Cost-benefit of dementia insurance for cognitively-unimpaired

Background: Dementia insurance, a private insurance product covering the first diagnosis of dementia of the insured, may be beneficial for asymptomatic individuals who recognize their own high genetic risk for Alzheimer's disease. Objective: We aimed to examine the cost-benefit of dementia insurance in cognitively unimpaired individuals, stratified by Methods: A simulation study using 18 years of longitudinal data from National Alzheimer's Coordinating Center study to simulate the income and expenses of dementia insurance from the insured's perspective. Cognitively unimpaired participants at baseline (approximately n = 9000) were included, and the loss ratio (= total benefits gained / total premium paid) was calculated by Results: For individuals aged 60 or older with ≥ 10-year follow-up, the estimated loss ratio was highest in Conclusions: Dementia insurance may be relatively more cost-beneficial for asymptomatic ε4-homozygotes in their 60 s or older compared to other genotypes over policy periods of 10 years or longer. However, it does not represent a clear financial gain for the insured, highlighting the need for careful consideration. Our study provides an important basis for further investigating the advantages and limitations of dementia insurance for individuals with high-risk gene.