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Financial Toxicity in Dementia Caregiving: Sociodemographic Predictors in a U.S. Nationally Representative Survey
Danielle E. Hart, Brandon Leggins, Clara Sanches, Elan L. Guterman, Winston Chiong. The Gerontologist, 2025-04-08
Topic: Risk, prevention and care in population studies
52.7% of dementia caregivers in the United States experience financial toxicity. Of those, 73.1% endure mild, 25.7% moderate, and 1.2% severe toxicity. 69.5% of Black, 54.1% of Hispanic, and 42.3% of White caregivers report financial toxicity, with prevalence significantly higher in Black caregivers compared to White caregivers (p = .017). Older caregiver age was associated with less financial toxicity (p = .024). Caregiver employment status mediated this effect, with retirement associated with less financial toxicity (p < .001) and unemployment associated with greater financial toxicity (p < .001). DISCUSSION AND Most dementia caregivers in the United States experience financial toxicity, with Black caregivers bearing the highest risk. Older caregiver age protects against financial toxicity, reflecting the relationship between age and employment status.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Hart, D. E., Leggins, B., Sanches, C., Guterman, E. L., & Chiong, W. (2025). Financial Toxicity in Dementia Caregiving: Sociodemographic Predictors in a U.S. Nationally Representative Survey. The Gerontologist. https://doi.org/10.1093/geront/gnaf092
Vancouver
Hart DE, Leggins B, Sanches C, Guterman EL, Chiong W. Financial Toxicity in Dementia Caregiving: Sociodemographic Predictors in a U.S. Nationally Representative Survey. The Gerontologist. 2025. doi:10.1093/geront/gnaf092. PMID: 40200799.
BibTeX
@article{hart2025-40200799,
author = {Hart, Danielle E. and Leggins, Brandon and Sanches, Clara and Guterman, Elan L. and Chiong, Winston},
title = {{Financial Toxicity in Dementia Caregiving: Sociodemographic Predictors in a U.S. Nationally Representative Survey}},
journal = {The Gerontologist},
year = {2025},
doi = {10.1093/geront/gnaf092},
pmid = {40200799},
url = {https://doi.org/10.1093/geront/gnaf092}
}
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Key findings
- 52.7% of dementia caregivers in the United States experience financial toxicity.
- Of those, 73.1% endure mild, 25.7% moderate, and 1.2% severe toxicity. 69.5% of Black, 54.1% of Hispanic, and 42.3% of White caregivers report financial toxicity, with prevalence significantly higher in Black caregivers compared to White caregivers (p = .017).
- Older caregiver age was associated with less financial toxicity (p = .024).
- Caregiver employment status mediated this effect, with retirement associated with less financial toxicity (p < .001) and unemployment associated with greater financial toxicity (p < .001).
- DISCUSSION AND Most dementia caregivers in the United States experience financial toxicity, with Black caregivers bearing the highest risk.
Why it matters
In a nationally representative U.S. survey, 52.7% of dementia caregivers reported financial toxicity, with the highest risk among Black caregivers. This describes a financial burden of caregiving and does not address treating, curing, or preventing dementia.
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Study details
- Effect size52.7%; 73.1%; 25.7%
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Gerontologist) |
| Journal's citation record | 2 / 4 | The Gerontologist: journal h-index 238 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 7 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 6.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Winston Chiong: h-index 27 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40200799) |
| Free to read | 2 / 2 | Free to read |
| Total | 42 / 100 | — |
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