Older adults with Alzheimer?s Disease and Related Dementias (ADRD) are especially vulnerable to the virus as many of them have comorbidities. Despite the need of frequent hands-on care due to their limitations in physical and cognitive functioning, home care services and institutional care services are limited and challenging during the pandemic. Family care support may mitigate the adverse effect of the pandemic on care utilization of persons with ADRD. However, there is substantial variation in family care availability across populations which may result in unequal consequences of COVID-19. Those with little family care availability (e.g., no spouse or no adult child nearby) are likely to be most vulnerable during the pandemic and may need to rely on institutional care despite the greater health risk. The pandemic has also profoundly impacted the social and economic circumstances of many families (e.g., job loss and home schooling) and consequently, on their care availability for older adults with ADRD. Despite an urgent public health need to address unmet care need for older adults, little is known about changes in family care availability and its influence on care use by persons with ADRD during the COVID-19 pandemic. To address this gap in evidence and hence inform interventions to minimize the adverse consequences of the pandemic on persons with ADRD and their families, the study has the following aims: First, the project will determine the extent to which family care availability (e.g., presence of healthy spouse, presence of adult children coresident or living nearby) moderates the influence of COVID-19 pandemic on care received by persons with ADRD. It will also assess differences in the impact of the pandemic on care utilization by persons with ADRD across demographic and socioeconomic groups. It will use nationally representative longitudinal studies to examine changes in care received by persons with ADRD over time -- including both the pre-pandemic and pandemic period. Newly added survey questions on COVID-19 to these studies will be also examined. Second, it will assess the extent to which COVID-19 pandemic affected family care availability for a person with ADRD and hence changed the care role of each family member and care allocations among family members. To understand family dynamics in caregiving while responding to various challenges during the pandemic, we will use a mixed-methods approach. The proposed aims are within the scope of the parent study (K01AG057820) since they assesse the implications of COVID-19 pandemic for family care availability and its consequences for older persons with ADRD and their family caregivers. Results from the study will inform public health interventions and policy to mitigate adverse consequences of the pandemic and identify vulnerable population groups among older persons with ADRD and their families. 1

Public Health Relevance

Older adults with Alzheimer?s disease and related dementias (ADRD) are especially vulnerable to the COVID- 19 as many of them have both physical and cognitive limitations. The caregiving role of family members ? spouses and adult children- becomes even more important as other home care services are limited during the pandemic and institutional care becomes challenging with greater risks of COVID-19. It is critically important to understand the role of family care resources for mitigating the adverse consequences of the pandemic on healthcare for adults with ADRD and to identify most vulnerable populations who have little care resources. 1

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
3K01AG057820-03S1
Application #
10305099
Study Section
Program Officer
Fazio, Elena
Project Start
2018-09-01
Project End
2023-04-30
Budget Start
2021-03-15
Budget End
2021-04-30
Support Year
3
Fiscal Year
2021
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109