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Cited by 2Dementia and Cognitive Impairment ResearchNursing care and researchGeriatric Care and Nursing Homes

Size and Composition of Caregiver Networks Who Manage Medications for Persons Living with Dementia: Cross-Sectional Analysis of the 2011–2022 National Health and Aging Trends Study

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Bratches, Reed WR, Puga, Frank, Barr, Paul J, Leggett, Amanda N, Masel, Meredith, Odom, James Nicholas, Jablonski, Rita·2025·Interactive Journal of Medical Research
DOI 10.2196/64499PMC PMC12121532
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Abstract

Background: Family caregivers commonly help manage medications taken by persons living with dementia. Recent work has highlighted the importance of caregiver networks, which are multiple caregivers managing care for a single person, on managing care for persons living with dementia, especially medication management. However, less is known about the composition of caregiver networks. Objective: The objective of this analysis was to describe the composition of caregiver networks that manage medications, the factors associated with helping with medications within caregiver networks, and whether racial or ethnic differences exist in caregiver network composition. Methods: This cross-sectional secondary analysis used data from the National Health and Aging Trends Study (NHATS) "other person" files from 2011 to 2022. Descriptive statistics were calculated for caregivers who were identified as helping manage medications for a person with dementia. Mixed-effect logistic regression was used to determine factors associated with helping with medications among caregiver networks, with odds ratios converted to predicted probabilities using marginal standardization. A P value of .05 or less was considered statistically significant. Secondary analysis was stratified by race and ethnicity due to identified cultural differences in living situation and overall caregiver network composition. Results: A total of 15,809 caregivers were analyzed. Of those, 3048 (19.2%) managed medications for persons living with dementia. Caregiver networks that manage medications tend to include a spouse or partner and child, at least one of whom has a college degree. Every person with dementia reported at least 1 person who managed their medications. White persons with dementia had an average of 2.4 (range 1-9) people who managed medications, while Black or African American persons with dementia had an average of 2.8 (range 1-9) and Hispanic or Latino persons with dementia had an average of 2.9 (range 1-8) people who managed medications. Spouses were most likely to manage medications across all racial and ethnic groups. In regression modeling, female gender (predicted probability [PP] 15%, 95% CI 13%-17%; P<.001), Black or African American race (PP 7%, 95% CI 4%-10%; P<.001), and Hispanic ethnicity (PP 4%, 95% CI 1%-9%; P=.04) were associated with an increased probability of helping with medications. Conclusions: The size and composition of caregiver networks that manage medications for persons living with dementia differ by race and ethnicity but typically includes at least 2 people, one of whom has a college degree. Helping with medications was more likely among non-White family caregivers, while White patients with dementia were more likely to use paid help to manage medications.

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  • The issue is not a lack of evidence, but a lack of structured implementation pathways, leadership, and policy levers.

    “The issue is not a lack of evidence, but a lack of structured implementation pathways, leadership, and policy levers [7,8,9,10].”

    From Home care comparison (2026) · cites this paper as [8]

    The Introduction and Discussion (Comparison With Prior Literature; page not provided) identify a gap between existing medication-management interventions, which focus on an individual caregiver, and the need to support caregiver networks. The paper does not say that evidence is sufficient or identify a lack of leadership or policy levers as the problem. (LLM, conf=0.78)

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Authors
Bratches, R. W., Puga, F., Barr, P. J., Leggett, A. N., Masel, M., Odom, J. N., & Jablonski, R.
Affiliations
  • University of Alabama at Birmingham (US)
  • Dartmouth College (US)
  • Wayne State University (US)
  • The University of Texas Medical Branch at Galveston (US)
Corresponding author
Bratches, Reed WR
ORCID
Venue
Interactive Journal of Medical Research
Publisher
JMIR Publications Inc.
Published
2025-05-22
Volume
14
Pages
e64499-e64499
ISSN
1929-073X (ISSN-L)
DOI
10.2196/64499
PMC
PMC12121532
OpenAlex
W4410836319
Cited by
2
References
30
Citations by year
2026: 2
FWCI
1.35
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Interactive Journal of Medical Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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
caregiver support networks, dementia, medication management, family caregivers, racial and ethnic differences, spouses, children, caregiver gender, caregiver education, older adults, National Health and Aging Trends Study, living arrangements, caregiver burden, caregiver well-being, caregiver support, caregiver self-care, caregiver role strain

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