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The costs of caring for people with Alzheimer disease (AD) in California are estimated using data from a study of the costs of caring for community-resident and institutionalized people with AD, combined will prevalence and population projections. Costs for community-resident patients will increase 83 percent in the period 2000 ($23.4 billion) to 2020 ($42.8 billion), and will grow an additional 59 percent from 2020 to 2040 ($68.1 billion). Costs for AD patients in institutions will increase 84 percent from 2000 ($2.5 billion) to 2020 ($4.6 billion), and will grow an additional 61 percent from 2020 to 2040 ($7.4 billion), assuming the supply of nursing home beds meets projected demand. Total costs of caring for AD patients will nearly triple between 2000 and 2040. The rapid aging of the U.S. population makes more aggressive societal action necessary if the personal and societal burden of Alzheimer's disease is to be reduced in the future.

To compare the self-assessed health status (SAHS) of female caregivers of older adults across the United States (N = 1,496), China (N = 485), and the United Kingdom (N = 252), data from three data sets were analyzed to isolate significant predictors of SAHS using an adapted meta-analytic technique. Higher income and full-time employment were predictors of higher SAHS; chronic health condition and emotional strain predicted lower SAHS. Female gender was a predictor of lower SAHS. The health status of women was negatively impacted by the caregiving experience. National policies, such as those in the United Kingdom, may result in higher SAHS for women caregivers.

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The Medicare Alzheimer Disease Demonstration tested a case management and community care benefit for persons with dementia. The demonstration produced statistically but not clinically significant reductions in caregiver burden and depression. It increased access to community-based long-term care services but did not affect the level of services used. It did not reduce informal caregiver hours spent helping people with dementia. It produced statistically significant but not budget-neutral reductions in Medicare expenditures in that the degree of reduction in regular Medicare expenditures was not enough to offset the added demonstration costs. It did not reduce rates of nursing home placement. Informal care networks providing care to demented enrollees were generally able to function effectively, regardless of whether a professional case manager was involved or whether a long-term care benefit was available.

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Individual and health-care-delivery-system factors play important roles in the obtaining of regular mammograms by low-income women. These findings highlight the importance of both factors in improving rescreening rates among older women.

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