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Acute Care Utilization by Dementia Caregivers Within Urban Primary Care Practices
Open accessAbstract
BACKGROUND: Caring for an individual with Alzheimer's dementia (AD) is stressful, and studies show that this stress has an impact on both the physical and mental health of the caregiver. However, many questions remain about the characteristics of AD patients and their caregivers that contribute to this stress and how it impacts caregivers' use of healthcare resources. OBJECTIVE: To study the impact of stress on the physical and mental health of the caregiver. DESIGN: Patients underwent extensive testing to allow description of their degree of cognitive impairment, behavioral and psychological symptoms, medical comorbidities, and functional abilities. Caregivers were assessed for depressive symptoms and also for emergency department (ED) use and hospitalizations in the previous six months. Multivariate logistic regression was used to evaluate impact of patients' dementia symptoms on caregivers' acute care utilization. PARTICIPANTS: One hundred and fifty-three AD patients and their caregivers attending two large, urban, university-affiliated primary care practices were enrolled in a cross-sectional study to examine the facets of dementia caregiving that impact caregiver acute health care utilization. RESULTS: Twenty-four percent of the caregivers had at least one ED visit or hospitalization in the six months prior to enrollment. After adjusting for caregiver age, gender, and education, our logistic regression model found that the caregivers' acute care utilization was associated with their depression as measured by the PHQ-9 (OR 1.09, 95% CI 1.00-1.18), the patients' behavioral and psychological symptoms as measured by the NPI (OR 1.04, 95% CI 1.01-1.08), and the patients' functional status as measured by the ADCS-ADL (OR 1.05, 95% CI 1.01-1.09). CONCLUSION: To improve the health of AD caregivers, a primary care system needs to reallocate resources to manage the functional, behavioral, and psychological symptoms related to the care-recipients suffering from AD.
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“When people with dementia also have depression, behavioral disturbances or low functional status, their caregivers face a higher risk of emergency department visits and hospitalization compared with caregivers of people with dementia alone.525,526”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [525]
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“When people with dementia also have depression, behavioral disturbances or low functional status, their caregivers face a higher risk of emergency department visits and hospitalization compared with caregivers of people with dementia without these challenges. 573 , 574”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [573]
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2016 Alzheimer's disease facts and figures
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2013 Alzheimer's disease facts and figures
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2023 Alzheimer's disease facts and figures
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2024 Alzheimer's disease facts and figures
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Metadata
- Authors
- Schubert, C. C., Boustani, M., Callahan, C. M., Perkins, A. J., Hui, S., & Hendrie, H. C.
- Affiliations
- Indiana University School of Medicine (US)
- Regenstrief Institute (US)
- Corresponding author
- Boustani, Malaz
- Venue
- Journal of General Internal Medicine
- Published
- 2008-08-09
- Volume
- 23
- Issue
- 11
- Pages
- 1736-1740
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2585674
- OpenAlex
- W2102192683
- Cited by
- 107
- References
- 34
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 8 · 2017: 7 · 2016: 6 · 2015: 10 · 2014: 14 · 2013: 10 · 2012: 3
- FWCI
- 4.45
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of General Internal Medicine (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (R01 HS10884-01, R01 HS010884)
- National Institute on Aging (K23 AG 26770-01, K23AG026770)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Keywords
- Alzheimer's disease, dementia caregiving, caregiver stress, caregiver depression, acute care utilization, emergency department visits, hospitalization, behavioral and psychological symptoms, functional status, primary care, caregiver health
- MeSH terms
- Academic Medical Centers, Aged, Aged, 80 and over, Cross-Sectional Studies, Dementia, Depression, Emergency Medical Services, Female, Hospitalization, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Quality of Life, Urban Population, Odds Ratio, Caregivers
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