The Effect of Physical and Cognitive Impairments on Caregiving
Open accessAbstract
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.
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Each decrease in ADL or IADL function in someone with dementia is associated with nearly five more hours of monthly caregiving than a similar decrease in someone without dementia.
“Each instance of a decrease in ADL or IADL function in someone with dementia results in nearly five more hours of monthly caregiving compared with a similar functional decrease for someone without dementia.459”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [459]
The Results report 4.90 more monthly caregiving hours per additional limitation for people with ADRD compared with people with no cognitive impairment. That estimate applies to the combined IADL/ADL measure, not separately to each type of limitation; the comparison group is also narrower than everyone without dementia. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEach instance of a decrease in ADL or IADL function in someone with dementia results in nearly five more hours of monthly caregiving compared with a similar functional decrease for someone without dementia.
“Each instance of a decrease in ADL or IADL function in someone with dementia results in nearly five more hours of monthly caregiving compared with a similar functional decrease for someone without dementia. 501”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [501]
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- Authors
- Jutkowitz, E., Gozalo, P., Trivedi, A., Mitchell, L., & Gaugler, J. E.
- Affiliations
- Brown University (US)
- Minneapolis VA Health Care System (US)
- University of Minnesota (US)
- Corresponding author
- Jutkowitz, Eric
- Gozalo, Pedro
- Trivedi, Amal
- Venue
- Medical Care
- Published
- 2020-04-13
- Volume
- 58
- Issue
- 7
- Pages
- 601-609
- ISSN
- 0025-7079 (ISSN-L)
- PMC
- PMC7289673
- OpenAlex
- W3015609942
- Cited by
- 25
- References
- 37
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 5 · 2020: 1 · 2019: 1
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Medical Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG060871, R21AG059623, U01AG009740)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- caregiving, informal care, Alzheimer's disease and related dementias, cognitive impairment, instrumental activities of daily living, activities of daily living, older adults, community-dwelling older adults, caregiver burden
- MeSH terms
- Physical Functional Performance, Aged, Aged, 80 and over, Cognition Disorders, Female, Persons with Disabilities, Humans, Male, Geriatric Assessment, Caregivers, Cognitive Dysfunction
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