The impact of cognitive status and decline on service and support utilization among older adults in Taiwan
Zimmer,Zachary; Ofstedal,Mary Beth; Chang,Ming-Cheng
Research on Aging 23(3): 267-303
Publication date: 2001
Using a sample of older adults in Taiwan, this study examinesthe impact of cognition on the use of informal support and formalhealth services. Results confirm the hypothesis that cognitiveimpairment is associated with increased use of informal care,while effects on formal service utilization are less consequential.A scale constructed from a subset of the Mini-Mental State Examis significantly associated with receipt of instrumental activitiesof daily living assistance, while correlations with use of formalservices such as hospitalization and physician visits are insignificant.A decline in cognitive status over time is correlated with theinitiation of informal support but is not associated with formalservice utilization. Implications of these results for a rapidlyaging society such as Taiwan are discussed. With current lowlevels of fertility, future generations of older adults willhave fewer social network resources. Absent of dramatic changesin cultural norms with respect to familial support in old age,the future will see an expanding care burden that must be borneby fewer family members.