Patterns of Informal & Formal LTSS Use by Race & Ethnicity among Older Americans with Dementia

Gaps in institutional and home-based care for older Americans with dementia adversely affect health outcomes and increase reliance on other, costly health services that may disproportionately affect racial and ethnic minorities. For dementia-related care, minority groups are overall less likely to rely on formal caregivers; however, little is known about specific care and service use patterns among minority groups over the course of disease progression, including whether informal care patterns vary by race/ethnicity before and after a clinical diagnosis. We will conduct retrospective cohort studies using survey data from the 2000-2018 Health and Retirement Survey and linked Medicare claims. First, we will examine time-to-diagnosis following dementia onset by race/ ethnicity, income and education level, and receipt of informal care. We then assess whether changes in informal caregiving, medical spending, and sick days at home after ADRD onset vary by race/ethnicity and by whether the ADRD was clinically diagnosed or not.