Baby Boomers Who Provide Informal Care for People Living with Dementia in the Community
Abstract
:1. Introduction
2. Methods
2.1. Data Source
2.2. Variables
2.3. Sample of Baby Boomer Caregivers
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Family Caregiver Alliance. Incidence and Prevalence of the Major Causes of Brain Impairment. 2001. Available online: https://www.caregiver.org/incidence-and-prevalence-major-causes-brain-impairment (accessed on 7 July 2021).
- Rajan, K.B.; Weuve, J.; Barnes, L.L.; McAninch, E.A.; Wilson, R.S.; Evans, D.A. Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020–2060). Alzheimer’s Dement. 2021. [Google Scholar] [CrossRef]
- Alzheimer’s Association. Alzheimer’s Disease Facts and Figures. Alzheimer’s Dement. 2020, 16, 391–460. [Google Scholar] [CrossRef]
- DeFries, E.L.; McGuire, L.C.; Andresen, E.M.; Brumback, B.A.; Anderson, L.A. Caregivers of older adults with cognitive impairment. Prev. Chronic Dis. 2009, 6, A46. [Google Scholar]
- Jutkowitz, E.; Gaugler, J.E.; Trivedi, A.N.; Mitchell, L.L.; Gozalo, P. Family caregiving in the community up to 8-years after onset of dementia. BMC Geriatr. 2020, 20, 216. [Google Scholar] [CrossRef] [PubMed]
- Kasper, J.D.; Freedman, V.A.; Spillman, B.C.; Wolff, J.L. The disproportionate impact of dementia on family and unpaid caregiving to older adults. Health Aff. 2015, 34, 1642–1649. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Miyawaki, C.E.; Bouldin, E.D.; Taylor, C.A.; McGuire, L.C. Baby boomers as caregivers: Results from the Behavioral Risk Factor Surveillance System in 44 States, the District of Columbia, and Puerto Rico, 2015–2017. Prev. Chronic Dis. 2020, 17, E80. [Google Scholar] [CrossRef] [PubMed]
- Family Caregiver Alliance. Caregiver Statistics: Demographics. 2019. Available online: https://www.caregiver.org/caregiver-statistics-demographics (accessed on 7 July 2021).
- The National Alliance for Caregiving (NAC) and the AARP Public Policy Institute. Caregiving in the U.S. 2020. Available online: https://www.caregiving.org/caregiving-in-the-us-2020/ (accessed on 7 July 2021).
- Glick, M. Health in 2020 and beyond: What do the numbers tell us? J. Am. Dent. Assoc. 2020, 151, 1–3. [Google Scholar] [CrossRef] [Green Version]
- Frey, W.H. Baby boomers and the new demographics of America’s seniors. Generations 2010, 34, 28–37. [Google Scholar]
- Kim, H.; Lee, S.; Cheon, J.; Hong, S.; Chang, M. A comparative study to identify factors of caregiver burden between baby boomers and post baby boomers: A secondary analysis of a US online caregiver survey. BMC Public Health 2018, 18, 579. [Google Scholar] [CrossRef] [Green Version]
- Quinn, S. Generational Challenges in the Workplace. Generation. 2010. Available online: https://library.ku.ac.ke/wp-content/downloads/2011/08/Bookboon/Human%20Resource/generational-challenges-in-the-workplace.pdf (accessed on 7 July 2021).
- Moon, H.; Dilworth-Anderson, P. Baby boomer caregiver and dementia caregiving: Findings from the National Study of Caregiving. Age Ageing 2015, 44, 300–306. [Google Scholar] [CrossRef] [Green Version]
- Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data; U.S. Department of Health and Human Services, Centers for Disease Control and Prevention: Atlanta, GA, USA, 2015–2018.
- Centers for Disease Control and Prevention. Measuring Healthy Days: Population Assessment of Health-Related Quality of Life; U.S. Department of Health and Human Services: Atlanta, GA, USA, 2000; p. 44. Available online: https://www.cdc.gov/hrqol/pdfs/mhd.pdf (accessed on 7 July 2021).
- National Center for Health Statistics. Technical Notes for Summary Health Statistics Tables: National Health Interview Survey; National Center for Health Statistics: Hyattsville, MD, USA, 2018. Available online: https://www.cdc.gov/nchs/nhis/SHS/tables.htm (accessed on 23 August 2021).
- Xiong, C.; Biscardi, M.; Astell, A.; Nalder, E.; Cameron, J.I.; Mihailidis, A.; Colantonio, A. Sex and gender differences in caregiving burden experienced by family caregivers of persons with dementia: A systematic review. PLoS ONE 2020, 15, e0231848. [Google Scholar] [CrossRef] [Green Version]
- Pinquart, M.; Sörensen, S. Associations of caregiver stressors and uplifts with subjective well-being and depressive mood: A meta-analytic comparison. Aging Ment. Health 2004, 8, 438–449. [Google Scholar] [CrossRef] [PubMed]
- Pinquart, M.; Sörensen, S. Correlates of physical health of informal caregivers: A meta-analysis. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 2007, 62, P126–P137. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Leggett, A.N.; Zarit, S.; Taylor, A.; Galvin, J.E. Stress and burden among caregivers of patients with Lewy Body dementia. Gerontologist 2011, 51, 76–85. [Google Scholar] [CrossRef]
- Karg, N.; Graessel, E.; Randzio, O.; Pendergrass, A. Dementia as a predictor of care-related quality of life in informal caregivers: A cross-sectional study to investigate differences in health-related outcomes between dementia and non-dementia caregivers. BMC Geriatr. 2018, 18, 189. [Google Scholar] [CrossRef] [Green Version]
- Pope, N.D.; Kolomer, S.; Glass, A.P. How women in late midlife become caregivers for their aging parents. J. Women Aging 2012, 24, 242–261. [Google Scholar] [CrossRef] [PubMed]
- O’Reilly, D.; Rosato, M.; Maguire, A. Caregiving reduces mortality risk for most caregivers: A census-based record linkage study. Int. J. Epidemiol. 2015, 44, 1959–1969. [Google Scholar] [CrossRef] [PubMed]
- Gruenewald, T.L.; Dickerson, S.S.; Kemeny, M.E. A social function for self-conscious emotions: The social self preservation theory. In The Self-Conscious Emotions: Theory and Research; Tracy, J.L., Robins, R.W., Tangney, J.P., Eds.; Guilford Press: New York, NY, USA, 2007; pp. 68–87. [Google Scholar]
- Greenwood, N.; Smith, R. Motivations for being informal carers of people living with dementia: A systematic review of qualitative literature. BMC Geriatr. 2019, 19, 169. [Google Scholar] [CrossRef]
- Lee, Y.; Bronstein, L.R. When do Korean-American dementia caregivers find meaning in caregiving? The role of culture and differences between spouse and child caregivers. J. Ethn. Cult. Divers. Soc. Work. 2010, 19, 73–86. [Google Scholar] [CrossRef]
- Miyawaki, C.E. A review of ethnicity, culture, and acculturation among Asian caregivers of older adults (2000–2012). SAGE Open 2015, 5, 2158244014566365. [Google Scholar] [CrossRef]
- Pinquart, M.; Sörensen, S. Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychol. Aging 2003, 18, 250–267. [Google Scholar] [CrossRef] [PubMed]
- Fredman, L.; Doros, G.; Ensrud, K.E.; Hochberg, M.C.; Cauley, J.A. Caregiving intensity and change in physical functioning over a 2-year period: Results of the caregiver-study of osteoporotic fractures. Am. J. Epidemiol. 2009, 170, 203–210. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- McCann, J.J.; Hebert, L.E.; Bienias, J.L.; Morris, M.C.; Evans, D.A. Predictors of beginning and ending caregiving during a 3-year period in a biracial community population of older adults. Am. J. Public Health 2004, 94, 1800–1806. [Google Scholar] [CrossRef] [PubMed]
- Roth, D.L.; Haley, W.E.; Hovater, M.; Perkins, M.; Wadley, V.G.; Judd, S. Family caregiving and all-cause mortality: Findings from a population-based propensity-matched analysis. Am. J. Epidemiol. 2013, 178, 1571–1578. [Google Scholar] [CrossRef] [Green Version]
Variable | Category | Caregivers of Persons with Dementia (PWD) (n = 1661) Weighted % | Caregivers of Persons with Other Conditions (PWOC) (n = 8941) Weighted % | p-Value 1 |
---|---|---|---|---|
Sex | Female | 72.5 | 64.2 | 0.008 |
Age | 50–54 | 20.6 | 24.8 | 0.358 |
55–59 | 25.9 | 26.3 | ||
60–64 | 27.4 | 27.9 | ||
65–72 | 26.1 | 21.0 | ||
Mean Age | Mean (SD) | 60.1 (6.4) | 59.5 (6.5) | 0.155 |
Race/ethnicity | Black only, non-Hispanic | 15.8 | 11.2 | 0.254 |
White only, non-Hispanic | 72.1 | 71.4 | 0.872 | |
Any race, Hispanic | 8.8 | 11.7 | 0.209 | |
Asian or Pacific Islander, non-Hispanic | 1.1 | 1.7 | 0.426 | |
Other race or multiracial, non-Hispanic | 2.3 | 4.0 | 0.093 | |
Education | Less than high school | 4.8 | 10.2 | 0.008 |
High school degree or equivalent | 23.9 | 29.0 | ||
Some college | 41.9 | 36.7 | ||
College graduate | 29.4 | 24.1 | ||
Employment Status | Employed/Self-employed | 49.7 | 49.8 | 0.956 |
Out of work | 5.4 | 5.2 | 0.852 | |
Homemaker | 5.8 | 6.8 | 0.452 | |
Retired | 28.7 | 24.2 | 0.265 | |
Unable to Work | 10.1 | 13.3 | 0.214 | |
Missing | 0.3 | 0.6 | -- | |
Annual Household Income | Less than $15,000 | 6.9 | 10.0 | 0.218 |
$15,000–24,999 | 10.8 | 15.6 | ||
$25,000–49,999 | 21.0 | 22.6 | ||
$50,000–74,999 | 19.4 | 16.1 | ||
$75,000 or more | 30.3 | 25.7 | ||
Missing | 11.7 | 10.1 | -- | |
General Health Status | Excellent, very good or good | 78.7 | 73.1 | 0.100 |
Fair or poor | 21.3 | 26.9 | ||
Frequent Mental Distress | ≥14 days of poor mental health in the past 30 days | 14.7 | 15.5 | 0.660 |
Chronic Health Conditions | Arthritis | 49.7 | 46.0 | 0.340 |
Asthma (current only) | 15.2 | 11.0 | 0.148 | |
Cancer (except skin) | 9.5 | 10.7 | 0.567 | |
Cardiovascular disease 2 | 14.4 | 13.3 | 0.719 | |
Diabetes (except gestational) | 18.6 | 19.3 | 0.810 | |
Chronic obstructive pulmonary disease | 11.7 | 12.7 | 0.751 | |
Any Chronic Condition | At least one of the chronic condition | 65.6 | 66.3 | 0.834 |
Variable | Category | Caregivers of Persons with Dementia (PWD) (n = 1661) % | Caregivers of Persons with Other Conditions (PWOC) (n = 8941) % | p-Value 1 |
---|---|---|---|---|
Relationship of care recipient | Parent or parent-in-law | 72.2 | 42.7 | <0.001 |
Spouse or partner | 10.7 | 29.3 | <0.001 | |
Other relative | 13.5 | 15.7 | 0.635 | |
Non-relative | 3.6 | 12.3 | <0.001 | |
Caregiving Duration | <2 years | 34.2 | 45.1 | 0.002 |
≥2 years | 65.8 | 54.9 | ||
Caregiving Hours | <20 h/week | 54.6 | 56.1 | 0.682 |
≥20 h/week | 45.4 | 43.9 | ||
Helps with Household Tasks | Yes | 91.8 | 90.8 | 0.494 |
Variable | Category | Fair or Poor General Health PR (95% CI) p-Value | Frequent Mental Distress PR (95% CI) p-Value | At least 1 Chronic Condition 1 PR (95% CI) p-Value |
---|---|---|---|---|
Caregiver Type | Caregivers of Persons with Dementia (PWD) | 0.91 (0.69–1.19) 0.478 | 1.04 (0.81–1.34) 0.738 | 1.03 (0.95–1.12) 0.455 |
Caregivers of Persons with Other Conditions (PWOC) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | |
Age | Per year | 0.99 (0.98–1.01) 0.399 | 0.97 (0.96–0.99) 0.001 | 1.02 (1.01–1.02) <0.001 |
Sex | Female | 0.92 (0.78–1.08) 0.301 | 1.39 (1.13–1.70) 0.002 | 1.00 (0.94–1.07) 0.914 |
Male | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | |
Highest education level | High school degree or less | 1.69 (1.42–2.02) <0.001 | 1.14 (0.92–1.41) 0.225 | 1.11 (1.04–1.18) 0.002 |
Some college or more | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | |
Race/ethnicity category | White, non-Hispanic | 0.81 (0.67–0.97) 0.024 | 1.51 (1.19–1.91) 0.001 | 1.01 (0.92–1.11) 0.811 |
All other groups | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | |
Care recipient relationship to caregiver | Parent | 0.72 (0.59–0.87) 0.001 | 0.71 (0.58–0.87) 0.001 | 0.88 (0.82–0.95) <0.001 |
Non-parent (other relative or friend) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | |
Duration of care | <2 years | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
≥2 years | 1.27 (1.07–1.51) 0.007 | 1.05 (0.86–1.29) 0.632 | 1.04 (0.98–1.12) 0.103 | |
Average hours of care per week | <20 h | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
≥20 h | 1.40 (1.18–1.67) <0.001 | 1.54 (1.25–1.89) <0.001 | 1.04 (0.98–1.11) 0.206 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Miyawaki, C.E.; Bouldin, E.D.; Taylor, C.A.; McGuire, L.C. Baby Boomers Who Provide Informal Care for People Living with Dementia in the Community. Int. J. Environ. Res. Public Health 2021, 18, 9694. https://doi.org/10.3390/ijerph18189694
Miyawaki CE, Bouldin ED, Taylor CA, McGuire LC. Baby Boomers Who Provide Informal Care for People Living with Dementia in the Community. International Journal of Environmental Research and Public Health. 2021; 18(18):9694. https://doi.org/10.3390/ijerph18189694
Chicago/Turabian StyleMiyawaki, Christina E., Erin D. Bouldin, Christopher A. Taylor, and Lisa C. McGuire. 2021. "Baby Boomers Who Provide Informal Care for People Living with Dementia in the Community" International Journal of Environmental Research and Public Health 18, no. 18: 9694. https://doi.org/10.3390/ijerph18189694