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Public 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.