Health‐care use and cost in dementia caregivers: Longitudinal results from the Predictors Caregiver Study
Open accessAbstract
Objective: To examine the effects of caregiver and patient characteristics on caregivers' medical care use and cost. Methods: One hundred forty‐seven caregiver/patient dyads were followed annually for 6 years in three academic Alzheimer's disease centers in the United States. Logistic, negative binomial, and generalized linear mixed models were used to examine overall effects of caregiver/patient characteristics on caregivers' hospitalizations, doctor visits, outpatient tests and procedures, and prescription and over‐the‐counter medications. Results: Patients' comorbid conditions and dependence were associated with increased health‐care use and costs of caregivers. Increases in caregiver depressive symptoms are associated with increases in multiple domains of caregivers' health‐care use and costs. Discussion: Findings suggest expanding our focus on dementia patients to include family caregivers to obtain a fuller picture of effects of caregiving. Primary care providers should integrate caregivers' needs in health‐care planning and delivery. Clinical interventions that treat patients and caregivers as a whole will likely achieve the greatest beneficial effects.
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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.
“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 [526]
The Introduction and Discussion report that an earlier study associated worsening behavioral or psychological symptoms and functional status in people with dementia with caregivers’ acute care, including emergency care and hospitalizations. This paper’s own Results find only a marginally significant association between care recipients’ psychiatric problems and caregiver hospitalization; they do not establish the claimed emergency-department and hospitalization risk for each listed condition, particularly depression. (LLM, conf=0.85)
Experimental — accuracy not yet measuredWhen 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.
“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 [574]
The Introduction and Discussion (pages unavailable) report an earlier study linking worsening behavioral and psychological symptoms and functional status in people with dementia to caregivers’ emergency care and hospitalizations. This paper does not establish that the patients’ depression specifically raises both risks; its own Results link care-recipient psychiatric problems to hospitalization only marginally and do not report an emergency-department finding. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIncreased depressive symptoms among caregivers over time are linked to more frequent doctor visits, increased outpatient tests and procedures, and greater use of over-the-counter and prescription medications.
“Increased depressive symptoms among caregivers over time are linked to more frequent doctor visits, increased outpatient tests and procedures, and greater use of over-the-counter and prescription medications.526”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [526]
Increased depressive symptoms among caregivers are linked to more frequent caregiver doctor visits, increased outpatient tests and procedures, and greater use of over-the-counter and prescription medications.
“Increased depressive symptoms among caregivers are linked to more frequent caregiver doctor visits, increased outpatient tests and procedures, and greater use of over‐the‐counter and prescription medications. 574”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [574]
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- Authors
- Zhu, C. W., Scarmeas, N., Ornstein, K., Albert, M., Brandt, J., Blacker, D., Sano, M., & Stern, Y.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Columbia University Irving Medical Center (US)
- Mount Sinai Hospital (US)
- Johns Hopkins University (US)
- Harvard University (US)
- James J. Peters VA Medical Center (US)
- Corresponding author
- Zhu, Carolyn W.
- ORCID
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2014-03-17
- Volume
- 11
- Issue
- 4
- Pages
- 444-454
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC4164583
- OpenAlex
- W1971554292
- Cited by
- 137
- References
- 53
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 15 · 2023: 13 · 2022: 20 · 2021: 18 · 2020: 10 · 2019: 10 · 2018: 11 · 2017: 12 · 2016: 7 · 2015: 5 · 2014: 1
- FWCI
- 6.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- federal (AG07370, RR00645, U01AG010483)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- dementia caregivers, family caregivers
- MeSH terms
- Aged, Aged, 80 and over, Delivery of Health Care, Dementia, Demography, Depression, Female, Hospitalization, Humans, Longitudinal Studies, Male, Middle Aged, Predictive Value of Tests, Severity of Illness Index, United States, Caregivers, Cost of Illness
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