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Variation in cost of informal caregiving and formal-service use for people with Alzheimer's desease

College of Nursing and Health Sciences, University of Massachusetts, Boston, Massachusetts

Diane F. Mahoney, PhD

HRCA Research and Training Institute, Hebrew Rehabilitation Center for Aged, Boston, Massachusetts

Aaron B. Mendelsohn, PhD

Office of Drug Safety, Division of Surveillance, Research and Communication Support, Food and Drug Administration, Rockville, Maryland

Marcia G. Ory, PhD

School of Rural Public Health, Texas A & M University, College Station, Texas

David W. Coon, PhD

Goldman Research Center, Goldman Institute on Aging, San Francisco, California

Steven H. Belle, PhD

Epidemiology Data Center, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania

Linda O. Nichols, PhD

Veterans Affairs Medical Center Memphis, Tennessee

This study used a geographically diverse sample to estimate the total cost of informal care and formal services for community-residing Alzheimer's disease (AD) care recipients. Baseline data were used for 1200 family caregivers from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) study, a multisite intervention trial. The replacement-wage-rate approach estimated informal cost. Formal services were assigned a cost based on secondary sources. Annual cost per care recipient amounted to $23,436 for informal care and $8,064 for formal services. Variation in informal cost was almost entirely due to instrumental activities of daily living (IADLs) assistance. Cross-site differences in cost persisted after controlling for caregiver and care-recipient characteristics. Geographic variation may suggest regional preferences or ethnic/cultural values. Further study is needed to determine whether this reflects differences in access or availability or how including a control group for care recipients with nondementia diagnoses might have affected these findings.

Key Words: Alzheimer's disease • dementia • care recipient • geographic variation • economic burden

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