Health Management Challenges: A Burden for Older US Adults

TOPLINE:

Over 80% of US adults aged 50 years or older reported that managing their health and healthcare was challenging, with some facing great difficulty. Administrative and financial challenges were major factors contributing to this.

Method ：

Researchers conducted a cross-sectional study using the 2022 Health and Retirement Study Treatment Burden Questionnaire to assess how perceived efforts to manage health and healthcare (treatment burden) affect community residents aged 50 or above in the United States. They included 1,795 adults who completed the questionnaire (with an average age of 68.5 years; 56% of women; (75% non-Hispanic white), including 15 projects, covering various fields, including burdens related to medication, appointments, self-monitoring, lifestyle changes, and the impact on interpersonal relationships. Participants rate the level of effort or burden they perceive, ranging from 0 (no burden) to 10 (high burden). The main result is the total treatment burden score, which is calculated by adding up the scores of all 15 items on the questionnaire. A score exceeding the threshold indicates a high burden. The relationship between the treatment burden and various factors, such as age, sociodemographic characteristics, physical and mental health, and functional status, was also evaluated.

 Introduction ：

Overall, 87% of the respondents reported some treatment burden, and 5.4% reported a high burden. The greatest burden of treatment is related to alerting health issues, followed by administrative tasks and financial expenses. Adults aged 50-64 reported higher administrative burdens (58.7% vs. 49.0%), financial burdens (55.6% vs. 39.4%), and difficulties in scheduling appointments (37.1% vs. 26.2%) than those aged 65 or above (P < 0.05). They also experienced a greater burden due to the impact of treatment on their relationship, while the elderly (aged 65 and above) reported that reminders of their health problems brought more burden. A lower treatment burden score was associated with older age (≥65 years vs. < 65 years;) P <.001), female (P =.003), and whether there is Medicaid and other insurances (P =.03). A higher treatment burden score was associated with more chronic diseases (P < 0.001), depression (P < 0.001), visual impairment (P = 0.01), hearing impairment (P = 0.006), and mobility difficulties (P < 0.001).

In practice:

The authors of the study wrote: "In the United States, efforts to reduce the burden of treatment may not only involve reducing the use of healthcare, but also include reforms to reduce the administrative and financial burdens on healthcare services and financing systems, as well as interventions to enhance patients' ability to cope with the burden."

Source:

This research was led by Audrey D. Zhang from Beth Israel Deaconess Medical Center in Boston. The research results were published online in the Journal of the American Geriatrics Society on June 19, 2025.