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An additional 15%\u201322% experience mild cognitive impairment (MCI), often preceding ADRD and in earlier life. However, CI burden estimates including MCI and early\u2010onset CI (age\u00a0&lt;\u00a065), remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Using microsimulation, we estimated CI burden (ADRD and\/or MCI) over remaining life\u2010years for Americans (aged 51\/52) who developed CI overall, by disease progression, onset age, and sociodemographic subgroups. Burden equaled the difference in quality\u2010adjusted life\u2010years (QALY valued at $150K\/year) and economic outcomes between a hypothetical intervention preventing CI and status quo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Per capita lifetime CI burden was $124K, driven by lost QALYs. Aggregate CI burden was $627B, 59% from ADRD, 41% from MCI. Early\u2010onset CI carried the largest per capita burden ($376K), \u223c50% from MCI. Individuals with less education, progression to ADRD, or from minoritized racial\/ethnic subgroups also carried disproportionate burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>MCI constitutes 41% of CI burden, disproportionately impacting individuals with early\u2010onset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The lifetime burden of cognitive impairment (CI) was estimated at $124,000 per capita, totaling $627 billion in aggregate\u2014with 59% attributed to Alzheimer's disease and related dementias (ADRD) and 41% to mild cognitive impairment (MCI).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Early\u2010onset CI (before age 65) carried the highest per capita burden at $376,000, with these individuals living with MCI for about 13 years\u2014over 7 years longer than those with late\u2010onset CI.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Significant disparities exist in CI burden, with racial\/ethnic minorities and those without a high school degree experiencing disproportionately higher burden. Despite representing just 36% of the CI population, non\u2010White individuals accounted for 47% of the aggregate CI burden.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70436","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T09:46:29Z","timestamp":1755164789000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The burden of cognitive impairment"],"prefix":"10.1002","volume":"21","author":[{"given":"Tadeja","family":"Gracner","sequence":"first","affiliation":[{"name":"Center for Economic and Social Research University of Southern California  Los Angeles California USA"},{"name":"RAND Corporation  Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritika","family":"Chaturvedi","sequence":"additional","affiliation":[{"name":"Center for Economic and Social Research University of Southern California  Los Angeles California USA"},{"name":"Leonard D. Schaeffer Center for Health Policy &amp; Economics University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PhuongGiang","family":"Nguyen","sequence":"additional","affiliation":[{"name":"RAND Corporation  Santa Monica California USA"},{"name":"Leonard D. Schaeffer Center for Health Policy &amp; Economics University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanke","family":"Heun\u2010Johnson","sequence":"additional","affiliation":[{"name":"Leonard D. Schaeffer Center for Health Policy &amp; Economics University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Tysinger","sequence":"additional","affiliation":[{"name":"Leonard D. 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