BACKGROUND: Previous studies of dementia and
family caregiving have focused on individuals
seeking diagnosis and treatment, and have rarely
been conducted in representative community samples.
Identifying demented individuals participating in a
community survey, we determined (a) the factors
associated with demented elderly living alone; (b)
the factors associated with the demented elderly
having caregivers; (c) the factors associated with
increased levels of burden among caregivers of
persons with dementia.
POPULATION AND METHODS:
During an epidemiological survey of a mostly rural
U.S. community, the authors identified 116
noninstitutionalized elderly individuals with
dementia. These individuals were classified into
those living alone and those living with others;
both groups were further classified into those with
and without identifiable family caregivers.
Characteristics of both caregivers and care
recipients were examined.
RESULTS:
Approximately a third of the subjects with dementia
lived alone, and only half of them had caregivers.
The average age of the caregivers was 67.4 years,
and 73% of them were women. Almost half of the
caregivers were spouses, whereas almost a third were
offspring, of the demented individuals. Over two
thirds of caregivers lived with the subjects. Female
caregivers were significantly younger than male
caregivers. Multivariate analyses revealed that
subjects with dementia who were living alone were
independently and significantly more likely to be
women and to have dementias of shorter duration,
lesser severity, and lesser functional impairment
than those living with others. Demented subjects
with caregivers were more likely to have greater
dementia severity, functional impairment, and
cognitive impairment and more current cognitive and
behavioral symptoms than those without caregivers.
Demented subjects whose caregivers reported higher
levels of burden were more likely to be women and to
have greater dementia severity, functional
impairment, and cognitive impairment and more
current symptoms than those whose caregivers had
no/minimal burden.
CONCLUSIONS: These results
draw attention to the problems of persons with
dementia living alone, particularly those without
caregivers. Our data also provide epidemiological
confirmation of previous clinical/volunteer studies
of dementia caregiving, as well as a preliminary
assessment of need in the community at large. Living
arrangements and caregiver issues should be taken
into account when planning services for the elderly.