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Supplemental Data

The Effect of Physical and Cognitive Impairments on Caregiving

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eTable 1. Instrumental Activities of Daily Living and Basic Activity of Daily Living Limitations

ADRD CIND No Cognitive Impairment

Person Observations = 1,098

Instrumental Activities of Daily Living, n (%)

Hot meals 646 (58.8) 159 (8.9) 634 (2.9)

Shopping 687 (62.6) 249 (14.0) 1,088 (4.5)

Phone calls 629 (57.3) 118 (6.6) 256 (1.2)

Medications 512 (46.6) 64 (3.6) 205 (0.9)

Basic Activities of Daily Living, n (%)

Getting across a room 367 (33.4) 208 (11.7) 864 (3.9)

Dressing 466 (42.4) 225 (12.6) 1,428 (6.5)

Bathing 529 (48.2) 200 (11.24) 780 (3.6)

Toileting 293 (26.7) 160 (9.0) 903 (4.1)

Eating 347 (31.6) 82 (4.6) 295 (1.3)

Getting in/out of Bed 317 (28.9) 130 (7.3) 588 (2.7)

ADRD = Alzheimer’s disease and related dementias

CIND = Cognitive impairment no dementia

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eTable 2: Regression Coefficients and Unconditional Marginal Effects from Two-part Model

Hours of Caregiving Received Days of Caregiving Received Number of Caregivers

Part 1:

Logistic Regression

Coefficient

Part 2: Amount of Caregiving

>0 Coefficient

Unconditional Marginal

Effect

Part 1:

Logistic Regression

Coefficient

Part 2: Amount of Caregiving

>0 Coefficient

Effect

Part 1:

Logistic Regression

Coefficient

Part 2:

Amount of Caregiving

>0 Coefficient

Effect

Intercept

-9.51 (-

10.67, -8.35) 3.19 (2.35, 4.03)

-9.40 (- 10.58,

-8.22)

2.57 (2.12, 3.01)

-9.18 (- 10.36, -7.99)

-0.41 (- 0.71, -0.11) Total IADL/ADL

limitations in previous period

0.86 (0.74 0.98)

0.13 (0.11

0.16) 3.98 (3.46 4.5) 0.76 (0.64 0.89)

0.04 (0.03 0.06)

0.62 (0.53 0.71)

0.73 (0.61 0.86)

0.05 (0.04 0.06)

0.04 (0.03 0.04) Total caregiving

received in the previous period

0 (0 0.01) 0 (0 0) 0.03 (0.03 0.04)

0.05 (0.04 0.06)

0.01 (0.01 0.01)

0.06 (0.05 0.06)

0.97 (0.77 1.16)

0.1 (0.08 0.12)

0.06 (0.05 0.07) Change in IADL/ADL

limitations

0.88 (0.78 0.97)

0.19 (0.16 0.23)

5.06 (4.56 5.55)

0.92 (0.82

1.02) 0.1 (0.08 0.12) 0.88 (0.81 0.94)

0.92 (0.82 1.02)

0.08 (0.06 0.09)

0.05 (0.05 0.06) Cognitive impairment

(ref=no cognitive impairment)

CIND 0.36 (0.11

0.61)

0.23 (0.07 0.39)

4.35 (1.96 6.73)

0.36 (0.1 0.62)

0.07 (-0.03 0.17)

0.43 (0.1 0.76)

0.41 (0.16 0.67)

0.02 (-

0.06 0.09) 0.02 (0 0.04)

ADRD 1.38 (0.95 0.71 (0.54 16.95 (13.18 1.24 (0.79 0.26 (0.17 1.85 (1.31 1.37 (0.92 0.01 (- 0.07 (0.04

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1.82) 0.88) 20.72) 1.7) 0.35) 2.39) 1.82) 0.06 0.09) 0.09) IADL/ADL limitations x

cognitive impairment (ref = no cognitive impairment)

CIND -0.11 (-0.26

0.03)

0.02 (-0.04 0.08)

1.43 (0.17, 2.69)

-0.13 (-

0.27 0.02) 0 (-0.03 0.04) 0.04 (-0.12, 0.19)

-0.15 (- 0.29 -0.01)

0 (-0.03 0.03)

0.00 (-0.01, 0.01)

ADRD 0.14 (-0.07

0.36)

-0.01 (-0.05 0.03)

4.90 (3.40, 6.39)

0.18 (-0.04

0.4) -0.02 (-0.04 0) 0.44 (0.20, 0.67)

0.15 (-0.07 0.37)

0 (-0.02 0.02)

0.02 (0.01, 0.03

Age 0.04 (0.03

0.06) 0 (-0.01 0.01) 0.06 (-0.09 0.21)

0.04 (0.03

0.05) 0 (0 0) 0.03 (0.01

0.04)

0.04 (0.03

0.05) 0 (0 0.01) 0 (0 0)

Education 0.01 (-0.03

0.04) 0 (-0.01 0.02) 0.07 (-0.22 0.36)

0 (-0.03

0.04) 0 (0 0.01) 0.01 (-0.02 0.05)

0 (-0.03

0.03) 0 (0 0.01) 0 (0 0)

Female 0.31 (0.14

0.48)

0.18 (0.07 0.28)

3.67 (1.83 5.51)

0.27 (0.1 0.45)

0.11 (0.05 0.16)

0.53 (0.32 0.75)

0.27 (0.09 0.44)

0.06 (0.02 0.11)

0.02 (0.01 0.04) Race (ref=white)

African American 0.09 (-0.19

0.38) 0.05 (-0.1 0.2) 0.46 (-1.73 3.84)

0.11 (-0.18 0.41)

0.05 (-0.04 0.13)

0.25 (-0.12 0.61)

0 (-0.3 0.29)

0.05 (- 0.01 0.11)

0.01 (-0.01 0.03)

Other^a 0.1 (-0.56

0.76)

0.32 (0.06 0.59)

6.95 (0.28 13.62)

0.1 (-0.55 0.76)

0.19 (0.04 0.34)

0.81 (0.02 1.6)

0.1 (-0.56 0.76)

0.05 (- 0.08 0.17)

0.01 (-0.02 0.05) Medicaid (ref=yes)

No 0.36 (0.05

0.67) 0.03 (-0.1 0.17) 1.29 (-1.35 3.93)

0.41 (0.1 0.73)

0.04 (-0.04 0.12)

0.42 (0.05 0.78)

0.35 (0.03 0.67)

0 (-0.06 0.06)

0.01 (-0.01 0.03)

Unknown 0.75 (-0.43

1.93)

-0.12 (-0.57 0.34)

-0.8 (-8.88 7.29)

0.89 (-0.3 2.08)

-0.28 (-0.5 -0.05)

-0.42 (-1.34 0.5)

0.84 (-0.32 2)

-0.01 (- 0.16 0.14)

0.03 (-0.03 0.09) Long-term care

insurance (ref=yes)

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No 0 (-0.21 0.21)

-0.06 (-0.22 0.09)

-1.13 (-3.88 1.62)

-0.01 (- 0.23 0.2)

-0.01 (-0.09 0.07)

-0.05 (-0.37 0.27)

0 (-0.22 0.21)

0.06 (0

0.12) 0.01 (0 0.03)

Unknown -0.03 (-0.61

0.54)

-0.23 (-0.48 0.02)

-3.85 (-7.64 -0.06)

-0.17 (- 0.76 0.43)

0.04 (-0.11 0.19)

0.03 (-0.63 0.69)

-0.1 (-0.69 0.5)

0.05 (- 0.06 0.17)

0.01 (-0.03 0.04) Proxy respondent 1.22 (0.79

1.64) 0.16 (0.03 0.3) 5.18 (2.57 7.79)

1.13 (0.69

1.57) 0.1 (0.03 0.18) 1.05 (0.67 1.42)

1.12 (0.68 1.56)

0.08 (0.01 0.15)

0.06 (0.04 0.08)

Net worth 0 (0 0) 0 (0 0) 0 (0 0) 0 (0 0) 0 (0 0) 0 (0 0) 0 (0 0) 0 (0 0) 0 (0 0)

Marital status

(ref=married/partnered)

Separated /divorced -1.08 (-1.38 -0.78)

-0.46 (-0.67 -0.25)

-9.26 (-12.17 -6.34)

-0.98 (- 1.28 -0.68)

-0.3 (-0.42 -0.19)

-1.52 (-1.87 -1.18)

-1.06 (- 1.36 -0.75)

0.14 (0.06 0.22)

-0.01 (-0.03 0.01)

Widowed -0.83 (-1.03

-0.64)

-0.17 (-0.29 -0.06)

-4.8 (-7.06 -2.53)

-0.74 (- 0.94 -0.54)

-0.14 (-0.2 -0.07)

-0.93 (-1.18 -0.68)

-0.84 (- 1.05 -0.64)

0.2 (0.15

0.25) 0.01 (0 0.02) Never married -0.83 (-1.37

-0.29)

-0.37 (-0.62 -0.12)

-7.74 (-11.41 -4.07)

-0.76 (- 1.31 -0.2)

-0.11 (-0.3 0.08)

-0.84 (-1.54 -0.15)

-0.95 (- 1.55 -0.36)

0.39 (0.23

0.56) 0.05 (0 0.1) Number of children -0.02 (-0.09

0.05)

0.04 (0.01 0.08)

0.78 (0.08 1.48)

-0.02 (- 0.09 0.04)

0.03 (0.01

0.05) 0.09 (0 0.17) -0.03 (-0.1 0.04)

0.03 (0.01

0.04) 0 (0 0.01) Number of married

children

0.09 (0.02 0.17)

-0.06 (-0.1 -0.01)

-0.9 (-1.73 -0.07)

0.09 (0.01 0.17)

-0.02 (-0.05 0.01)

-0.02 (-0.12 0.09)

0.09 (0.01 0.17)

0 (-0.02

0.02) 0 (0 0.01) Number of living

siblings

0.01 (-0.03

0.05) 0 (-0.02 0.02) 0.01 (-0.41 0.43)

0.01 (-0.03

0.05) 0 (-0.01 0.01) 0.01 (-0.05 0.06)

0.01 (-0.03 0.05)

0.01 (0

0.02) 0 (0 0)

*Omitted from the table are the coefficients for the indicator variables for the combination of IADL/ADL limitations and combination of chronic conditions.

a

Other race category includes American Indian, Alaskan Native, Asian, Native Hawaiian, and Pacific Islander.

eTable 3: Effect of Change in IADL, Early ADL, and Late ADL Limitations on Caregiving Outcomes

^a

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Hours of Caregiving Received

Days of Caregiving Received

Number of Caregivers Marginal Effect

(95% CI)

Marginal Effect (95% CI)

IADL limitations

^b

7.60***

(6.72, 8.48)

1.47***

(1.35, 1.59)

0.09***

(0.08, 0.09) Early ADL limitations 3.61***

(2.86. 4.36)

0.67***

(0.58, 0.77)

0.04***

(0.04, 0.05)

Late ADL limitations 3.53***

(2.24, 4.81)

0.46***

(0.28, 0.63)

0.03***

(0.02, 0.04) IADL x cognitive

impairment (ref = no cognitive impairment)

^d

CIND 1.94

(-0.33, 4.21)

-0.04 (0.35, 0.27)

-0.01 (-0.02, 0.01)

ADRD 7.26***

(4.86, 9.66)

0.73***

(0.31, 1.15)

0.02*

(0.00, 0.04) Early ADL x cognitive

^d

CIND -0.31

(-2.20, 1.58)

0.00 (-0.27, 0.27)

0.00

(-0.02, 0.01)

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ADRD 2.73*

(0.47, 4.99)

0.28 (-0.08, 0.64)

0.02*

(0.00, 0.04) Late ADL x cognitive

^d

CIND 4.49*

(0.88, 8.10)

0.39 (-0.11, 0.89)

0.02 (-0.01, 0.05)

ADRD 0.12

(-3.63, 3.88)

-0.23 (-0.87, 0.40)

-0.01 (0.05, 0.03) ADRD = Alzheimer’s disease and related dementias

CIND = Cognitive impairment no dementia IADL = instrumental activities of daily living ADL = basic activities of daily living

*p<0.05; ** p<0.01; *** p<0.001

a

Unconditional marginal effect from the estimated two-part model. In the first part (n=24,530) a logistic regression was estimated to determine if a respondent received >0 caregiving. In the second part (n=2,920), the amount of caregiving received was estimated using a generalized linear model with gamma distribution and log link. In the first part of the two- part model, 340 observations were removed from analyses due to collinearity. All models control for age, gender, years of education, race, Medicaid enrollment, long-term care insurance, net worth, marital status, number of children, number of married children, number of living siblings, if a respondent had a proxy, number of functional activity limitations in previous HRS interview, an indicator for the combination of functional activity limitations in the current and previous interview, an indicator for the combination of chronic conditions in the current and previous interview, and amount of caregiving received (i.e., lag of the outcome) in the prior interview.

b

Marginal effect represents how a change in functional activity limitations, averaged over all persons, effects caregiving received.

c

Marginal effect represents the incremental difference in caregiving received, averaged over all persons, by levels of cognitive impairment.

d

Marginal effect represent the incremental difference in caregiving received by levels of cognitive impairment given a

change in function activity limitations.

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