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

Carolyn W. Zhu, Nikolaos Scarmeas, Katherine Ornstein, Marilyn Albert, Jason Brandt, Deborah Blacker, Mary Sano, Yaakov Stern

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)444-454
Number of pages11
JournalAlzheimer's and Dementia
Issue number4
StatePublished - Apr 1 2015


  • Alzheimer's disease
  • Caregiving
  • Cost
  • Dementia
  • Longitudinal study
  • Medical care

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience


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