Economic Burden of Informal Caregiving Associated With History of Stroke and Falls Among Older Adults in the U.S

Am J Prev Med. 2017 Dec;53(6S2):S197-S204. doi: 10.1016/j.amepre.2017.07.020.

Abstract

Introduction: Older adults are at high risk for stroke and falls, both of which require a large amount of informal caregiving. However, the economic burden of informal caregiving associated with stroke and fall history is not well known.

Methods: Using the 2010 Health and Retirement Study, data on non-institutionalized adults aged ≥65 years (N=10,129) in 2015-2017 were analyzed. Two-part models were used to estimate informal caregiving hours. Based on estimates from the models using a replacement cost approach, the authors derived informal caregiving hours and costs associated with falls in the past 2 years for stroke and non-stroke persons.

Results: Both the prevalence of falls overall and of falls with injuries were higher among people with stroke than those without (49.5% vs 35.1% for falls and 16.0% vs 10.3% for injurious falls, p<0.01). Stroke survivors needed more informal caregiving hours than their non-stroke counterparts, and the number of informal caregiving hours was positively associated with non-injurious falls and even more so with injurious falls. The national burden of informal caregiving (2015 U.S. dollars) associated with injurious falls amounted to $2.9 billion (95% CI=$1.1 billion, $4.7 billion) for stroke survivors (about 0.5 million people), and $6.5 billion (95% CI=$4.3 billion, $8.7 billion) for those who never had a stroke (about 3.6 million people).

Conclusions: In U.S. older adults, informal caregiving hours and costs associated with falls are substantial, especially for stroke survivors. Preventing falls and fall-related injuries, especially among stroke survivors, therefore has potential for reducing the burden of informal caregiving.

MeSH terms

  • Accidental Falls / economics*
  • Accidental Falls / prevention & control
  • Accidental Falls / statistics & numerical data
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Caregivers / economics*
  • Cost of Illness*
  • Female
  • Humans
  • Informal Sector
  • Longitudinal Studies
  • Male
  • Patient Care / economics*
  • Patient Care / methods
  • Prevalence
  • Stroke / economics*
  • Stroke / epidemiology
  • Stroke / therapy
  • Survivors / statistics & numerical data
  • United States / epidemiology