Dementia Caregiving Experiences and Health Across Geographic Contexts by Race and Ethnicity

Tiffany B Kindratt; Dominique L Sylvers; Aya Yoshikawa; Mónika López-Anuarbe; Noah J Webster; Erin D Bouldin

doi:10.1093/geronb/gbac182

Dementia Caregiving Experiences and Health Across Geographic Contexts by Race and Ethnicity

J Gerontol B Psychol Sci Soc Sci. 2023 Mar 13;78(Suppl 1):S48-S58. doi: 10.1093/geronb/gbac182.

Authors

Tiffany B Kindratt¹, Dominique L Sylvers², Aya Yoshikawa³, Mónika López-Anuarbe⁴, Noah J Webster⁵, Erin D Bouldin⁶

Affiliations

¹ Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas, USA.
² Population Studies Center, Institute for Social Research and School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
³ School of Health Promotion and Kinesiology, College of Health Sciences, Texas Woman's University, Denton, Texas, USA.
⁴ Economics Department, Connecticut College, New London, Connecticut, USA.
⁵ Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
⁶ Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.

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.

Keywords: Caregivers; Dementia; Metro; National Study of Caregiving (NSOC); Nonmetro.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Aged
Aging
Caregivers
Dementia*
Ethnicity*
Humans
Minority Groups
Racial Groups

Abstract

Publication types

MeSH terms

Grants and funding