RACIAL/ETHNIC DISPARITIES IN THE HEALTH OF SPOUSAL CAREGIVERS FOR PERSONS WITH AND WITHOUT DEMENTIA

Abstract

Alzheimer’s disease and other dementias (ADRD) causes memory loss, reduces ability to communicate and changes personality and behavior thus requiring intensive levels of care that is most often provided by family members. Evidence from cross-sectional studies suggests caregiving for persons with ADRD is associated with adverse health outcomes. The study examined biennial data on white, black and Hispanic respondents and their spouses from the nationally representative Health and Retirement Study, 1998 to 2012. We used mixed-effect logistic regression to estimate the change in a person’s depressive symptoms and self-reported health from before to after onset of dementia of his/her spouse and differences across caregivers and non-caregivers. Black and Hispanics caregivers had higher rates of depressive disorder and poor health compared to whites even before onset of a spouse’s dementia and the take-up of caregiving tasks. Onset of dementia in a spouse was associated with higher odds of onset of depressive disorder (OR=1.61, p<0.001) and poor health (OR=1.16, p<0.011). Constant across race, becoming a spousal caregiver, was associated with higher odds of onset of depressive disorder (<20hours per week: OR=1.47, p<0.001; and high hours of care ≥20 hours per week: OR=1.80, p<0.001) and transitions into poor health (<20hours per week: OR=1.16, p<0.001) relative to non-caregivers. Clinical attention to the health of persons with a spouse with dementia is warranted for both caregivers and non-caregivers. High rates of depressive disorder and poor health, and increased risk of new onset among Hispanics compared to whites reveal racial disparities and mandate culturally informed interventions.