This study used dynamic microsimulation (the US Cost of Dementia Model), the Health and Retirement Study (1998–2020), and other national data to quantify the full societal cost of dementia in the US in 2026, covering adults aged 51+ and their care partners across six cost domains: medical/long-term care, unpaid caregiving, earnings losses, and quality-of-life losses.
In 2026, 5.7 million US adults (95% CI [5.6, 6.0]) live with dementia, supported by 5.2 million care partners. Total costs reach **$818 billion** (95% CI [$759B, $866B]). The largest single driver is quality-of-life loss for persons with dementia ($320B). Unpaid care accounts for $237B, medical/long-term care for $222B (70% covered by Medicare/Medicaid), and earnings losses for $23B combined. Families bear over three times the cost compared to health systems.
- Dementia classified by TICS score without distinguishing etiology; caregiver counts rely on care-recipient reports, which tend to undercount. - Quality-of-life and earnings loss estimates for caregivers under age 51 were extrapolated from older HRS respondents, inflating uncertainty. - Costs exclude legal/financial planning expenses, housing modifications, and some state Medicaid programs, likely underestimating true burden.
Clinicians should recognize that the bulk of dementia's economic toll falls on families — through unpaid care, out-of-pocket costs, earnings losses, and quality-of-life decline — not on health systems. Screening and planning conversations should address caregiver burden and financial strain early, and treatment decisions should weigh potential reductions in caregiver burden alongside direct medical costs.
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