Estimated labor market outcomes of people progressing from preclinical to early-stage Alzheimer's disease in the United States.

INTRODUCTION: Secondary prevention treatments for Alzheimer's disease (AD) that are currently in late-stage clinical trials may preserve productivity and workforce participation.

METHODS: Using the nationally representative Health and Retirement Study waves from 1996 to 2020, we estimated changes in labor force participation, annual earnings, and social assistance payments between incident cases of cognitively impaired and statistically matched cognitively normal individuals.

RESULTS: Among 20,717 respondents (aged 50 to 79), 5232 developed mild cognitive impairment or mild dementia. Disease onset was associated with a five-percentage-point (p.p.) reduction in workforce participation, annual earnings losses of US$8233 (23%) and US$5616 (18%) for men and women who remained in the labor force, respectively, and an increase of 3.5. p.p. male and 5.6 p.p. female social assistance beneficiaries.

DISCUSSION: Onset of cognitive impairment was associated with statistically significant and meaningful reduction in workforce participation and earnings and increased participation in social assistance programs.