O4‐08‐01: UNMET NEEDS AMONG AMERICANS LIVING ALONE WITH DEMENTIA: A POPULATION‐BASED STUDY

An estimated one-third of older US adults with cognitive impairment live alone. Little is known about this vulnerable population's potentially unmet needs for care, including differences by race/ethnicity. We identified older adults living alone with cognitive impairment or probable dementia in the 2014 U.S. Health and Retirement Study (HRS) using cognitive scores and proxy interviews. We applied the Crimmins et al (2011) probabilistic algorithm to classify respondents as living with dementia, cognitive impairment without dementia (CIND), or no cognitive impairment. We estimated the prevalence of a) self-reported limitations in any of six activities of daily living (ADLs) or five instrumental activities (IADLs), and b) unmet need, defined as having at least one I/ADL limitation for which no help was reported. HRS survey weights were applied to reflect the United States (US) community dwelling population age ≥ 55 years in 2014. Weighted estimates indicated 1.1 million US adults (unweighted n=278) aged 55+ lived alone with probable dementia, and another 3.7 million lived alone with CIND (unweighted n=884; Table 1). A larger share of older adults living alone with dementia/CIND belonged to a racial/ethnic minority group compared to those with no cognitive impairment. Nearly half (45%) of older adults living alone with dementia/CIND had ≥1 I/ADL, compared to 23% of those living alone with no cognitive impairment. Older adults living alone with dementia/CIND were more likely to have ≥1 unmet need for I/ADL assistance compared to those without cognitive impairment (32% vs 19%). Unmet needs for assistance were reported by 41% of African Americans, 39% of Latinos, and 26% of whites living alone with dementia/CIND (Table 3).