Cognitive Health and Caregiving

What to know

  • About 1 in 10 adults (45 and older) reports worsening memory loss (or cognitive decline) and another 1 in 4 reports caring for someone who has a cognitive impairment.
  • Dementias, like Alzheimer's disease, start with mild memory loss and can lead to an inability to carry on conversations or respond to one's environment.
  • Caregiving can be rewarding, but it can also put a burden on caregivers, at the risk of their own health.
  • As our aging population grows, so does the need for public health strategies to reduce the impact of dementias and raise awareness of caregiving as a public health issue.

More information

Definition details

Population
Adults aged 45 years and older.
Numerator
Adults aged 45 years and older with SCD. Adults who reported confusion or memory loss that is happening more often or is getting worse in the past 12 months were classified as having SCD.
Denominator
All adults aged 45 years and older.
Measure
Prevalence (crude and age-adjusted).
Time Period of Case Definition
Past 12 months.
Summary
Alzheimer’s disease is one of the leading causes of death in the United States.1 SCD, which involves confusion or memory loss, is an early symptom of possible future Alzheimer’s disease and related dementias (ADRD).2 Not all people with these symptoms develop dementia, but many do.2 Public health strategies addressing dementia risk reduction, early detection and diagnosis, and support for dementia caregivers are needed to comprehensively address ADRD at the population level.3,4
Notes
Data are obtained from the Cognitive Decline optional module of the Behavioral Risk Factor Surveillance System. States opting to administer this module vary by year.
Data Source
Behavioral Risk Factor Surveillance System (BRFSS).
Related Objectives or Recommendations
None.
Related CDI Topic Area
None.
Reference 1
National Center for Health Statistics. Leading causes of death. Centers for Disease Control and Prevention. Updated January 18, 2023. Accessed April 5, 2023. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
Reference 2
Subjective cognitive decline — a public health issue. Centers for Disease Control and Prevention. Updated February 27, 2019. Accessed April 5, 2023. https://www.cdc.gov/aging/data/subjective-cognitive-decline-brief.html
Reference 3
Alzheimer’s Disease and Healthy Aging. Centers for Disease Control and Prevention. Updated May 2, 2022. Accessed April 5, 2023. https://www.cdc.gov/aging/index.html
Reference 4
Healthy Brain Initiative: State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map. Centers for Disease Control and Prevention, Alzheimer’s Association; 2018. https://www.cdc.gov/aging/pdf/2018-2023-Road-Map-508.pdf

Population
Adults aged 45 years and older with SCD.
Numerator
Adults aged 45 years and older with SCD who have discussed their confusion or memory loss with a health care professional.
Denominator
Adults aged 45 years and older with SCD.
Measure
Prevalence (crude and age-adjusted).
Time Period of Case Definition
Past 12 months.
Summary
Alzheimer’s disease is one of the leading causes of death in the United States.1 SCD, which involves confusion or memory loss, is an early symptom of possible future Alzheimer’s disease and related dementias (ADRD).2 Not all people with these symptoms develop dementia, but many do.2 If people with SCD talk to a health care provider about their symptoms, it may lead to early diagnosis and treatment.3,4 The earlier dementia is diagnosed, the sooner care can be provided, including building a care team, participating in support services and counseling, addressing other chronic conditions, and better managing medications.5
Notes
Data are obtained from the Cognitive Decline optional module of the Behavioral Risk Factor Surveillance System. States opting to administer this module vary by year.
Data Source
Behavioral Risk Factor Surveillance System (BRFSS).
Related Objectives or Recommendations
Healthy People 2030 objective: DIA-03. Increase the proportion of adults with subjective cognitive decline who have discussed their symptoms with a provider.
Related CDI Topic Area
None.
Reference 1
National Center for Health Statistics. Leading causes of death. Centers for Disease Control and Prevention. Updated January 18, 2023. Accessed April 5, 2023. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
Reference 2
Alzheimer’s disease and healthy aging: subjective cognitive decline — a public health issue. Centers for Disease Control and Prevention. Updated February 27, 2019. Accessed April 5, 2023. https://www.cdc.gov/aging/data/subjective-cognitive-decline-brief.html
Reference 3
Olivari BS, Baumgart M, Lock SL, et al. CDC Grand Rounds: promoting well-being and independence in older adults. MMWR Morb Mortal Wkly Rep. 2018;67(37):1036–1039. doi:10.15585/mmwr.mm6737a4
Reference 4
Olivari BS, Baumgart M, Taylor CA, McGuire LC. Population measures of subjective cognitive decline: a means of advancing public health policy to address cognitive health. Alzheimers Dement. 2021;7(1). doi: 10.1002/trc2.12142
Reference 5
Healthy Brain Initiative: State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map. Centers for Disease Control and Prevention, Alzheimer’s Association; 2018. https://www.cdc.gov/aging/pdf/2018-2023-Road-Map-508.pdf

Population
All adults.
Numerator
Adults who provided regular care to a friend or family member with Alzheimer’s disease, dementia, or other cognitive impairment in the past 30 days.
Denominator
All adults.
Measure
Prevalence (crude and age-adjusted).
Time Period of Case Definition
Past 30 days.
Summary
Although caregiving provides numerous benefits to both caregivers and recipients, it can also negatively impact caregivers’ mental and physical health.1 In addition, caring for a person with Alzheimer’s disease or related dementias can present unique challenges.2 For example, people with dementias may stop recognizing the person who is caring for them, can have trouble sharing their desires and feelings, and may become completely dependent on their caregiver for daily activities such as eating, using the bathroom, and bathing.2 Developing effective public health and clinical interventions to support caregivers for people with dementia can promote their health and improve the care they provide. The 2022 National Strategy to Support Family Caregivers (National Strategy) provides a national vision for recognizing, assisting, including, supporting, and engaging caregivers and includes a goal to “expand data, research, and evidence-based practices to support caregivers.”3
Notes
Data are obtained from the Caregiver optional module of the Behavioral Risk Factor Surveillance System. States opting to administer this module vary by year.
Data Source
Behavioral Risk Factor Surveillance System (BRFSS).
Related Objectives or Recommendations
None.
Related CDI Topic Area
None.
Reference 1
Alzheimer’s disease and healthy aging: caregiving for family and friends — a public health issue. Centers for Disease Control and Prevention. Updated July 30, 2019. Accessed April 5, 2023. https://www.cdc.gov/aging/caregiving/caregiver-brief.html
Reference 2
Alzheimer’s disease and healthy aging: helping Alzheimer’s caregivers. Centers for Disease Control and Prevention. Updated November 1, 2018. Accessed April 5, 2023. https://www.cdc.gov/aging/publications/features/alzheimers_caregivers.html
Reference 3
Recognize, Assist, Include, Support, and Engage (RAISE) Act Family Caregiving Advisory Council, Advisory Council to Support Grandparents Raising Grandchildren. 2022 National Strategy to Support Family Caregivers. Administration for Community Living, US Dept of Health and Human Services; 2022. https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers.pdf

Population
All adults.
Numerator
Adults who provided regular care to a friend or family member with a health condition or disability in the past 30 days.
Denominator
All adults.
Measure
Prevalence (crude and age-adjusted).
Time Period of Case Definition
Past 30 days.
Summary
Although caregiving provides numerous benefits to both caregivers and recipients, it can also negatively impact caregivers’ mental and physical health.1 Developing effective public health and clinical interventions to support caregivers can promote their health and improve the care they provide. The 2022 National Strategy to Support Family Caregivers (National Strategy) provides a national vision for recognizing, assisting, including, supporting, and engaging caregivers and includes a goal to “expand data, research, and evidence-based practices to support caregivers.”.2
Notes
Data are obtained from the Caregiver optional module of the Behavioral Risk Factor Surveillance System. States opting to administer this module vary by year.
Data Source
Behavioral Risk Factor Surveillance System (BRFSS).
Related Objectives or Recommendations
None.
Related CDI Topic Area
None.
Reference 1
Alzheimer’s disease and healthy aging: caregiving for family and friends — a public health issue. Centers for Disease Control and Prevention. Updated July 30, 2019. Accessed April 5, 2023. https://www.cdc.gov/aging/caregiving/caregiver-brief.html
Reference 2
Recognize, Assist, Include, Support, and Engage (RAISE) Act Family Caregiving Advisory Council, Advisory Council to Support Grandparents Raising Grandchildren. 2022 National Strategy to Support Family Caregivers. Administration for Community Living; 2022. https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers.pdf

Resources

Additional Data Sources