title: Health-care use and cost in dementia caregivers: Longitudinal results from the Predictors Caregiver Study.
abstract: OBJECTIVE
  To examine the effects of caregiver and patient characteristics on caregivers' medical care use and cost.
  
  
  METHODS
  One hundred forty-seven caregiver/patient dyads were followed annually for 6 years in three academic Alzheimer's disease centers in the United States. Logistic, negative binomial, and generalized linear mixed models were used to examine overall effects of caregiver/patient characteristics on caregivers' hospitalizations, doctor visits, outpatient tests and procedures, and prescription and over-the-counter medications.
  
  
  RESULTS
  Patients' comorbid conditions and dependence were associated with increased health-care use and costs of caregivers. Increases in caregiver depressive symptoms are associated with increases in multiple domains of caregivers' health-care use and costs.
  
  
  CONCLUSIONS
  Findings suggest expanding our focus on dementia patients to include family caregivers to obtain a fuller picture of effects of caregiving. Primary care providers should integrate caregivers' needs in health-care planning and delivery. Clinical interventions that treat patients and caregivers as a whole will likely achieve the greatest beneficial effects.
authors.affiliation: Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY, USA. Electronic address: carolyn.zhu@mssm.edu.
authors.forename: Carolyn W
authors.initials: CW
authors.lastname: Zhu
authors.affiliation: Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA; Department of Neurology, Columbia University Medical Center, New York, NY, USA.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Scarmeas
authors.affiliation: Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY, USA; Division of General Internal Medicine, Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Ornstein
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Albert
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA; The Copper Ridge Institute, Sykesville, MD, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Brandt
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Blacker
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA; James J. Peters VA Medical Center, Bronx, NY, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Sano
authors.affiliation: Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA; Department of Neurology, Columbia University Medical Center, New York, NY, USA.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics* / Q000523:psychology*; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D003704:Dementia / Q000191:economics* / Q000628:therapy*; D003710:Demography; D003863:Depression / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014481:United States
keywords: Alzheimer's disease; Caregiving; Cost; Dementia; Longitudinal study; Medical care