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Current and Future Replacement and Opportunity Costs of Family Caregiving for Older Americans With and Without Dementia
Mudrazija S, Aranda MP. Innovation in Aging, 2025-05-31
Topic: Risk, prevention and care in population studies
Plain-language summary
Background and objectives Family caregivers in the United States provide substantial value of unpaid care to older adults while less recognized are the employment-related costs they endure and the trajectory of these costs. We estimate the replacement cost of unpaid family caregiving to U.S. adults aged 70 and older with and without dementia and the opportunity costs of forgone earnings and lost productivity between 2011 and 2060. Research design and methods We match caregivers to older adults from the National Study of Caregiving with similar noncaregivers from the Panel Study of Income Dynamics. We use population projections alongside current and historical data on educational attainment, wages, inflation, and average wages for in-home care aides to approximate total replacement and opportunity costs. Results Current annual replacement cost of unpaid family care is between $96 and $182 billion, 44% of which is accounted for by dementia caregiving. By 2060, it will increase to $277-571 billion, and 53% will be for dementia caregiving. The opportunity costs of forgone earnings and productivity loss, however, will grow faster, increasing from current levels of $107 billion and $26 billion to $380 billion and $102 billion, respectively, in 2060. Projections show that opportunity costs of family caregiving will be increasingly borne by caregivers of older adults with dementia and racial/ethnic minoritized caregivers. Discussion and implications As the employment-related opportunity costs of family caregiving for older adults are on a trajectory to become increasingly similar in value to associated replacement costs of unpaid care, policymakers, health insurance payers, and employers should focus on supporting unpaid family caregivers to remain attached to the labor force through efforts such as strengthening paid family leave options, expanding consumer-directed in-home services options, and offering increased work flexibility.
What this study adds
Evidence grade: Moderate
This modelling study estimated the current annual replacement cost of unpaid family care at between $96 and $182 billion, 44% of which is accounted for by dementia caregiving, projected to rise to $277-571 billion by 2060 with 53% for dementia caregiving. Reported effect size: Replacement cost $96-182 billion/year now, $277-571 billion by 2060; dementia share 44% rising to 53%.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Mudrazija, S., & Aranda, M. P. (2025). Current and Future Replacement and Opportunity Costs of Family Caregiving for Older Americans With and Without Dementia. Innovation in Aging. https://doi.org/10.1093/geroni/igaf049
Vancouver
Mudrazija S, Aranda MP. Current and Future Replacement and Opportunity Costs of Family Caregiving for Older Americans With and Without Dementia. Innovation in Aging. 2025. doi:10.1093/geroni/igaf049. PMID: 40662057.
BibTeX
@article{mudrazija2025-40662057,
author = {Mudrazija, S. and Aranda, M. P.},
title = {{Current and Future Replacement and Opportunity Costs of Family Caregiving for Older Americans With and Without Dementia}},
journal = {Innovation in Aging},
year = {2025},
doi = {10.1093/geroni/igaf049},
pmid = {40662057},
url = {https://doi.org/10.1093/geroni/igaf049}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Results Current annual replacement cost of unpaid family care is between $96 and $182 billion, 44% of which is accounted for by dementia caregiving.
Why it matters
This modelling study estimated the current annual replacement cost of unpaid family care at between $96 and $182 billion, 44% of which is accounted for by dementia caregiving, projected to rise to $277-571 billion by 2060 with 53% for dementia caregiving. It also projected that opportunity costs of forgone earnings and productivity loss will grow faster, so it concerns caregiving economics rather than treatment, cure, or prevention.
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Study details
- Study designmodelling
- Effect sizeReplacement cost $96-182 billion/year now, $277-571 billion by 2060; dementia share 44% rising to 53%
- Evidence strengthModerate
Limitations
Dementia in NHATS is classified from respondent or proxy report and cognitive tests rather than clinical diagnosis, so misclassification is possible; unpaid care was valued at minimum and replacement wages without accounting for efficiency gains of professional care or the intrinsic value of family care; and data did not allow assessment of caregiver burden on government programmes, lost fringe benefits or forgone retirement savings.
How this study scored 47/100
Published in a peer-reviewed journal, and it is a computer model rather than new measurements. Scored zero for sample size, studied in people and randomized / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 46 of the 98 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Innovation in Aging) |
| Journal's citation record | 0 / 4 | Innovation in Aging: journal h-index 48 (OpenAlex, 2026-10-29) |
| Study design | 3 / 12 | A computer model rather than new measurements |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 5 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 9.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 5 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author María Aranda: h-index 32 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40662057) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 46 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 46 of the 98 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
What each of these 20 components measures, and what this score is not →
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