less support from others compared with Mexican American older adults who live with others.414 Cultural values may also influence gender disparities in perceptions of support among caregivers across diverse racial and ethnic contexts.415 In a nationally representative study,416 Black and Hispanic participants had poorer health prior to becoming a caregiver for a spouse with dementia than those of similar race/background who did not become caregivers; such differences were not apparent among White caregivers. The onset of dementia in a spouse was associated with a greater risk of depression across all race/ethnicities. Black caregivers are more likely than White caregivers to report positive aspects of caregiving.417 A meta-analysis found that Black dementia caregivers indicate slightly higher psychological well-being than White dementia caregivers. Hispanic dementia caregivers, however, reported slightly lower physical well-being than White dementia caregivers.418 Other research has examined variations in self-rated health among dementia caregivers of diverse racial and ethnic backgrounds. Support from family and friends is associated with better self-rated health for Black dementia caregivers but not for White or Hispanic caregivers. Among dementia caregivers of care recipients who have experienced severe psychiatric symptoms, those who live in low- or mediumincome neighborhoods indicated higher distress than those caregivers living in high-income neighborhoods.419 A more positive perceived relationship between the caregiver and person with dementia was associated with better self-rated health among Black and White caregivers.411 Dementia caregiving is clearly common, regardless of race or ethnicity. The comparisons above suggest that the experience of caregiving often varies depending on racial and ethnic context. Studies of caregivers often lack sufficient numbers of diverse participants to confirm these findings or delve deeper into them for important insights. Recent reviews and national summits have emphasized the need to revise recruitment strategies to capture the range of dementia care experiences among Black caregivers, indigenous caregivers and caregivers of color.413 If representation in dementia care research is not improved, our ability to generalize findings or determine whether findings vary by diverse subgroups is not possible. This hinders the progress of all Alzheimer's disease caregiving research, and, by extension, if these individuals continue to lack representation in Alzheimer’s research, they will not receive the benefits of prevention, treatment or care innovations.413 Establishing stronger relationships with existing organizations and resources in Black communities, indigenous communities and communities of color offers the potential of research-based partnerships that not only enhance representation in Alzheimer’s disease research but may also result in more culturally appropriate and effective services.420-432 In addition, a greater understanding is needed of how multiple chronic diseases (multimorbidity) intersect with dementia among Black people, indigenous peoples and people of color.433 Caregiving Tasks The care provided to people with Alzheimer’s or other dementias is wide-ranging and in some instances allencompassing. Table 7 (see page 38) summarizes some of the most common types of dementia care provided. Though the care provided by family members of people with Alzheimer’s or other dementias is somewhat similar to the help provided by caregivers of people with other conditions, dementia caregivers tend to provide more extensive assistance. Family caregivers of people with dementia are more likely to monitor the health of the care recipient than are caregivers of people without dementia (79% versus 66%).434 Data from the 2011 National Health and Aging Trends Study indicated that caregivers of people with dementia are more likely than caregivers of people without dementia to provide help with self-care and mobility (85% versus 71%) and health or medical care (63% versus 52%).384,394 Figure 9 illustrates how caregivers of people with dementia are more likely than caregivers of other older people to assist with ADLs.398 The need for culturally responsive services and supports for people living with dementia and their caregivers is also pronounced.420 41 Created from data from the National Alliance for Caregiving in Partnership with the Alzheimer's Association.398 50 40 30 20 10 0 Getting in and out of beds and chairs Dealing with incontinence Activity Bathing or showering Feeding Getting to and from the toilet Getting dressed Percentage Caregivers of people with Alzheimer’s or other dementias Caregivers of other older people 45% 43% 38% 30% 34% 23% 33% 20% 32% 25% 32% 12% Proportion of Caregivers of People with Alzheimer’s or Other Dementias Versus Caregivers of Other Older People Who Provide Help with Specific Activities of Daily Living, United States, 2015 figure 9 People with dementia tend to have larger networks of family and friends involved in their care compared with people without dementia. Family members and friends in dementia care networks tend to provide help for a larger number of tasks than do those in non-dementia care networks.435 When a person with Alzheimer’s or another