Incident Care Trajectories for Older Adults With and Without Dementia

Objective Despite cross-sectional evidence that persons living with dementia receive disproportionate hours of care, studies of how care intensity progresses over time and differs for those living with and without dementia have been lacking. Method We used the 2011-2018 National Health and Aging Trends Study to estimate growth mixture models to identify incident care hour trajectories (classes) among older adults (N = 1,780). Results We identified 4 incident care hour classes: Low, stable, High, increasing, 24/7 then high, stable, and Low then resolved. The high-intensity classes had the highest proportions of care recipients with dementia and accounted for nearly half of that group. Older adults with dementia were 3-4 times as likely as other older adults to experience one of the 2 high-intensity trajectories. A substantial proportion of the 4 in 10 older adults with dementia who were predicted to be in the Low, stable class lived in residential care settings. Discussion Information on how family caregiving is likely to evolve over time in terms of care hours may help older adults with and without dementia, the family members, friends, and paid individuals who care for them, as well as their health care providers assess and plan for future care needs.

Automated summary

This study used data from 2011 to 2018 and identified different trajectories of incident care hours among older adults. The results showed that older adults with dementia were more likely to experience high-intensity care trajectories compared to other older adults, and a significant proportion of older adults with dementia lived in residential care settings.