Cognitive Decline and Consumption Changes Among Community-Dwelling Older Adults

Cognitive impairment is associated with financial burdens on individuals and their families, yet less is known about how families change consumption patterns around the onset of cognitive decline beyond out-of-pocket medical expenditures. Using data from the Health and Retirement Study (HRS) and the Consumption and Activities Mail Survey (CAMS) from 2002 to 2018, we examined changes in spending during the six years before and after the first onset of cognitive impairment no dementia (CIND) and dementia among community-dwelling older adults. We found that older adults with cognitive decline reduced total spending, as well as spending on food at home and away from home and on non-durables, before and after onset. Out-of-pocket medical expenses, transportation, and housing spending remained unchanged, but there is suggestive evidence of declines in leisure spending, gift-giving, and utility costs. Future research should explore the potential for material deprivation related to these consumption changes.