Use of cognitive screening among older adults who care for people with dementia: a national survey.

Abstract

Background and objectives: Older adults caring for people with dementia experience substantial burden and bear higher risk of cognitive decline themselves. Little is known on their uptake of cognitive screening.

Research design and methods: Between December 19, 2023, and February 28, 2024, US residents aged 65+ from a nationally representative, probability-based internet panel were surveyed on their experience with cognitive screening in the past 12 months. Self-reported caregiving status, including the health conditions of the care recipients, was collected between 2011 and 2023. Multivariable logistic regression examined the association between the probability of taking a cognitive test and the caregiver status (dementia caregiver, non-dementia caregiver, or non--caregiver), after accounting for the demographics, whether having subjective memory concerns, and whether having a usual source of care.

Results: Among the 2,272 participants (74% of eligibles), 19.7% reported having undergone a cognitive test during a doctor's visit: 25.2% of dementia caregivers, 19.2% of non-dementia caregivers, and 19.1% of non-caregivers. After regression adjustment, dementia caregivers had a 6 percentage points higher rate of screening (adjusted odds ratio [AOR] = 1.44, 95% CI = 1.01, 2.07), whereas no difference was found between non-dementia caregivers and non-caregivers (AOR = 1.03, 95% CI = 0.82, 1.30).

Discussion and implications: This study provides evidence that older dementia caregivers are significantly but only marginally more likely to undergo cognitive screening than their non-dementia caregiver and non-caregiver counterparts, despite their increased risk of cognitive impairment. These findings call for attention to this potential gap in care, and interventions to address the barriers faced by older dementia caregivers.