Extent and cost of informal caregiving for older Americans with symptoms of depression.
OBJECTIVE
The purpose of this study was to obtain nationally representative estimates of the additional time and cost associated with informal caregiving for older Americans with depressive symptoms.


METHODS
Data from the 1993 Asset and Health Dynamics Among the Oldest Old Study, a nationally representative survey of people age 70 years or older (N=6,649), were used to determine the weekly hours and imputed costs of informal caregiving for elderly people with no depressive symptoms in the last week, one to three depressive symptoms in the last week, and four to eight depressive symptoms in the last week.


RESULTS
Forty-four percent of survey respondents reported one to three depressive symptoms, and 18% reported four to eight depressive symptoms. In multivariate regression analyses that adjusted for sociodemographics, caregiver network, and coexisting chronic health conditions, respondents with no depressive symptoms received an average of 2.9 hours per week of informal care, compared with 4.3 hours per week for those with one to three symptoms and 6.0 hours per week for those with four to eight symptoms. Caregiving associated with depressive symptoms in elderly Americans represented a yearly cost of about $9 billion.


CONCLUSIONS
Depressive symptoms in elderly persons are independently associated with significantly higher levels of informal caregiving, even after the effects of major coexisting chronic conditions are adjusted. The additional hours of care attributable to depressive symptoms represent a significant time commitment for family members and, therefore, a significant societal economic cost. Further research should evaluate the causal pathways by which depressive symptoms lead to high levels of caregiving and should examine whether successful treatment of depression reduces the need for informal care.
Langa
Kenneth M
KM
Division of General Medicine, University of Michigan Health System, 300 North Ingalls Building, Room 7E01, Box 0429, Ann Arbor, MI 48109-0429, USA. klanga@umich.edu
Valenstein
Marcia A
MA
Fendrick
A Mark
AM
Kabeto
Mohammed U
MU
Vijan
Sandeep
S
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics* / Q000706:statistics & numerical data / Q000600:supply & distribution; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003866:Depressive Disorder / Q000175:diagnosis / Q000191:economics / Q000451:nursing*; D005249:Fees and Charges / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006701:Home Nursing / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010555:Personality Inventory; D016526:Workload / Q000191:economics / Q000706:statistics & numerical data