{"doi":"10.1093/geront/gnaf062","title":"Family Structure and Unmet Care Needs Among Older Adults With and Without Dementia in the United States","abstract":"BACKGROUND AND OBJECTIVES: Family members provide the bulk of assistance to older adults with care needs, but implications of family structure for unmet care needs-and differences when dementia is present-are less clear. RESEARCH DESIGN AND METHODS: We use samples of older adults with care needs from the 2015 National Health and Aging Trends Study (NHATS) and the 2017 Panel Study of Income Dynamics (PSID). We examine 2 measures that indicate whether needs are being met for self-care and mobility activities: having unassisted difficulty with at least one activity (NHATS, PSID) and experiencing any adverse consequences related to a lack of help (NHATS). In NHATS we also combine these to identify individuals with met (no unassisted difficulty; no consequences), self-met (unassisted difficulty only), under-met (any consequence only), and unmet needs (unassisted difficulty, any consequence). RESULTS: Adverse consequences were reported more often among those with dementia (43%) relative to those without (24%); in contrast, unassisted difficulty was reported by fewer older adults with dementia (68%, 70%) than without dementia (85%, 87%). Having more family members was positively associated (OR = 1.039) and having a spouse or partner was inversely associated (OR = 0.700) with experiencing adverse consequences. Having stepchildren was associated with lower odds of having unassisted difficulty (OR = 0.228, 0.531), but greater odds of unmet (relative to met) needs (RRR = 1.610). Most family associations were not moderated by dementia. DISCUSSION AND IMPLICATIONS: Adverse consequences, unassisted difficulty, and unmet need are distinct concepts, and produce different estimates and distinctive relationships with dementia and family structure.","journal":"The Gerontologist","year":2025,"id":520548,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7248,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":638501,"name":"Vicki A. Freedman","orcid":"0000-0002-4604-4207","position":1,"is_corresponding":false},{"id":877503,"name":"Sarah Patterson","orcid":"0000-0002-5040-7576","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-19T02:49:28.470782Z","pmid":"39932438","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}