Background and ObjectivesClinic-based studies of patients with Alzheimer’s disease (AD) have demonstrated the value of assessing dependence when characterizing patients’ functional status. The Dependence Scale, a validated tool to assess level of caregiving needs, is associated with markers of disease severity, cost, and progression, while offering independent functional information about patients. This study examines whether such associations between the Dependence Scale and markers of disease severity demonstrated in clinical cohorts are similarly exhibited in a multiethnic community population of individuals with AD.Research Design and MethodsOne hundred fifty four elders with AD enrolled in the Predictors 3 cohort were assessed with the Dependence Scale, modified Mini-Mental State Examination (mMMS), instrumental (IADL) and basic (BADL) activities of daily living, and Clinical Dementia Rating (CDR) Scale, and were assigned an Equivalent Institutional Care (EIC) rating. Cross-sectional associations were examined using bivariate correlations and one-way analysis of variance analyses. Fisher-z tests examined differences in strengths of associations across previous clinic and current community cohorts.ResultsDependence Scale scores were associated with CDR (r = .20, p = .013), mMMS (r = −.23, p = .005), IADL (r = .39, p < .001), BADL (r = .65, p < .001), and EIC (r = .51, p < .001). Dependence was unassociated with ethnicity (F[3,144] = 1.027, p = .3822), age (r = .120, p = .145), and education (r = −.053, p = .519). The strength of the correlations was comparable across cohorts except that BADLs were more strongly associated with dependence (z = −4.60, p < .001) in the community cohort, and living arrangement was not associated with dependence (r = .13, p = .130).Discussion and ImplicationsAssociations between the Dependence Scale and markers of disease severity in a clinic-based cohort of AD patients are similar to associations in a multiethnic community cohort of individuals diagnosed with AD. The Dependence Scale relates to markers of disease severity rather than demographic factors, and may offer an unbiased assessment of care required in multiethnic and community populations.

Due to the sexual nature of their work, strip club dancers have long been subject to marginalization and occupational stigma. During the coronavirus disease (COVID-19) pandemic, dancers faced unique stressors due to their status as contract workers within the stigmatized commercial sex/adult entertainment industry, and these stressors have likely impacted their financial, occupational, and emotional well-being. We surveyed 102 strip club dancers across 35 U.S. states and Puerto Rico to examine how their well-being has been impacted by the COVID-19 pandemic and to guide recommendations for policy reform. Findings revealed that during the pandemic, dancers experienced occupational stigmatization, structural and systematic exclusion from financial support during the pandemic, and numerous obstacles in obtaining employment outside of their industry, all of which contributed to reported financial and occupational stress. Furthermore, results demonstrated that strip club dancers experienced significant financial loss, and associated financial concern was associated with poorer mental health outcomes. Structural changes to financial relief packages are necessary for inclusion of strip club dancers, and there is also a clear need for more efforts to decrease discrimination and violence toward strip club dancers generally, including legal recognition of sex workers as laborers.

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