National estimates of the quantity and cost of informal caregiving for the elderly with dementia.
OBJECTIVE
Caring for the elderly with dementia imposes a substantial burden on family members and likely accounts for more than half of the total cost of dementia for those living in the community. However, most past estimates of this cost were derived from small, nonrepresentative samples. We sought to obtain nationally representative estimates of the time and associated cost of informal caregiving for the elderly with mild, moderate, and severe dementia.


METHODS
Multivariable regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people age 70 years or older (N = 7,443).


METHODS
National population-based sample of the community-dwelling elderly.


METHODS
Incremental weekly hours of informal caregiving and incremental cost of caregiver time for those with mild dementia, moderate dementia, and severe dementia, as compared to elderly individuals with normal cognition. Dementia severity was defined using the Telephone Interview for Cognitive Status.


RESULTS
After adjusting for sociodemographics, comorbidities, and potential caregiving network, those with normal cognition received an average of 4.6 hours per week of informal care. Those with mild dementia received an additional 8.5 hours per week of informal care compared to those with normal cognition (P < .001), while those with moderate and severe dementia received an additional 17.4 and 41.5 hours (P < .001), respectively. The associated additional yearly cost of informal care per case was 3,630 dollars for mild dementia, 7,420 dollars for moderate dementia, and 17,700 dollars for severe dementia. This represents a national annual cost of more than 18 billion dollars.


CONCLUSIONS
The quantity and associated economic cost of informal caregiving for the elderly with dementia are substantial and increase sharply as cognitive impairment worsens. Physicians caring for elderly individuals with dementia should be mindful of the importance of informal care for the well-being of their patients, as well as the potential for significant burden on those (often elderly) individuals providing the care.
Langa
K M
KM
Division of General Medicine, Department of Medicine, the Institute for Social Research, University of Michigan, Ann Arbor, Mich., USA. klanga@umich.edu
Chernew
M E
ME
Kabeto
M U
MU
Herzog
A R
AR
Ofstedal
M B
MB
Willis
R J
RJ
Wallace
R B
RB
Mucha
L M
LM
Straus
W L
WL
Fendrick
A M
AM
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics*; D017281:Cost of Illness; D003704:Dementia / Q000191:economics* / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D012720:Severity of Illness Index; D013997:Time Factors; D014481:United States