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P4‐625: RURAL, URBAN, AND SUBURBAN DIFFERENCES OF FORMAL AND INFORMAL SUPPORT SYSTEMS ON THE PREVALENCE OF CAREGIVER BURDEN IN DEMENTIA AND ALZHEIMER'S‐RELATED CAREGIVERS
Author(s) -
Kezirian Olivia
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.08.174
Subject(s) - dementia , caregiver burden , residence , poisson regression , gerontology , population , family caregivers , medicine , service (business) , psychology , environmental health , demography , disease , business , pathology , marketing , sociology
Background: This study delineates the prevalence ratios of caregiver burden in the doubly burdened population of dementia related caregivers in rural environments. Our aim was to investigate the relationship between formal (congregate meals, home delivered meals, case management services, transportation services, adult daycare services, etc.) and informal (family and friends helping with caregiving) support systems with caregiver burden and determine if the relationship differs by caregiver residence. Methods: Cross sectional study (n1⁄4976 subjects) evaluating caregiver burden by caregiver location and interactions of formal and informal caregiving support. Poisson regression with robust variance was performed to directly approximate prevalence ratios (PR). Possible effect modification was evaluated as interaction coefficients of formal and informal supports by caregiver residence. Results: For the rural population, accessing no services (PR: 1.21, p1⁄40.02) or one service (PR: 1.26, p1⁄40.01) was shown to be associated with a statistically increased prevalence ratio of burden compared to urban caregivers accessing no services. Suburban caregivers who accessed one service (PR: 1.19, p1⁄40.07) showed as statistically increased prevalence ratio of burden compared to urban caregivers accessing no services. Informal support from family or friends was not shown to have a statistically significant relationship with the prevalence caregiver burden. Conclusions: Differences in caregiver burden and formal service utilization exist between urban, suburban and rural populations. Rural and suburban caregivers have a higher prevalence of caregiver burden than their urban counter parts. However, utilization of two or more formal services reduces the prevalence ratio of burden to be not statistically different from an urban caregiver receiving no services. This demonstrates the potential effectiveness and impact of increasing formal services in these populations.