Early-onset dementia lowers work productivity years before formal diagnosis

People diagnosed with early-onset dementia had reduced work productivity up to 15 years before diagnosis, according to a study published July 8, 2026, in Neurology®, the medical journal of the American Academy of Neurology. Researchers also found the number of years of lower productivity varied depending on the type of dementia.

Early-onset dementia is when someone under 65 is diagnosed with any type of dementia.

The study does not prove that having early-onset dementia lowers productivity in the years prior, it only shows an association.

Early-onset dementia affects people during their most productive years and is associated with a decreased ability to work, increased unemployment and leaving jobs sooner than planned. These changes can reduce household income and contribute to broader economic impact. Our study found an association between reduced work productivity and early-onset dementia up to 15 years before diagnosis."

Eino Solje, MD, PhD,  study author, University of Eastern Finland, Kuopio

The study included 793 people diagnosed with early-onset dementia at two Finnish hospitals during a 12-year period. They were matched by age and sex to 7,926 people without dementia. Of those with dementia, 421 had Alzheimer's disease, 179 had frontotemporal dementia, 46 had alpha-synucleinopathies, which include dementia with Lewy bodies and Parkinson's disease dementia, and 147 had other forms of dementia including vascular cognitive disorders and mixed dementias.

Researchers used national registries to identify education levels and other health conditions for each participant. They used national tax records to find participants' incomes.

To determine productivity loss, researchers calculated the average annual income difference between people with early-onset dementia and people without dementia. They also accounted for other factors that could affect the difference, such as education level and other medical conditions.

Researchers found people with early-onset dementia showed progressively increasing productivity losses up to 15 years before diagnosis when compared to people without dementia. Over the course of the study, they had total average productivity losses of 74,577 Euros, or approximately 86,000 U.S. dollars, per person with early-onset dementia.

When looking at different types of dementia, they found average productivity losses for people with Alzheimer's disease began six years before diagnosis, for people with frontotemporal dementia, 11 years before diagnosis, and for those with alpha-synucleinopathies, losses were only apparent at diagnosis. For other dementias, average productivity losses were consistently high throughout the years.

"Our study found productivity loss was strikingly large, averaging around 12,000 Euros, or approximately 13,800 U.S. dollars, per year per person, with losses beginning up to 15 years before diagnosis," said Solje. "These findings may partly be explained by delays in diagnosis, which can prolong the period of unrecognized symptoms, and they underscore the harmful, long-term socioeconomic impact of early-onset dementia."

A limitation of the study was it looked back at data, so it does not show cause and effect.

Solje noted that future research should include neuropsychological tests to track changes in cognition over time, and interventions should be developed that could prevent or delay productivity decline.

The study was funded by Roche Oy, the Finnish subsidiary of Roche.

Source:
Journal reference:

Kivisild, A., et al. (2026). Long-Term Income and Productivity Losses in Individuals With Early-Onset Dementia. Neurology. DOI: 10.1212/wnl.0000000000218268. https://www.neurology.org/doi/10.1212/WNL.0000000000218268

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