%0 Journal Article %J Am J Psychiatry %D 2004 %T Extent and cost of informal caregiving for older Americans with symptoms of depression. %A Kenneth M. Langa %A Marcia A. Valenstein %A A. Mark Fendrick %A Mohammed U Kabeto %A Sandeep Vijan %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Caregivers %K Comorbidity %K Costs and Cost Analysis %K Depressive Disorder %K Fees and Charges %K Female %K Health Care Costs %K Home Nursing %K Humans %K Longitudinal Studies %K Male %K Personality Inventory %K Workload %X

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.

%B Am J Psychiatry %I 161 %V 161 %P 857-63 %8 2004 May %G eng %N 5 %L pubs_2004_Langa-etal_AJP.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/15121651?dopt=Abstract %4 Depression Symptoms/Caregiving %$ 12252 %R 10.1176/appi.ajp.161.5.857 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2002 %T Informal caregiving for diabetes and diabetic complications among elderly americans. %A Kenneth M. Langa %A Sandeep Vijan %A Rodney A. Hayward %A M.E. Chernew %A Caroline S Blaum %A Mohammed U Kabeto %A David R Weir %A Steven J. Katz %A Robert J. Willis %A A. Mark Fendrick %K Aged %K Aged, 80 and over %K Caregivers %K Cost of Illness %K Costs and Cost Analysis %K Diabetes Complications %K Diabetes Mellitus %K Disabled Persons %K Female %K Health Surveys %K Humans %K Hypoglycemic Agents %K Insulin %K Male %K Time Factors %X

OBJECTIVES: Little is known regarding the amount of time spent by unpaid caregivers providing help to elderly individuals for disabilities associated with diabetes mellitus (DM). We sought to obtain nationally representative estimates of the time, and associated cost, of informal caregiving provided to elderly individuals with diabetes, and to determine the complications of DM that contribute most significantly to the subsequent need for informal care.

METHODS: We estimated multivariable regression models using data from the 1993 Asset and Health Dynamics Among the Oldest Old Study, a nationally representative survey of people aged 70 or older (N = 7,443), to determine the weekly hours of informal caregiving and imputed cost of caregiver time for community-dwelling elderly individuals with and without a diagnosis of DM.

RESULTS: Those without DM received an average of 6.1 hr per week of informal care, those with DM taking no medications received 10.5 hr, those with DM taking oral medications received 10.1 hr, and those with DM taking insulin received 14.4 hr of care (p <.01). Disabilities related to heart disease, stroke, and visual impairment were important predictors of diabetes-related informal care. The total cost of informal caregiving for elderly individuals with diabetes in the United States was between $3 and $6 billion per year, similar to previous estimates of the annual paid long-term care costs attributable to DM.

DISCUSSION: Diabetes imposes a substantial burden on elderly individuals, their families, and society, both through increased rates of disability and the significant time that informal caregivers must spend helping address the associated functional limitations. Future evaluations of the costs of diabetes, and the cost-effectiveness of diabetes interventions, should consider the significant informal caregiving costs associated with the disease.

%B J Gerontol B Psychol Sci Soc Sci %I 57B %V 57 %P S177-86 %8 2002 May %G eng %N 3 %L pubs_2002_Langa_KJGSeriesB.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/11983744?dopt=Abstract %4 Aged, 80 and Over/Caregivers/Cost of Illness/Costs and Cost Analysis/Diabetes Mellitus/Complications/Therapy/Disabled Persons/Female/Health Surveys/Hypoglycemic Agents/Insulin/Support, Non U.S. Government/Support, U.S. Government--non PHS/Support, U.S. Government--PHS/Time Factors %$ 4080 %R 10.1093/geronb/57.3.s177