This research elucidates the risk of institutional care and/or death of patients with Alzheimer's disease (AD) or other dementia (OD) compared with noncases. Community dwelling incident cases of AD (n = 240) or OD (n = 208) and age-matched noncases (n = 363) living in an enumerated population were included. The adjusted hazard ratio (HR) of being admitted to a nursing home compared with controls was 5.44 (95% confidence interval, CI: 3.68,8.05) for AD cases and 5.08 (95% CI: 3.38, 7.63) for OD cases. The adjusted RR of death compared to controls was 1.90 (95% CI: 1.36, 2.65) for AD cases and 2.27 (95% CI: 1.62, 3.18) for OD cases. This is the only population-based study in the U.S. documenting that AD/OD increases the risk of death independent of comorbid conditions. AD/OD patients have more comorbidities and are at greater risk of entering a nursing home than to die during the follow-up, compared with those without these diagnoses.