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This study examined associations between mental health care utilization and caregiving network characteristics, including caregiving network size, caregiving intensity, the presence of formal helpers, and primary caregiver characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using a sample of 692 respondents in the health and retirement study (\n                      <jats:styled-content style=\"fixed-case\">HRS<\/jats:styled-content>\n                      ) with linkage to veterans affairs healthcare records (mean age\u2009=\u200978.7,\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      \u2009=\u20098.08; 97.1% male), logistic regression models tested caregiving network characteristics as predictors of mental health care utilization, adjusting for demographics and health conditions. Moderation effects of cognitive status (Langa\u2010Weir\n                      <jats:styled-content style=\"fixed-case\">HRS<\/jats:styled-content>\n                      Classification) and depressive symptoms (\n                      <jats:styled-content style=\"fixed-case\">CESD<\/jats:styled-content>\n                      \u20108 Scale) were explored.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean network size was 1.6 helpers (\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      1.0), with 77.6% of networks comprising only family caregivers and 41.7% of care recipients reporting high\u2010intensity caregiving. Primary caregiver was most often a spouse (61.1%) and female (89.4%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949 (7.1%) missing data). In multivariable models, primary caregiver female gender was associated with a three\u2010fold increase in likelihood of mental health service utilization (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      \u2009=\u20093.95, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.72\u20139.05), while other caregiving network characteristics were not associated. Having a primary caregiver who was female was most strongly associated with service utilization for care recipients with less severe depressive symptoms or impaired cognition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Caregiver characteristics, particularly gender, may be important factors in facilitating greater mental health care use for older veterans. Targeted education and support may improve caregivers' effectiveness as a resource to help reduce age\u2010related disparities in mental health access. This study contributes to the growing body of research examining the impact of caregivers on healthcare outcomes of older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70082","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T13:50:24Z","timestamp":1756993824000},"page":"3376-3386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Caregiving Network Characteristics and Mental Health Care Utilization by Older Adults"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5371-9105","authenticated-orcid":false,"given":"Mary F.","family":"Wyman","sequence":"first","affiliation":[{"name":"W.S. Middleton Memorial Veterans Hospital  Madison Wisconsin USA"},{"name":"Department of Medicine, Division of Geriatrics University of Wisconsin School of Medicine &amp; Public Health  Madison Wisconsin USA"},{"name":"Department of Psychiatry University of Wisconsin School of Medicine &amp; Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josephine","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Health Economics Resource Center VA Palo Alto Health Care System  Menlo Park California USA"},{"name":"Department of Health Policy Stanford University School of Medicine  Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9226-1667","authenticated-orcid":false,"given":"Lily","family":"Stalter","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Wisconsin  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manasa","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Wisconsin  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4114-912X","authenticated-orcid":false,"given":"Ranak B.","family":"Trivedi","sequence":"additional","affiliation":[{"name":"HSR&amp;D Center for Innovation to Implementation Palo Alto VA Medical Center  Palo Alto California USA"},{"name":"Department of Psychiatry and Behavioral Sciences Stanford University  Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy L.","family":"Byers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences; Division of Geriatrics, Department of Medicine University of California  San Francisco California USA"},{"name":"Center for Data to Discovery and Delivery Innovation San Francisco VA Health Care System  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20996"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201100121"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201300469"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010023\u201004229\u2010x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e3181c29495"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/1541\u20101559.5.3.275"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4362"},{"key":"e_1_2_11_9_1","first-page":"396","volume-title":"The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?","author":"Institute of Medicine","year":"2012"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2024.116625"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17055"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbac150"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010publhealth\u2010090419\u2010102354"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2024.06.010"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06736-2"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0231848"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18213"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201400370"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/00110000221074019"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201600240"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.10.004"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127\u2010015\u20101038\u2010x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.19368"},{"key":"e_1_2_11_24_1","unstructured":"C.Phibbs W.Scott N.Flores andP.Barnett \u201cHERC's Outpatient Average Cost Datasets for VA Care. 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