Volume 11, Issue 4 p. 444-454
Featured Article

Health-care use and cost in dementia caregivers: Longitudinal results from the Predictors Caregiver Study

Carolyn W. Zhu

Corresponding Author

Carolyn W. Zhu

Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY, USA

Corresponding author. Tel.: 718-584-9000x6146; Fax: 718-741-4211.

E-mail address: [email protected]

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Nikolaos Scarmeas

Nikolaos Scarmeas

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

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Katherine Ornstein

Katherine Ornstein

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

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Marilyn Albert

Marilyn Albert

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA

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Jason Brandt

Jason Brandt

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA

The Copper Ridge Institute, Sykesville, MD, USA

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Deborah Blacker

Deborah Blacker

Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

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Mary Sano

Mary Sano

Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA

James J. Peters VA Medical Center, Bronx, NY, USA

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Yaakov Stern

Yaakov Stern

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

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First published: 17 March 2014
Citations: 84

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.

Discussion

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.