RAND researchers used a large longitudinal study of the general population to examine whether individuals with cognitive decline, such as dementia or Alzheimer's disease, and their families took action after formal or informal diagnoses. Using two classification measures, the authors determined whether and how taking action affects short- and long-term outcomes related to life satisfaction, depression, wealth, and well-being.

Benefits of Seeking Early Detection of Cognitive Decline

Michael D. Hurd, Peter Hudomiet, Susann Rohwedder

ResearchPublished Dec 3, 2024

Dementia profoundly affects individuals and their families. Even in the absence of effective treatments, an individual with an elevated risk of developing dementia might be able to take actions that would ameliorate some of the consequences. Such actions can include estate planning, involving children in financial decisions, moving closer to family, and adopting a healthier lifestyle.

Using a large longitudinal study of the general population, RAND researchers examined whether individuals with cognitive decline, such as dementia or Alzheime'’s disease, and their families took action after a formal or informal diagnosis.

The authors used two measures, one of which they developed, to classify an individual's cognitive status. They then determined whether and how affected individuals and their families took action after becoming aware of the individual's cognitive decline. The authors focused on six outcomes: survival, probability of having dementia, life satisfaction, depression, wealth, and being in fair or poor health. By tracking and analyzing years' worth of data, the authors found trends in the types of actions taken and how those actions (or lack thereof) affected the individuals' and families' short- and long-term outcomes.

The authors of this report present the findings in detail and provide context for the study, how the study adds to the literature on response to cognitive decline, and how they developed their findings. With this new study, the authors show how objective measures similar to theirs can lead to improved detection of cognitive decline.

Key Findings

  • After receiving information about the onset of cognitive decline, many individuals and their families took action, such as a child helping with finances or establishing a living will.
  • Generally, those who took action subsequently fared worse in the six outcomes that the authors studied (survival, probability of having dementia, life satisfaction, depression, wealth, and being in fair or poor health).
  • But those who took action had worse cognition, health, and finances before the onset of dementia, suggesting that taking action signaled that the individual had more-advanced cognitive decline.
  • The most favorable outcomes for those who took action were related to depression and wealth: In half of the comparisons of those measures, the subsequent outcomes were better compared with when action was not taken.
  • The objective measure of cognitive decline that the authors developed was substantially stronger at predicting or confirming action than relying on a doctor's diagnosis alone.

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RAND Style Manual

Hurd, Michael D., Peter Hudomiet, and Susann Rohwedder, Benefits of Seeking Early Detection of Cognitive Decline, RAND Corporation, RR-A3207-3, 2024. As of April 30, 2025: https://www.rand.org/pubs/research_reports/RRA3207-3.html

Chicago Manual of Style

Hurd, Michael D., Peter Hudomiet, and Susann Rohwedder, Benefits of Seeking Early Detection of Cognitive Decline. Santa Monica, CA: RAND Corporation, 2024. https://www.rand.org/pubs/research_reports/RRA3207-3.html.
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This research was sponsored by Genentech and conducted in the Social and Behavioral Policy Program within RAND Social and Economic Well-Being.

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