认知健康、家庭财务决策和家庭内部财务溢出（英）

Carole Roan Gresenz|Jean M. Mitchell|R. Scott Turner|Wilbert van der Klaauw|Crystal Wang Cognitive Health, Household FinancialDecision-Making, andIntrahousehold FinancialSpilloversCarole Roan Gresenz,Jean M. Mitchell,R. Scott Turner,Wilbert van der Klaauw, andCrystal WangFederal Reserve Bank of New York Staff Reports, no.1169October2025https://doi.org/10.59576/sr.1169 Abstract We study the spillover effects of cognitive decline in one member of a coupled household on the financialoutcomes of their partner and assess how “own” and spillover effects are moderated by the structure ofhousehold financial decision-making. We use a large, nationally representative longitudinal data setspanning 2000-2017 that includes credit report data merged at the individual level with Medicare claimsand enrollment data. We find the own adverse financial consequences of cognitive decline depend onhousehold financial integration and other characteristics associated with household financial management,and find significant, albeit smaller (vs own), adverse financial spillover effects on partners. JEL classification:G51, G41, D91Keywords:debt repayment, cognitive decline, household financial management, spillover effects This paper presents preliminary findings and is being distributed to economists and other interestedreaders solely to stimulate discussion and elicit comments. The views expressed in this paper are those ofthe author(s) and do not necessarily reflect theposition of theNational Institutes of Health, theFederalReserve Bank of New York,or the Federal Reserve System. Any errors or omissions are theresponsibility of the author(s). To view the authors’ disclosure statements, visithttps://www.newyorkfed.org/research/staff_reports/sr1169.html. 1Introduction Individual characteristics such as financial literacy (Lusardi & Messy, 2023; Lusardi &Mitchell, 2008, 2014), education (Cole et al., 2014) and age (Agarwal et al., 2009) ex-ert substantial influence on individuals’ financial decision-making and financial outcomes.For individuals in coupled households, the approach used to manage household finances(Fonseca et al., 2012) may also consequentially affect their financial outcomes. Coupledhouseholds employ a variety of arrangements for managing their finances.Some poolincome (Evans & Gray, 2021; Hiekel et al., 2014; Pepin, 2022) and jointly hold liabilit-ies, such as sharing a mortgage or credit card accounts (Horymski, 2023). Other couplesoperate as separate economic units, with each person independently holding their incomeand taking responsibility for managing their own debts (Evans & Gray, 2021; Pahl, 1989).Among couples who integrate their finances, some may vest authority over financial de-cisions in one individual and others may make joint decisions or distribute decisions acrossthe couple (Kim et al., 2017; Pahl, 1989). This study examines how the approach a couple uses for household financial decision-making affects the financial outcomes of each partner when one member experiences adecline in cognitive health from the onset of Alzheimer’s disease or a related dementia(ADRD). We focus on households that include an adult age 65 or over, as more than 90percent of ADRD cases affect individuals over age 65 (National Institute on Aging (NIA),2023). ADRD is highly prevalent, affecting more than 1 in 9 older adults and more thanone in three individuals over the age of 85 (Alzheimer’s Association, 2025). Our analysesfocus on financial outcomes related to debt and debt management. These outcomes rep-resent an increasingly important and sometimes under-appreciated dimension of financialwell-being among the aged (Lusardi et al., 2020). We assess whether the effects of ADRD-related cognitive decline on a coupled individual’s own credit outcomes are amplified ordiminished depending on the approach the couple takes to financial organization. We alsoevaluate spillover effects on the financial outcomes of their partner, and how these effectsvary with a household’s financial decision-making strategy. Our work leverages a large, nationally representative, longitudinal data set spanning2000-2017 that includes quarterly credit report data from Equifax (Lee & van der Klaauw,2010) merged at the individual level using Social Security number (SSN) with Medicareclaims and enrollment data. We successfully merged these data with a very high quality(92 percent) match rate.Our merged data in total include 7.9 million individuals andhundreds of millions quarterly observations.Financial outcomes include credit score,which is an overall measure of an individual’s credit worthiness; payment delinquency forany account and for mortgages and credit card accounts; and whether an individual is“maxed out” on their credit card accounts, which we define as using more than 90 percentof the credit available to them through their credit cards. ADRD in its earliest stages adversely affects various domains of cognitive function,including the ability t