Examples include costs of medical care, personal care and household expenses for the person with dementia, and personal expenses and respite services for the caregiver. Caregivers of a spouse with dementia indicate higher home health care expenditures but lower outpatient expenditures than those who do not have a spouse with dementia, which suggests a possible “substitution” effect and greater referrals to home health care by providers for patients with dementia 512,513 . Data from the 2016 Alzheimer's Association Family Impact of Alzheimer's Survey indicated that among care contributors (a friend or relative who paid for dementia expenses and/or provided care for someone with dementia at least once a month in the prior year), 48% cut back on other spending and 43% cut back on savings due to the out‐of‐pocket costs of providing help to someone with dementia 452 .…”

Section: Caregivingmentioning

confidence: 99%

2022 Alzheimer's disease facts and figures

2022

Alzheimer's & Dementia

1,549

664

View full text Add to dashboard Cite

This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes -costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI 700

show abstract

2023 Alzheimer's disease facts and figures

2023

Alzheimer's & Dementia

1,458

425

View full text Add to dashboard Cite

This article describes the public health impact of Alzheimer's disease, including prevalence and incidence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report examines the patient journey from awareness of cognitive changes to potential treatment with drugs that change the underlying biology of Alzheimer's. An estimated 6.7 million Americans age 65 and older are living with Alzheimer's dementia today.This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, and Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated by the COVID-19 pandemic in 2020 and 2021. More than 11 million family members and other unpaid caregivers provided an estimated 18 billion hours of care to people with Alzheimer's or other dementias in 2022. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $339.5 billion in 2022. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes -costs that have been aggravated by COVID-19. Members of the paid health care workforce are involved in diagnosing, treating and caring for people with dementia. In recent years, however, a shortage of such workers has developed in the United States. This shortage -brought about, in part, by COVID-19 -has occurred at a time when more members of the dementia care workforce are needed. Therefore, programs will be needed to attract workers and better train health care teams. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2023 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $345 billion. The Special Report examines whether there will be sufficient numbers of 1598

show abstract

Incremental Health Care Expenditures of the Spouses of Older Adults With Alzheimer's Diseases and Related Dementias (ADRD)

Cited by 11 publications

References 42 publications

Family Caregiver Comorbidities in Lewy Body Dementia Versus Alzheimer Disease and Associated Disorders

Family Caregiver Comorbidities in Lewy Body Dementia Versus Alzheimer Disease and Associated Disorders

2022 Alzheimer's disease facts and figures

2023 Alzheimer's disease facts and figures

Contact Info

Product

Resources

About