PartnerRe | Dementia the protection gap insurers can no longer ignore

June 26 2026

Dementia is emerging as one of the defining challenges of ageing societies, particularly in Asia – Pacific, where demographic change is accelerating at an unprecedented pace. As life expectancy rises, more individuals and families are facing the long-term consequences of cognitive decline. Yet despite the scale and trajectory of the issue, insurance solutions have struggled to adapt. 

This mismatch is becoming increasingly difficult to ignore. Dementia does not behave like the acute conditions traditional insurance products were designed to cover. Instead, it unfolds gradually over many years, creating a sustained financial, emotional and caregiving burden. As a result, a significant protection gap is emerging – one that exposes families and insurers to growing risk. 

A growing and concentrated challenge 

According to The Lancet Public Health, dementia cases are projected to increase sharply worldwide, rising from an estimated 57 million in 2019 to more than 150 million by 2050. This growth is driven primarily by ageing populations rather than changes in disease incidence.  

The trend is especially pronounced in Asia Pacific, where populations are ageing more rapidly than in many other parts of the world. By the middle of the century, the region is expected to account for nearly half of all dementia cases worldwide, as noted in Alzheimer’s Disease International’s Dementia in the Asia Pacific Region report. This concentration of risk underscores the urgency for insurers operating in the region to reassess their approach. 

A fundamentally different risk profile 

Dementia presents a very different risk profile from most health conditions traditionally covered by insurance. It is a progressive disease that gradually erodes memory, judgment and independence over time. 

Unlike acute illnesses, where costs are concentrated around the time of diagnosis or initial treatment, dementia creates a long tail of financial need. As the disease advances, individuals increasingly require supervision, assistance with daily activities, and eventually full-time care. This progression can span many years – sometimes a decade or more – resulting in sustained and cumulative financial pressure. 

The impact extends far beyond patients themselves. Families often step into caregiving roles, absorbing the emotional strain and the economic consequences. Lost income, reduced productivity and out-of-pocket care expenses compound over time, making dementia a multi-layered financial risk. 

For every person living with dementia, at least one family member typically assumes a caregiving role. That means the impact extends well beyond patients themselves, through emotional strain, lost productivity and depleted savings. Ignoring caregivers means overlooking the full scale of the risk. 

Rising costs and limited coverage 

Treatment options for dementia have historically been limited to alleviating symptoms rather than altering the course of the disease. More recently, new therapies have emerged that can slow progression in early-stage Alzheimer’s disease. While clinically promising, these treatments are costly and often fall outside standard medical coverage. 

At the same time, non-medical costs – such as caregiving, supervision, home modifications and long-term care – represent a substantial and growing share of the overall financial burden. Taken together, the economic impact of dementia extends well beyond what conventional insurance structures were designed to address. 

The protection gap 

This combination of long duration, rising costs and complex care needs has exposed a significant protection gap. 

Public systems across Asia provide varying degrees of support, including community-based services, long-term care programs and disability schemes. However, these systems are rarely comprehensive. Co-payments, strict eligibility criteria and limited capacity mean that families are still required to absorb a considerable share of the cost. 

Private insurance, meanwhile, has not fully bridged this gap. Most traditional products – such as critical illness or disability coverage – are structured around clearly defined stage of the disease that trigger a payout. Dementia does not fit this model.

“The financial burden begins much earlier than typical insurance triggers. During the moderate stages of the disease, individuals may already require supervision, ongoing treatment and support, leading to mounting expenses. While some plans already cover moderate dementia, the broader challenge remains: dementia is a long, slow decline, a single lump sum, however well-timed, may not align with years of accumulating expenses”

This misalignment creates a critical gap in protection. By the time benefits are paid out, families may already have depleted a significant portion of their savings. 

Why traditional models struggle 

Dementia is uniquely difficult to insure. The condition is highly susceptible to anti-selection. Biomarkers can appear years before mild cognitive impairment (MCI) is detectable, and genetic tests can indicate elevated risk well in advance. The duration from MCI to moderate dementia can stretch a decade or more, giving individuals who suspect their risk ample time to seek coverage. This makes traditional risk selection exceptionally challenging. 

Beyond anti-selection, what is the right benefit design? Monetary support is most meaningful in early stages, where new drugs offer the greatest clinical value. Yet providing significant benefits early invites anti-selection and defies traditional risk assessment. A standard critical illness payout, designed for acute events, is ill-suited to a condition demanding sustained support – covering early treatment and ongoing non-clinical needs like home modifications. Designing alternative benefit structures that balance meaningful support with manageable risk remains an unresolved industry challenge. 

Reframing the opportunity 

Despite these challenges, dementia also represents a significant opportunity for insurers willing to rethink established models. 

Rather than treating dementia as a niche or late-life issue, it should be viewed as a structural shift in risk driven by population ageing. Addressing this shift requires a broader perspective – one that considers not only clinical needs but also the long-term financial realities faced by patients and families. 

Insurers are uniquely positioned to play a role in closing the protection gap, but doing so will require meaningful innovation in both product design and customer engagement. 

Where insurers can act 

Several areas stand out as particularly promising directions: 

  • Rethinking benefit structures
    Traditional lump sum payouts may not be sufficient for a condition that unfolds over many years. More flexible models – such as staged payments or benefits linked to the use of specific services – could better align with real-world needs. 
  • Supporting earlier intervention
    Emerging treatments are most effective in the earliest stages of the disease. Insurance solutions that facilitate early diagnosis and access to treatment could improve outcomes while also shifting the timing of financial support. 
  • Recognising the role of caregivers
    Expanding coverage to include caregiver support – such as respite care, mental health services or financial assistance – could address a critical but often overlooked aspect of the dementia burden. 
  • Encouraging earlier purchase  

True sustainability requires engaging customers earlier in life, when premiums are affordable and risk is not yet present. This is as much about consumer education as product design.

These approaches are not without challenges, but they also represent a path toward solutions that better reflect the realities of dementia. 

A strategic imperative 

As populations continue to age, the prevalence and impact of dementia will only increase. The protection gap is therefore not a temporary issue but a structural one – one that will shape the future of health and life insurance markets. 

For insurers, the question is no longer whether dementia will become a central challenge, but how quickly will they adapt to address it. 

Those who succeed will not only respond to a growing customer need but also redefine their role in supporting ageing societies. Those who do not risk being left with products that are increasingly misaligned with the realities their customers face. 

PartnerRe works with insurers globally to navigate these challenges, combining medical insight, underwriting expertise and regional experience to support the development of sustainable dementia solutions. 

This article presents a condensed perspective. For a deeper analysis of dementia progression, costs and insurance implications across Asia –Pacific, read the full article on the PartnerRe website www.partnerre.com. 

This article is for general information, education and discussion purposes only and does not in any way constitute medical, legal or professional advice.  

Dr. Peter Lau,

Chief Medical Officer, APAC Life & Health

PartnerRe

Bernice Yu

Senior Director, Product & Solutions, Greater China Region &

Southeast Asia, APAC Life & Health,

PartnerRe
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