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The out-of-pocket costs to care for individuals living with dementia are high, and is exacerbated by the expense of managing behavioral and psychological symptoms of dementia (BPSD) (e.g., depression, irritability). STELLA (Support via TEchnology: Living and Learning with Advancing AD) is a telehealth-based intervention that provides a personalized approach to teach care partners (CPs) strategies to manage BPSD. To understand the relationship between BPSDs and costs, weekly surveys were administered to CPs (n=12). Surveys asked about out-of-pocket costs incurred from: hospitalizations and emergency department (ED) utilization, primary care visits, use of paid in-home care, prescription drugs, and over-the-counter medications. The most frequent cost reported by CPs was prescription drug related (11 CPs), while costs associated with hospitalizations and ED were the least frequently reported (4 CPs). A longitudinal weekly survey-based approach to quantify CP costs is a novel approach examine an intervention outcome (cost) that matters to families and policymakers.

Many people living with Alzheimer’s disease and related dementias (ADRD) never receive a formal disease diagnosis. This compromises wellbeing and increases health services utilization and care costs. Wider screening and assessment for ADRD may increase access to supportive care, improve allocation of medical care, and foster interventions that prevent or delay disease progression. A sample of Medicare-enrolled individuals 65+ (n=60) consecutively presenting to the Oregon Health & Science University (OHSU) emergency department (ED) in Portland, Oregon consented to the study and were administered the TICS, a validated tool for telephone-based assessments of cognition, post-discharge from the ED. Study participants were asked about their physical health via the modified Cumulative Illness Rating Scale (M-CIRS), and their cognitive health via the PROMIS Cognitive Measure Questions on Mental Clarity. Care utilization patterns were measured via review of participants’ electronic health records (EHR) for three years prior to study enrollment focusing on total hospitalizations, ED visits, and primary care (PC) visits.Medicare-enrolled adults 65+ recently discharged from the ED were a feasible population to perform a cognitive assessment. The study enrollment rate was 24.2% (n=60). Enrollment was limited to patients with their PC affiliated with the OHSU health system, which excluded the majority (792, 73.8%) of ED patients Medicare-enrolled, 65+ from our study (1,072). This study provides preliminary evidence to support focusing on older ED patients to administer cognitive assessments, linking outcomes to the EHR, and ultimately providing a platform for future research on impacts of under-diagnosed ADRD on population-level health outcomes and care utilization.

The COVID-19 pandemic has greatly impacted the economic security of millions of older adults. Job loss and reductions in personal income were significant in 2020 stemming from pandemic-induced shutdowns that temporarily closed large swaths of the U.S. economy. Yet, the specific financial impacts of the pandemic on older adults, including family care partners, are not well understood. To understand the COVID-19 pandemic’s effects on the health and financial well-being of older adults, we gathered data from the Research via Internet of Technology and Experience (RITE) Study, a longitudinal survey panel providing data from thousands of participants of various ages and backgrounds in the U.S. on their use of healthcare and technology (N=1,365). We measured by population strata including age, sex, and education and other characteristics including caregiver status. Adults between 20-40 years of age experienced the highest rate of job loss and reduction in wages (33%) as a result of the pandemic, while adults aged >70 years experienced the lowest rate (12.5%). However, adults aged 50-60 and 60-70 also experienced relatively high levels of job loss at (28.4% and 25.7%, respectively). Behavior changes and disruptions to typical routines to avoid COVID-19 infections may have contributed to job and personal income loss amongst Individuals aged 50-60 and 60-70. However, these findings suggest potentially high levels of economic insecurity amongst individuals who continue to work into late-life. These results may help policymakers understand how to better tailor interventions and policies to mitigate economic insecurity, particularly for populations disproportionately impacted by the pandemic.