Lynne Gershenson Hodgson

Adult Grandchildren and Their Grandparents: The Enduring Bond

This article presents findings from a national survey of 208 adult grandchildren concerning relationships with their “closest” grandparent. Levels of contact and perceptions of closeness are two indices used to evaluate the strength of the bonds between the cross-generations. The evidence suggests that along these two dimensions, grandchild/grandparent relationships are significant and meaningful. Although there is diversity among the respondents, interaction levels are high for the majority of the sample. Additionally, most respondents report that their relationships with their grandparents are close and enduring. A comparison of ranked means suggests that several factors are related to the strength of the grandchild/grandparent bonds: age, lineage, geographical proximity, the child/parent relationship, and the parent/grandparent relationship. This research provides a new understanding of a significant family role, that of adult grandchild.

Expenditures in caring for patients with dementia who live at home.

OBJECTIVES Given the national interest in progressive dementia, we estimated expenditures incurred in caring for dementia patients who live at home. METHODS Primary caregivers of 264 patients from a university-based memory disorders clinic were interviewed at baseline and asked to keep service use diaries for 6 months; 141 caregivers who returned the diaries are the focus of this report. We examined both formal and informal services (distinguished by whether money was exchanged) and associated expenditures. RESULTS Neither caregivers returning diaries nor their patients differed at baseline from those not returning diaries and their patients. Expenditures incurred over 6 months were extensive for both formal (

Correlates of personal concerns about developing Alzheimer's disease among middle-aged persons.

6986) and informal (

Social Service Interventions for Caregivers of Patients with Dementia: Impact on Health Care Utilization and Expenditures

786) services. Out-of-pocket expenditures were high (e.g., in-home companion or sitter, adult day care, visiting nurse). Multivariable analyses indicated that patients with more severe symptoms of dementia and families with higher incomes reported significantly higher expenditures. CONCLUSIONS The expense of caring for patients with progressive dementia living at home may be higher than previously estimated and frequently involves expenses paid directly by patients and their families.

To test or not to test: Interest in genetic testing for Alzheimer's disease among middle-aged adults

We examine correlates of personal concerns about developing Alzheimers disease (AD) among (1) adult children, 40 to 60 years of age, who have a living pare n t with a diagnosis of probable AD (N = 108), and (2) a matched comparison group of persons with no parental history of AD (N = 150). Using stepwise regression, predictors measuring subjective perceptions of memory functioning, overall family history of AD, knowledge of AD, and sociodemographic characteristics were entered into models for the total sample and each of the subsamples. The results indicate that worries about memory functioning play a consistent role in personal concerns about developing AD across both groups, but that additional pathways to personal concerns differ among individuals having and not having a parent with AD.

Help Seeking for Personal Concerns About Developing Alzheimer’s Disease

An intervention, which had as its primary goal the enhancement of compliance to social work recommendations, was shown to produce extremely high rates of compliance. This report addresses the secondary objective of the study: to evaluate the impact of the intervention on short‐term (ie, 6‐month) health services utilization and expenditures.

Looking for Signs of Alzheimer's Disease

Based on a hypothetical scenario positing 100 percent accuracy in test results, we examined interest in genetic testing for Alzheimers disease (AD) among adult children, 40-60 years of age, who have a living parent with a diagnosis of probable AD (N = 108), and a matched comparison group of persons with no parental history of AD (N = 150). For both groups, planning for the future was the most important reason cited for being tested; lack of good treatment options and concerns about losing health insurance were the most important reasons for not being tested. Hierarchical regression was used to examine the effects of sociodemographic characteristics, subjective perceptions of memory functioning, concerns about having and developing AD, and mastery on interest in being tested. Personal concerns about developing AD and mastery emerged as significant predictors and subsample membership approached significance, although the full model explained just 18 percent of the variance. Because persons in the comparison group were more likely to report an interest in being tested, educational efforts about genetic testing should not be restricted only to family members of persons with a diagnosis of AD.

Alzheimer's disease and symptom-seeking

This study examined the patterns and predictors of help-seeking behavior for personal concerns about developing Alzheimer’s disease (AD) among middle-aged persons. Data were obtained from a survey of two subsamples of 40- to 60-year-old adults with concerns about AD: (a) 99 adult children with a living parent with a diagnosis of probable AD and(b)70 adults in a matched group with no parental history of AD. Descriptive analyses of the types and levels of help seeking show that respondents who are concerned about developing AD take their fears mainly to their informal rather than formal networks. Bivariate and multivariate analyses identified significant correlates of help seeking within three clusters: memory assessment, AD experience, and sociodemographics. The most robust predictors were aspects of AD experience. Understanding the patterns and correlates of help seeking for AD concerns can help health care professionals to develop more effective models of early intervention with implications for early detection of the disease.

Anticipatory dementia and well-being Lynne Gershenson Hodgson, PhD:

This study examined the correlates of symptom-seeking behavior for Alzheimers disease (AD) among middle-aged persons. Symptom seeking, the tendency to search for signs of disease, is one manifestation of an individuals concern about developing AD. The data were obtained from a survey of two subsamples of 40–60 year old adults: 1) 108 adult children with a living parent with a diagnosis of probable AD; and 2) 150 adults in a matched group with no parental history of AD. Bivariate and multivariate analyses were used to identify significant predictors of symptom seeking, which was measured by a composite index comprised of responses from three questions about checking for signs of AD, interpreting signs as symptoms of AD, and soliciting external validation for concerns. Four clusters of predictors were examined: memory assessment, AD experience, sociodemographics, and well-being. Within these clusters, the constellations of significant predictors varied by subsample, but the most robust predictors were aspects of subjective assessments of memory functioning and AD experience. An understanding of the correlates of symptom seeking for AD has implications for early detection of the disease as well as identifying populations under stress from excessive worry about their own future health.

CAREGIVING AND ALZHEIMER'S DISEASE

Descriptive analyses of qualitative data revealed that adult children of parents with Alzheimers disease (AD) engage in symptom-seeking behavior regarding their own health. Responses of two groups of adults, one with (n = 25) and one without (n = 25) a parent with a diagnosis of probable AD, were obtained during individual, face-to-face interviews and were compared. Common theme analysis of open- and closed-ended questions on anxieties about developing AD and symptom recognition identified three dimensions of symptom-seeking behavior: repeatedly checking for signs of AD, interpreting signs as symptomatic of AD, and soliciting external validation for concerns. The adult children of afflicted parents and women engaged in more symptom-seeking behaviors than the comparison group and men. Results may be useful to physicians and other health practitioners in the early detection of AD, and in identifying and caring for populations under stress both from caring for a parent with AD and from excessive worry about their own future health.