@article {6918, title = {Extent and cost of informal caregiving for older Americans with symptoms of depression.}, journal = {Am J Psychiatry}, volume = {161}, year = {2004}, month = {2004 May}, pages = {857-63}, publisher = {161}, abstract = {

OBJECTIVE: The purpose of this study was to obtain nationally representative estimates of the additional time and cost associated with informal caregiving for older Americans with depressive symptoms.

METHOD: Data from the 1993 Asset and Health Dynamics Among the Oldest Old Study, a nationally representative survey of people age 70 years or older (N=6,649), were used to determine the weekly hours and imputed costs of informal caregiving for elderly people with no depressive symptoms in the last week, one to three depressive symptoms in the last week, and four to eight depressive symptoms in the last week.

RESULTS: Forty-four percent of survey respondents reported one to three depressive symptoms, and 18\% reported four to eight depressive symptoms. In multivariate regression analyses that adjusted for sociodemographics, caregiver network, and coexisting chronic health conditions, respondents with no depressive symptoms received an average of 2.9 hours per week of informal care, compared with 4.3 hours per week for those with one to three symptoms and 6.0 hours per week for those with four to eight symptoms. Caregiving associated with depressive symptoms in elderly Americans represented a yearly cost of about $9 billion.

CONCLUSIONS: Depressive symptoms in elderly persons are independently associated with significantly higher levels of informal caregiving, even after the effects of major coexisting chronic conditions are adjusted. The additional hours of care attributable to depressive symptoms represent a significant time commitment for family members and, therefore, a significant societal economic cost. Further research should evaluate the causal pathways by which depressive symptoms lead to high levels of caregiving and should examine whether successful treatment of depression reduces the need for informal care.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Caregivers, Comorbidity, Costs and Cost Analysis, Depressive Disorder, Fees and Charges, Female, Health Care Costs, Home Nursing, Humans, Longitudinal Studies, Male, Personality Inventory, Workload}, issn = {0002-953X}, doi = {10.1176/appi.ajp.161.5.857}, author = {Kenneth M. Langa and Marcia A. Valenstein and A. Mark Fendrick and Mohammed U Kabeto and Sandeep Vijan} } @article {6989, title = {Workplace characteristics and work disability onset for men and women.}, journal = {Soz Praventivmed}, volume = {49}, year = {2004}, month = {2004}, pages = {122-31}, publisher = {49}, abstract = {

OBJECTIVES: This paper investigates the association between job characteristics and work disability among men and women in older working ages in the United States. We examine whether the association persists when controlling for major chronic disease experience. We also address whether job characteristics are ultimately associated with the receipt of disability benefits.

METHODS: Data are from the Health and Retirement Survey and are nationally representative of noninstitutionalized persons 51-61 in 1992. Disability onset is estimated using a hazard modeling approach for those working at wave 1 (N = 5,999). A logistic regression analysis of disability benefits is based on a risk set of 525 persons who become work-disabled before the second interview.

RESULTS: Women{\textquoteright}s disability onset and health problems appear less related to job characteristics than men{\textquoteright}s. For men, work disability is associated with stressful jobs, lack of job control, and environmentally hazardous conditions but is not associated with physical demands. Participation in disability benefit programs among those with work disability is unrelated to most job characteristics or health conditions.

CONCLUSIONS: Understanding of the differing process to work disability for men and women and the relationship between work and health by gender is important for current policy development.

}, keywords = {Disabled Persons, Female, Humans, Logistic Models, Male, Middle Aged, Occupational Diseases, Proportional Hazards Models, Retirement, Risk, Sex Factors, Sick Leave, Stress, Psychological, United States, Workers{\textquoteright} compensation, Workload, Workplace}, issn = {0303-8408}, doi = {10.1007/s00038-004-3105-z}, author = {Eileen M. Crimmins and Mark D Hayward} } @article {6715, title = {The prevalence and impact of accommodations on the employment of persons 51-61 years of age with musculoskeletal conditions.}, journal = {Arthritis Care Res}, volume = {13}, year = {2000}, month = {2000 Jun}, pages = {168-76}, publisher = {13}, abstract = {

OBJECTIVE: To provide estimates of the frequency with which persons 51 to 61 years of age with musculoskeletal conditions receive workplace accommodations from their employers and to determine if the receipt of such accommodations is associated with higher rates of employment two years later.

METHODS: The estimates derive from the Health and Retirement Survey, a national probability sample of 8,781 respondents who were interviewed both in 1992 and 1994 and who were between the ages of 51 and 61 years, of whom 5,495 reported one or more musculoskeletal conditions. We tabulated the frequency of accommodations provided in 1992 and then estimated the impact of accommodations and demographic and medical characteristics on 1994 employment status, using logistic regression.

RESULTS: In 1992, about 14.40 million persons aged 51-61 years reported a musculoskeletal condition. Of these, 1.32 million (9.2\%) reported a disability and were employed, the target population for accommodations. Overall, fewer than 1 in 5 persons with musculoskeletal conditions who had a disability and were employed indicated that they had received any form of accommodation on their current jobs. Although no form of accommodation was reported with great frequency, the most commonly used ones included getting someone to help do one{\textquoteright}s job (12.1\%), scheduling more breaks during the work day (9.5\%), changing the time that the work day started and stopped (6.3\%), having a shorter work day (5.6\%), getting special equipment (5.3\%), and changing the work tasks (5.3\%). Persons with one or more accommodations in 1992, however, were no more likely to be working in 1994 than those with none. Only one specific accommodation--getting someone to help do one{\textquoteright}s job--was associated with a higher rate of employment in 1994.

CONCLUSIONS: Receipt of employment accommodations occurred infrequently, and was not generally associated with an improvement in the employment rate of persons with musculoskeletal conditions and disabilities.

}, keywords = {Disabled Persons, Employment, Supported, Female, Health Status, Health Surveys, Humans, Logistic Models, Longitudinal Studies, Male, Middle Aged, Morbidity, Musculoskeletal Diseases, Personnel Turnover, Program Evaluation, Surveys and Questionnaires, United States, Workload, Workplace}, issn = {0893-7524}, doi = {10.1002/1529-0131(200006)13:3<168::aid-anr6>3.0.co;2-r}, author = {Yelin, Edward and Sonneborn, Dean and Laura S. Trupin} }