The extra costs associated with a cognitive impairment: Estimates from 15 OECD countries

The objective of this study is to estimate the additional income required of a household containing an older adult member living with a cognitive impairment (CI) consistent with dementia (CID).

Secondary analyses were provided of data from the Survey of Health Aging and Retirement in Europe incorporating data of adults' age 65 years old and older across 15 OECD countries in 2013. We also analyzed longitudinal data of a smaller subset of respondents interviewed in a previous survey wave in 2011. We used OLS regression and the Standard of Living (SOL) approach to estimating the extra costs of disability.

Households containing a member experiencing a CID are estimated to require 48% more income to maintain their SOL compared to similar households not including an adult with CID. Those with CI without dementia are estimated to have lower costs (14%). Those with longer-term CID are estimated to incur greater costs than those with a more recent onset of a CI. The extra costs are estimated to be lower in countries with more formalized public long-term care arrangements. We further identified out of pocket costs for home care services as a likely expenditure item driving these cost estimates.

Results suggest that caring for a person living with dementia can lead to considerable expenses. These additional direct costs associated with dementia provide insights for households in anticipating the risks of financial insecurity as they grow older. Future research is needed to identify the consumption items driving these estimates.