OBJECTIVES: Prevalence of Alzheimer’s Disease and related dementias (ADRD) is increasing as the US population ages. ADRD patients become increasingly dependent on assistance with basic daily care, routine tasks, and safety as dementia progresses. The objective of this analysis was to examine the association between type of care and insurance type among US community-living patients with ADRD.

METHODS: This was a secondary analysis of Medicare Current Beneficiary Survey (MCBS) 2013, a nationally representative survey of Medicare beneficiaries. Any beneficiary/proxy respondent reporting diagnosis of ADRD was included. Type of care (dependent variable) was characterized into ordinal levels as independent living, at-home living utilizing informal care, home health aide utilization, or skilled nursing facility (SNF) stay. SNF was used as predictor of long-term care (LTC) based on literature. The independent variable of interest was insurance type: Medicare FFS only, Medicare Advantage or FFS+Medigap insurance with and without LTC coverage, and Medicare+Medicaid dual-eligibles. A multivariate ordered logistic regression model was run, adjusting for potential confounders (age, gender, marital status, mental disorders, functional limitations measured by activities of daily living, and overall health).

RESULTS: CONCLUSIONS: Among patients self-reporting as ADRD, having either Medicare Advantage or FFS+Medigap is related to receiving informal care. Income is a potential mediator in this analysis which is not accounted for. Given the increasing prevalence of ADRD, strategies to support informal care are needed.