INTRODUCTION There are approximately 49 million Americans aged 65 and older, with projections estimating that the population of older adults will grow to 98 million in 2060. Chronic diseases are a leading cause of disability and mortality in the US adult population. In all US adults, 6 in 10 have a chronic disease and 4 in 10 adults have 2 or more chronic diseases. Among US older adults, 80% have at least one chronic disease and 77% have at least two chronic diseases. Diabetes affects 23% of US older adults and 1 in 4 US older adults experience some mental disorder, including depression and dementia. Chronic diseases account for 75% of the US national spending on health care. Previous research has suggested that behavioral interventions may play a role in effective treatment of chronic diseases. OBJECTIVE To describe our experience in using utility measures in three randomized trials of behavioral interventions (BI) in older adults; the three diseases were depression, diabetes, and dementia.