The Risk and Costs of Severe Cognitive Impairment at Older Ages: Key Findings from our Literature Review and Projection Analyses Research Brief

02/01/2021

The Risk and Costs of Severe Cognitive Impairment at Older Ages: Key Findings from our Literature Review and Projection Analyses
ASPE RESEARCH BRIEF

Melissa Favreault and Richard W. Johnson

Urban Institute

January 2021

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ABSTRACT: Projections of future care needs and costs are difficult because the older population is changing in ways that will likely shape the course of cognitive impairment. This study uses the Dynamic Simulation of Income Model (DYNASIM) to project the risk and costs of severe cognitive impairment at older ages over the coming decades. We project large differences in the chances of ever experiencing severe cognitive impairment for different groups, for example, African Americans, Hispanics, and women. Our estimates of the prevalence and duration of severe cognitive impairment fall within the bounds of prior literature. Lastly, those lower in the income distribution can expect to use most or all of their wealth on care should they become impaired.

The authors gratefully to the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and to all our funders, who make it possible for Urban to advance its mission. Brenda Spillman of Urban's Health Policy Center and Judith Dey, Helen Lamont, and William Marton of ASPE provided helpful comments on earlier drafts.

This brief was prepared under contract #HHSP233201600024I between HHS's ASPE/BHDAP and the Urban Institute. For additional information about this subject, you can visit the BHDAP home page at https://aspe.hhs.gov/bhdap or contact the ASPE Project Officers, at HHS/ASPE/BHDAP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C., 20201; Judith.Dey@hhs.gov, Lauren.Anderson@hhs.gov, Helen.Lamont@hhs.gov.

DISCLAIMER: The opinions and views expressed in this report are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This report was completed and submitted on July 2020.

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