Vision difficulty and dementia: economic hardships among older adults and their caregivers.

Autor:	Kumar P; Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, United States., Chung G; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, United States., Garcia-Morales E; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States., Reed NS; Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, United States.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States., Sheehan OC; The Johns Hopkins Center on Aging and Health, Johns Hopkins University, Baltimore, MD, United States.; RCSI Hospital Group, Connolly Hospital, Dublin, Ireland., Ehrlich JR; Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, United States.; Institute for Social Research, University of Michigan, Ann Arbor, MI, United States., Swenor BK; Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, United States.; The Johns University School of Nursing, Johns Hopkins University, Baltimore, MD, United States., Varadaraj V; Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, United States.; The Johns University School of Nursing, Johns Hopkins University, Baltimore, MD, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in epidemiology [Front Epidemiol] 2023 Aug 03; Vol. 3, pp. 1210204. Date of Electronic Publication: 2023 Aug 03 (Print Publication: 2023).
DOI:	10.3389/fepid.2023.1210204
Abstrakt:	Introduction: Limited research has examined the economic impact of vision difficulty (VD) and dementia on older adults and their caregivers. We aimed to determine whether older adults with VD and/or dementia, and their caregivers, face more economic hardships than their counterparts without VD or dementia. Methods: We used cross-sectional data from the 2015 National Health and Aging Trends Study (NHATS), a population-based survey of Medicare beneficiaries, linked to their family/unpaid caregivers from the National Study of Caregiving (NSOC). Regression models characterized the association of VD (self-report), dementia (survey and cognitive assessments), and co-occurring VD and dementia with debt, receiving financial help from relatives, government-based Supplemental Nutrition Assistance Program (SNAP), other food assistance, utility assistance, and caregiver financial difficulty. Results: The NHATS sample included 6,879 community-dwelling older adults (5670 no VD/dementia, 494 VD-alone, 512 dementia-alone, 203 co-occurring VD and dementia). Adults with VD and dementia had higher odds of receiving SNAP benefits (OR = 2.6, 95%CI = 1.4-4.8) and other food assistance (OR = 4.1, 95%CI = 1.8-9.1) than adults without VD/dementia, while no differences were noted for debt, financial help, and utility assistance. Adults with VD-alone had higher odds of debt (OR = 2.1, 95%CI = 1.3-3.2), receiving financial help (OR = 1.7, 95%CI = 1.1-2.5) and other food assistance (OR = 2.7, 95%CI = 1.7-4.3); while adults with dementia-alone had higher odds of debt (OR = 2.8, 95%CI = 1.4-5.5). The NSOC sample included 1,759 caregivers (995 caring for adults without VD/dementia, 223 for VD-alone, 368 for dementia-alone, and 173 for co-occurring VD and dementia). Compared to caregivers of older adults without VD/dementia, caregivers of adults with VD and dementia had higher odds of financial difficulty (OR = 3.0, 95%CI = 1.7-5.3) while caregivers of adults with VD-alone or dementia-alone did not. Discussion: While older adults with VD- or dementia-alone experienced increased economic hardships, disparities in food assistance were amplified among older adults with co-occurring disease. Caregivers of adults with co-occurring disease experienced more financial difficulty than caregivers of adults with a single or no disease. This study highlights the need for interventions across clinical and social services to support the economic wellbeing of our aging population and their caregivers. Competing Interests: The authors VV, BS, and JE declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Kumar, Chung, Garcia- Morales, Reed, Sheehan, Ehrlich, Swenor and Varadaraj.)
Databáze:	MEDLINE
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