Alzheimer Disease and Related Dementias Cause Surging Economic Burden for Minoritized Communities

African American and Latino older adults with Alzheimer disease and related dementias and their families are likely to face disproportionately high burdens, primarily associated with unpaid caregiving, suggesting the need for policies that may reduce economic burdens for all US residents. | Image Credit: ipopba - stock.adobe.com

The total economic burden of Alzheimer disease and related dementias (ADRD) is expected to be disproportionately high for minoritized groups, particularly that from unpaid caregiving, highlighting the need for policies to mitigate these economic strains for all US residents, according to a study published in JAMA Network Open.1

Alzheimer disease is the most common form of dementia and contributes to 60% to 70% of cases among US residents 65 years and older.2 Related dementias include vascular dementia, dementia with Lewy bodies, and a group of diseases that contribute to frontotemporal dementia. Typically, symptoms worsen over time, and the progression of the disease increases the amount of help with personal care needed. People living with ADRD require ongoing health care and long-term services and supports based on cognitive, behavioral, affective, social, and financial changes they experience.

ADRD is one of the costliest disease groups in the US, with a recent estimate of $305 to $450 billion in caregiving alone.1 These costs exceed cancer care ($21.1 billion), stroke ($56.5 billion), heart disease ($239.9 billion), and even diabetes ($412.9 billion). Increased medical costs for patients with ADRD stem from treating the disease and additional costs when treating related health conditions.

Researchers conducted a cross-sectional study using nationally representative data (2014-2020 Medical Expenditure Panel Survey [MEPS], 2011-2017 National Study of Caregiving [NSOC], and 2013 Panel Study of Income Dynamics) to analyze medical and work-related costs for adults 50 years and older with ADRD, as well as their unpaid caregivers.

The MEPS sample included 31,028 older adults who identified as African American (10%), American Indian or Alaska Native (<1%), Asian (3%), Latino (10%), another Asian/Native Hawaiian/Pacific Islander (2%), and White (75%). In the NSOC sample of 1929 individuals, there were individuals who identified as African American (33%), Latino (9%), and White (58%) adults. In the MEPS sample, almost half of respondents were 65 years and older, with a similar share of men and women and those with at least some college education.

The total estimated economic burden of ADRD was almost $344 billion in 2020 and was estimated to increase to over $3 trillion in 2060. Medical care spending for ADRD was about $20 billion in 2020, and minoritized populations accounted for almost 20% ($4 billion), split roughly equally between African American and Latino adults.

Finances are expected to reach $147 billion in 2060, with faster growth for Latino ($32 billion) and African American adults ($24 billion) compared with White adults ($91 billion). The work-related costs for adults with ADRD exceeded over $4 billion in 2020, and were projected to surpass $22 billion in 2060, with African American and Latino adults’ share increasing from 24% to 43%. The overall economic burden of ADRD for African American and Latino populations was $113 billion in 2020 and was projected to increase to $1.7 trillion in 2060, surpassing the economic burden for the White population (increase from $231 billion to $1.4 trillion).

Paid home care costs are expected to increase faster than nursing home costs due to projected increases in paid care prices. In 2020, formal care for African American and Latino adults with ADRD cost $19 billion, while White adults incurred $64 billion in expenses.

By 2060, these figures will reach an estimated $293 billion and $386 billion, respectively. These projections indicate that despite the much faster demographic growth of minoritized populations, public supports will primarily continue to benefit the caregiving of older White adults.

In 2020, the estimated value of unpaid care for ADRD for older White adults stood at $76 billion, surpassing the combined value for African American and Latino adults ($62 billion). The annual value of unpaid care for African American and Latino adults is projected to increase substantially, growing from over $62 billion in 2020 to over $842 billion by 2060, with Latino adults accounting for $586 billion of this total. In contrast, the value for White adults will rise to $382 billion in 2060.

Forgone wages for ADRD caregivers also show notable trends across racial groups. In 2020, African American caregivers lost $7 billion, Latino caregivers lost $12 billion, and White caregivers lost $44 billion in wages. By 2060, these figures are projected to surge to almost $105 billion for African American caregivers, over $271 billion for Latino caregivers, and $312 billion for White caregivers.

As of 2020, the combined forgone wages for African American and Latino caregivers exceeded $4 billion, a figure that is projected to increase to almost $68 billion by 2060, with Latino caregivers contributing $43 billion to this loss. This compares with an $88 billion loss for White caregivers in 2060.

By 2060, assuming current tax rates, White ADRD caregivers will account for $23 billion in lost income tax payments, while Latino caregivers will contribute over $17 billion, and African American caregivers almost $7 billion. Unpaid caregivers also provide financial support for persons with ADRD, such as purchasing food or medicine. In 2020, the total value of these transfers reached $11 billion, and by 2060, this is projected to grow to $83 billion, with more than $19 billion attributed to African American and Latino caregivers.

In 2020, Latino caregivers experienced the largest percentage of earnings lost, at 16% of their household income, followed by African American (9%) and White (8%) caregivers. By 2050, these percentages are projected to increase to 18% for Latino, 12% for African American, and 9% for White caregivers, with a further increase projected for African American caregivers by 2060.

The analysis draws on data from Genworth's Cost of Care Survey, the CDC, and KFF, though these estimates carry inherent uncertainties. The figures do not fully account for caregiver burden, its impact on caregiver health, or potential changes in disease progression due to medical advancements. Due to sample size limitations, the analysis disaggregates estimates only by education, race, and ethnicity, and only reflects federal, not state or local, lost income taxes.

“Researchers and policymakers should include African American and Latino families living with ADRD in the clinical trials and demonstration projects to improve the effectiveness of interventions for these communities,” the study authors concluded.

References

1. Mudrazija S, Aranda MP, Gaskin DJ, Monroe S, Richard P. Economic burden of Alzheimer disease and related dementias by race and ethnicity, 2020 to 2060. JAMA Netw Open. 2025;8(6):e2513931. doi:10.1001/jamanetworkopen.2025.13931

2. Dementia. World Health Organization. March 31, 2025. Accessed June 5, 2025. https://www.who.int/news-room/fact-sheets/detail/dementia