do not yet know how COVID-19 has influenced Alzheimer’s mortality or increased the burden of living with Alzheimer’s. Future reports will assess the influence of the COVID-19 pandemic on trends in mortality and morbidity from Alzheimer’s disease. With population aging, the percentage of deaths related to Alzheimer’s disease will likely continue to increase. A focus should be on ensuring the health and well-being of people with Alzheimer’s disease in the years before death. Innovation in methods and data sources is required to understand the contribution of Alzheimer’s disease to poor health, disability, and mortality. Alzheimer’s Association. 2022 Alzheimer’s Disease Facts and Figures. Alzheimers Dement 2022;18. Family members and friends provided more than $271 billion in unpaid care to people living with Alzheimer’s and other dementias in 2021. CAREGIVING Caregiving often includes assistance with one or more activities of daily living (ADLs), including bathing and dressing, as well as multiple instrumental activities of daily living (IADLs), such as paying bills, shopping and using transportation.381-382 Caregivers also provide emotional support to people with Alzheimer’s as well as communicating and coordinating care with other family members and health care providers, ensuring safety at home and elsewhere, and managing health conditions (see Table 7). In addition to providing descriptive information about caregivers of people with Alzheimer’s or other dementias, this section compares caregivers of people with dementia to either caregivers of people with other medical conditions or, if that comparison is not available, to people who are not caregivers (referred to here as non-caregivers). Unpaid Caregivers Eighty-three percent of the help provided to older adults in the United States comes from family members, friends or other unpaid caregivers.383 Nearly half of all caregivers (48%) who provide help to older adults do so for someone with Alzheimer’s or another dementia.384 More than 11 million Americans provide unpaid care for people with Alzheimer's or other dementias.A8 In 2021, caregivers of people with Alzheimer’s or other dementias provided an estimated 16 billion hours of informal (that is, unpaid) assistance, a contribution to the nation valued at $271.6 billion. This is approximately 49% of the net value of Walmart’s total revenue in fiscal year 2020 ($559.2 billion)385 and 14 times the total revenue of Caregiving refers to attending to another person’s health needs and well-being. Helping with instrumental activities of daily living (IADLs), such as household chores, shopping, preparing meals, providing transportation, arranging for doctor’s appointments, managing finances and legal affairs, and answering the telephone. Helping the person take medications correctly, either via reminders or direct administration of medications. Helping the person adhere to treatment recommendations for dementia or other medical conditions. Assisting with personal activities of daily living (ADLs), such as bathing, dressing, grooming and feeding and helping the person walk, transfer from bed to chair, use the toilet and manage incontinence. Managing behavioral symptoms of the disease such as aggressive behavior, wandering, depressive mood, agitation, anxiety, repetitive activity and nighttime disturbances. Finding and using support services such as support groups and adult day service programs. Making arrangements for paid in-home, nursing home or assisted living care. Hiring and supervising others who provide care. Assuming additional responsibilities that are not necessarily specific tasks, such as: • Providing overall management of getting through the day. • Addressing family issues related to caring for a relative with Alzheimer’s disease, including communication with other family members about care plans, decision-making and arrangements for respite for the main caregiver. • Managing other health conditions (i.e., “comorbidities”), such as arthritis, diabetes or cancer. • Providing emotional support and a sense of security. Dementia Caregiving Tasks table 7 38 Alzheimer’s Association. 2022 Alzheimer’s Disease Facts and Figures. Alzheimers Dement 2022;18. 39 McDonald’s in 2020 ($19.2 billion).386 The total lifetime cost of care for someone with dementia was estimated at $377,621 in 2021 dollars. Seventy percent of the lifetime cost of care is borne by family caregivers in the forms of unpaid caregiving and out-of-pocket expenses for items ranging from medications to food for the person with dementia.387-388 Current estimates of the lifetime costs of care may underestimate the impact of a relative’s dementia on family caregivers’ health and workplace productivity.389 Three of the main reasons caregivers provide assistance to a person with Alzheimer’s or another dementia are: (1) the desire to keep a family member or friend at home (65%), (2) proximity to the person with dementia (48%) and (3) the caregiver’s perceived obligation to the person with dementia (38%).A9 Caregivers often indicate love and a sense of duty and obligation when describing what motivates them to assume care responsibilities for a relative or friend living with dementia.390 Individuals with dementia living in the community are more likely than older adults without dementia to rely on multiple unpaid caregivers (often family