Before the Diagnosis: Dementia's Early Financial Toll
AARP Resources
The impact of dementia is broad, affecting nearly one in ten adults in the United States over age 65, and a growing body of research points to the six- to eight-year period before a dementia diagnosis as being particularly hazardous for personal and family finances . During these years, affected individuals’ increased vulnerability and diminished financial management may be compounded by others’ lack of awareness of their cognitive decline.(Nicholas et al., 2021; Cho et al., 2023; Gresenz et al., 2024; Li et al., 2023; Li et al., 2026). Recently, researchers have created a clearer picture of the scale of these early, often substantial, financial losses. Our new report reviews this relatively recent timeline of research into the topic and summarizes the insights from an April 2024 symposium on dementia’s early financial toll convened by AARP and the MIT AgeLab. It discusses the nature of the financial threats, the levers for change, and barriers to action, including the difficulties of talking about cognitive decline.
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References and Additional Resources
- Alzheimer’s Association. (2025). 2025 Alzheimer’s Disease Facts and Figures. Report. Chicago, IL: Alzheimer’s Association.
- Cho, T.C., Yu, X., Gross, A.L., Zhang, Y.S., Lee, J., Langa, K.M., & Kobayashi, L.C. (2023). Negative wealth shocks in later life and subsequent cognitive function in older adults in China, England, Mexico, and the USA, 2012-18: A population-based, cross-nationally harmonised, longitudinal study. The Lancet Healthy Longevity, 4(9), e461–e469.
- Coughlin, J.F., & Yoquinto, L. May 19, 2025. Dementia’s Financial Toll: How Losses Can Often Predate the Diagnosis. PLANSPONSOR.
- Giebel, C.M., Flanagan, E., & Sutcliffe, C. (2019). Predictors of finance management in dementia: Managing bills and taxes matter. International Psychogeriatrics, 31(2), 277-286.
- Gresenz, C.R., Mitchell, J.M., Rodriguez, B., Turner, R.S., & van der Klaauw, W. (2024, May). The Financial Consequences of Undiagnosed Memory Disorders. Federal Reserve Bank of New York Staff Reports, No. 1106, May.
- Karlawish, J. (2026). Neurotransmissions. STAT. Requires paid subscription. Access via
- Li, J., McGarry, K.M., Nicholas, L.H., and Skinner, J.S. (2026, January). Dementia and Long-run Trajectories in Household Finances. NBER Working Paper, No. 34659, January. JEL No. G51, I10, I3.
- Li, J., Skinner, J.S., McGarry, K., Nicholas, L.H., Wang, S.P., Bollens-Lund, E., & Kelley, A.S. (2023). Declines in wealth among US older adults at risk of dementia. JAMA Neurology, 80(11), 1250–1252.
- Manly, J.J., Jones, R.N., Langa, K.M., et al. (2022). Estimating the prevalence of dementia and mild cognitive impairment in the US: The 2016 Health and Retirement Study harmonized cognitive assessment protocol project. JAMA Neurology, 79(12):1242–1249.
- Nicholas, L.H., Langa, K.M., Bynum, J.P.W., & Hsu, J.W. (2021). Financial presentation of Alzheimer disease and related dementias. JAMA Internal Medicine, 181(2), 220–227.
- University of Pennsylvania. (2026). The Age of Aging. Podcast. Includes episodes related to aging generally and to dementia in particular.
- Weissberger, G.H., Yassine, H.N., Axelrod, J., Fenton, L., Noriega-Makarskyy, D.T., Molinare, C., Williams, J.T., Oyen, E., Kim, P., Lai, M.H.C., & Han, S.D. (2025). Cognitive functioning predicts vulnerability to financial exploitation in APOE e4 carriers. International Psychogeriatrics, 100162.
- Yoquinto, L., Kali, K.S., & Miller, J. (2024). Before the Diagnosis: Dementia’s Early Financial Toll. White Paper. Washington, DC: AARP.
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