Dementia Caregiving Experiences and Health Across Geographic Contexts by Race and Ethnicity. (13th March 2023)

• Record Type: Journal Article
• Authors: Kindratt, Tiffany B; Sylvers, Dominique L; Yoshikawa, Aya; López-Anuarbe, Mónika; Webster, Noah J; Bouldin, Erin D
• Editors: Ajrouch, Kristine J
• Is Part Of: Journals of gerontology. Volume 78(2023)Supplement 1
• Page Start: S48
• Page End: S58
• Publication Date: 2023-03-13
• Subjects: Caregivers -- Dementia -- Metro -- National Study of Caregiving (NSOC) -- Nonmetro; Geriatrics -- Periodicals; Gerontology -- Periodicals; Aged -- Periodicals; Aging -- Periodicals; Psychology, Social -- Periodicals; 305.26
• DOI: 10.1093/geronb/gbac182
• Languages: English
• ISSNs: 1079-5014

Abstract

Abstract: Objectives: Few studies have examined how the intersectionality of geographic context and race/ethnicity influences dementia caregiving. Our objectives were to determine whether caregiver experiences and health (a) differed across metro and nonmetro areas and (b) differed by caregiver race/ethnicity and geography. Methods: We used data from the 2017 National Health and Aging Trends Study and National Study of Caregiving. The sample included caregivers ( n = 808) of care recipients ages 65 and older with "probable" dementia ( n = 482). The geographic context was defined as the care recipient's residence in metro or nonmetro counties. Outcomes included caregiving experiences (care situation, burden, and gains) and health (self-rated anxiety, depression symptoms, and chronic health conditions). Results: Bivariate analyses indicated that nonmetro dementia caregivers were less racially/ethnically diverse (82.7% White, non-Hispanic) and more were spouses/partners (20.2%) than their metro counterparts (66.6% White, non-Hispanic; 13.3% spouses/partners). Among racial/ethnic minority dementia caregivers, nonmetro context was associated with more chronic conditions ( p < .01), providing less care ( p < .01), and not coresiding with care recipients ( p < .001). Multivariate analyses demonstrated that nonmetro minority dementia caregivers had 3.11 times higher odds (95% confidence interval [CI] = 1.11–9.00) of reporting anxiety in comparison to metro minority dementia caregivers. Discussion: Geographic context shapes dementia caregiving experiences and caregiver health differently across racial/ethnic groups. Findings are consistent with previous studies that have shown that feelings of uncertainty, helplessness, guilt, and distress are more prevalent among people providing caregiving from a distance. Despite higher rates of dementia and dementia-related mortality in nonmetro areas, findings suggest both positive and negative aspects of caregiving among White and racial/ethnic minority caregivers.