Little research has addressed culturally-linked differences in outcomes for Alzheimer's Disease patients, even though there is less likelihood that Blacks will be placed in institutions than Whites. Since there are comparable rates of the disease for Blacks and Whites, examining the placement patterns of the two groups and their possible predictors affords researchers the opportunity to consider the placement process. Furthermore, such research can investigate differential caregiving outcomes for Black and White Alzheimer's patients as they relate to ethnic differences in attitudes of caregivers toward assisting ailing elders. This work will attempt to determine the cultural impact on caregiving outcomes among 600 Alzheimer's patients and care providers, half Black and half White. The longitudinal study will examine attitudes, behavior, and the stress of caregiving and associate their relationship with placement in institutions. Four caregiver interviews will take place and patient outcomes will be tracked. Culturally sensitive instruments will be used wherever they exist and all measures will be validated among the population under study. Hypotheses will link ethnicity-attitudes- placement outcomes as they are reflected in three sub-models. Specifically, we hypothesize that Black Alzheimer's patients will be less likely to be placed in institutions, even when their caregivers experience comparable primary and secondary stress, because expectations for home-based care are stronger than among White caregivers. Statistical analysis will include structural models and also event history analysis. In using the latter, investigators can consider the time-varying aspects of placement and determine which predictor variables are associated with early, later, or non-placement outcomes. Including ethnic considerations as they involve attitudinal variables can enable researchers to better address placement and similar outcomes of Alzheimer's Disease, especially since racial differences in placement have not been explained.