Informal caregiving for diabetes and diabetic complications among elderly americans.
OBJECTIVE
Little is known regarding the amount of time spent by unpaid caregivers providing help to elderly individuals for disabilities associated with diabetes mellitus (DM). We sought to obtain nationally representative estimates of the time, and associated cost, of informal caregiving provided to elderly individuals with diabetes, and to determine the complications of DM that contribute most significantly to the subsequent need for informal care.


METHODS
We estimated multivariable regression models using data from the 1993 Asset and Health Dynamics Among the Oldest Old Study, a nationally representative survey of people aged 70 or older (N = 7,443), to determine the weekly hours of informal caregiving and imputed cost of caregiver time for community-dwelling elderly individuals with and without a diagnosis of DM.


RESULTS
Those without DM received an average of 6.1 hr per week of informal care, those with DM taking no medications received 10.5 hr, those with DM taking oral medications received 10.1 hr, and those with DM taking insulin received 14.4 hr of care (p <.01). Disabilities related to heart disease, stroke, and visual impairment were important predictors of diabetes-related informal care. The total cost of informal caregiving for elderly individuals with diabetes in the United States was between $3 and $6 billion per year, similar to previous estimates of the annual paid long-term care costs attributable to DM.


CONCLUSIONS
Diabetes imposes a substantial burden on elderly individuals, their families, and society, both through increased rates of disability and the significant time that informal caregivers must spend helping address the associated functional limitations. Future evaluations of the costs of diabetes, and the cost-effectiveness of diabetes interventions, should consider the significant informal caregiving costs associated with the disease.
Langa
Kenneth M
KM
Division of General Medicine, Department of Medicine, University of Michigan, Ann Arbor 48109-0429, USA. klanga@umich.edu
Vijan
Sandeep
S
Hayward
Rodney A
RA
Chernew
Michael E
ME
Blaum
Caroline S
CS
Kabeto
Mohammed U
MU
Weir
David R
DR
Katz
Steven J
SJ
Willis
Robert J
RJ
Fendrick
A Mark
AM
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000191:economics / Q000628:therapy*; D006233:Persons with Disabilities; D005260:Female; D006306:Health Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D013997:Time Factors
D007004:Hypoglycemic Agents; D007328:Insulin