NBER Working Papers · 2026 · Elsa Perdrix、Axel H. Börsch-Supan、Johannes Geyer、Peter Haan、Sami Louahlia
中文摘要
德国的长期照护（LTC）领取者人数不断增加，这既源于人口老龄化，也源于相关改革使认知障碍者更容易获得长期照护福利。既有研究记录了长期照护成本及其演变，但对于患有认知障碍的老年人这一特定群体，相关认识仍然有限。因此，我们衡量认知障碍带来的经济成本，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。我们观察到，居家生活的老年人中有4%患有严重认知障碍（SCI，采用Langa等（2017）的定义）。这些人接受任何形式照护的可能性高出30%，平均每周多获得6小时正式照护和6小时非正式照护。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（ADL）能力受限。因此，一旦控制ADL后，SCI便无法解释使用照护服务的任何额外概率。然而，由于患有SCI的人更可能存在ADL受限，其照护的年度成本估计平均为每人每年1万欧元。
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.