The Effect of Physical and Cognitive Impairments on Caregiving

TitleThe Effect of Physical and Cognitive Impairments on Caregiving
Publication TypeJournal Article
Year of Publication2020
AuthorsJutkowitz, E, Gozalo, P, Trivedi, A, Mitchell, L, Gaugler, JE
JournalMedical Care
Volume58
Issue7
Pagination601-609
Type of ArticleJournal
ISBN Number0025-7079
KeywordsAlzheimer disease, cognitive impairment, Dementia
Abstract

BACKGROUND: Many older adults receive caregiving; however, less is known about how a change in a care recipient's functional activity limitations [instrumental activities of daily living (IADL) and basic activities of daily living (ADL)] as well as their cognitive impairment influence the amount of caregiving received. METHODS: Using the Health and Retirement Study (2002-2014) we identified community-dwelling respondents with Alzheimer disease and related dementias (ADRD; n=674), cognitive impairment no dementia (CIND; n=530), and no cognitive impairment (n=6126). We estimated a series of two-part regression models to identify the association between care recipients' level of cognitive impairment, change in total number of IADL/ADL limitations and amount of caregiving received. RESULTS: Persons with ADRD received 235.8 (SD=265.6) monthly hours of care compared with 26.0 (SD=92.6) and 6.0 (SD=40.7) for persons with CIND and no cognitive impairment, respectively. An increase in one IADL/ADL limitation resulted in persons with ADRD and CIND receiving 4.90 (95% confidence interval: 3.40-6.39) and 1.43 (95% confidence interval: 0.17-2.69) more hours of caregiving than persons with no cognitive impairment. Increases in total IADL/ADL limitations were associated with persons with ADRD, but not CIND, receiving more days of caregiving and having more caregivers than persons with no cognitive impairment. CONCLUSIONS: Compared with persons with no cognitive impairment, increases in IADL/ADL limitations disproportionally increases the caregiving received for persons with ADRD. Policies and programs must pay attention to functional impairments among those living with ADRD.

DOI10.1097/mlr.0000000000001323
Citation Key10688
PubMed ID32287048
PubMed Central IDPMC7289673
Grant ListU01 AG009740 / AG / NIA NIH HHS / United States