德国重度认知障碍与长期照护
Severe Cognitive Impairments and Long-term Care in Germany
NBER Working Papers · 2026 · [{"name": "Elsa Perdrix", "affiliation": []}, {"name": "Axel H. Börsch-Supan", "affiliation": []}, {"name": "Johannes Geyer", "affiliation": []}, {"name": "Peter Haan", "affiliation": []}, {"name": "Sami Louahlia", "affiliation": []}]
中文摘要
由于人口老龄化，同时也因为相关改革使认知障碍者更容易获得长期照护(LTC)福利，德国的长期照护受益人数正在增加。既往研究已记录了长期照护的成本及其演变，但对认知障碍老年人这一具体群体的了解仍然有限。为此，我们测算了认知障碍的经济成本，其中包括大量的医疗、护理及居家长期照护支出。我们使用欧洲健康、老龄化与退休调查(SHARE)第9轮数据，观察到4%的居家老年人患有重度认知障碍(SCI)(采用Langa等人(2017)的定义)。这些个体接受任何照护的可能性高出30%，且平均每周多获得6小时的正式照护和6小时的非正式照护。其主要驱动因素并非认知障碍本身，而是SCI所导致的日常生活活动(ADLs)受限。因此，一旦控制了ADLs，SCI便不能再解释接受照护的任何额外概率。然而，由于患有SCI的老年人出现ADLs受限的可能性更高，其护理的年成本估计平均为每人每年10,000欧元。
Abstract
Germany experiences an increase in LTC recipients, due to population ageing but also to reforms which made LTC benefits easier accessible for individuals with cognitive impairments. Previous studies documented the cost of long-term care, and how it evolved. However, less is known about the specific case of elderly people suffering from cognitive impairment. Thus, we measure the economic costs of cognitive impairment, which include extensive medical, nursing care and at-home long-term care. We use the SHARE, the Survey on Health, Ageing and Retirement in Europe, Wave 9. We observe 4% of elderly people living at home with severe cognitive impairment (SCI) (Langa et al. (2017) definition). These individuals are 30% more likely to receive any care, and obtain on average 6 more hours of formal care and 6 more hours of informal care per week. The main driver is not the cognitive impairment per-se but the limitation in activities of daily living (ADLs) which SCI leads to. Thus, once controlling for ADLs, SCI does not explain any additional probability to use care. However, because people with SCI are more likely to have ADLs, the annual cost of their care is estimated to 10,000 euros per year per individual on average.