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

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.