Financial toxicity and multidimensional economic strain among dementia caregivers

INTRODUCTION Financial toxicity is an underrecognized but significant burden among caregivers of individuals with Alzheimer's disease and related dementias (ADRD). The interactions among economic hardship, caregiver burden, and social determinants of health (SDOH) remain poorly defined. METHODS We conducted a cross‑sectional survey of 79 ADRD caregivers recruited through the University of Kansas Alzheimer's Disease Research Center. Participants completed the Comprehensive Score for Financial Toxicity (COST) measure, Zarit Caregiver Burden Survey, Resource Utilization in Dementia Questionnaire, and an SDOH assessment. The primary outcome was moderate‑to‑severe financial toxicity (COST ≤ 26). RESULTS Financial toxicity affected 50.6% of caregivers. After adjusting for caregiver age and household income, higher caregiver burden was associated with greater financial toxicity (odds ratio [OR] = 1.12), while older age was associated with lower odds of financial toxicity (OR = 0.93), and low household income was associated with greater financial toxicity compared to high‐income households (OR = 7.63). DISCUSSION Financial toxicity is common among ADRD caregivers and closely linked to burden and socioeconomic disadvantages, underscoring the need for policy and support interventions.