NBER Working Papers · 2026 · Agar Brugiavini、Ludovico Carrino、Gloria Moroni、Rinaldo Naci、Giacomo Pasini
中文摘要
本章考察意大利长期照护（LTC）体系中老年人认知障碍的发生率及其经济负担。基于SHARE（欧洲健康、老龄化与退休调查）第9轮（2022年）数据，本文通过标准化记忆力和计算能力测试衡量认知障碍，并将8.6%的65岁及以上人群归类为认知障碍者。认知能力衰退随年龄增长而急剧加重，并与更高的照护需求密切相关，尤其是密集型正式照护。尽管身体障碍者和认知障碍者均高度依赖非正式照护，但认知障碍者获得照护的时长要多得多。长期照护总成本达353亿美元（占国内生产总值的1.66%），其中认知障碍者所占支出份额最大。在所有群体中，非正式照护造成的经济负担均高于正式照护。研究结果凸显了大量未获满足的照护需求，并强调迫切需要推进政策改革和健康老龄化战略，以确保长期照护体系的可持续性。
Abstract
This chapter examines the incidence and economic burden of cognitive impairment among older individuals in Italy within the long-term care (LTC) system. Using SHARE Wave 9 data (2022), cognitive impairment is measured through standardized memory and numeracy tests, classifying 8.6% of individuals aged 65+ as cognitively impaired. Cognitive decline rises sharply with age and is strongly associated with higher care needs, particularly intensive formal care. While both physically and cognitively impaired individuals rely heavily on informal care, cognitively impaired individuals receive substantially more hours of care. Total LTC costs amount to $35.3 billion (1.66% of GDP), with cognitively impaired individuals accounting for the largest share of expenditures. Informal care represents a greater financial burden than formal care across all groups. The findings highlight significant unmet care needs and underscore the urgent necessity of policy reforms and healthy ageing strategies to ensure LTC sustainability.