Birth Cohort Differences in Family Care Availability among U.S. Older Adults

Xueqing Wang , University of Michigan
Bingxin Chen, University of Michigan
Hwajung Choi, University of Michigan

In the United States, family members provide most long-term care for older adults, yet demographic shifts like declining marriage rates, lower fertility, and greater geographic mobility have altered family structures across birth cohorts, potentially reducing caregiver availability as later birth cohorts enter old age. We examine how family care availability (FCA) differs across birth cohorts among older adults, with particular attention to those at high risk for Alzheimer's disease and related dementias (ADRD). Using the Health and Retirement Study (2006-2020), we developed a novel FCA measure integrating network size, spatial proximity, health status of potential caregivers, and competing demands. Comparing four birth cohorts (pre-1920-1930, 1930-1940, 1940-1950, 1950-1960) stratified by age group (60-69, 70-79, 80+), we found that FCA declined substantially among adults aged 60-69. This decline occurred despite slight increasing functional limitation prevalence in recent birth cohorts, indicating that changing family structures—particularly declining spouse availability—rather than delayed disability drove the reduction. Similar patterns emerged among those at high risk for ADRD. Thus, more recent cohorts of older adults face substantially reduced family care resources at younger-old ages, with important implications for long-term care policy and planning.

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 Presented in Session P3. Families, Fertility, and the Life Course 3