Objective: The impact of financial access barriers to health care on the quality of life of patients with cognitive impairment is unknown. We aimed to estimate the association between the financial access barriers to health care and the quality of life among patients with cognitive impairment.

Methods: We used a retrospective pooled cross-sectional study with the data from the 2010 to 2017 National Health Interview Survey (NHIS). Measurement of financial access barriers was based on respondents’ "yes" to any of the following survey prompts: “couldn't afford medical care,” couldn't afford dental care,” “couldn't afford eyeglasses,” “couldn't afford mental health care,” “couldn't afford follow-up care,” or “couldn't afford specialists.” Cognitive impairment was determined if respondents answered “yes” to “limited in any way because of difficulty remembering or because of experiencing periods of confusion.” A multivariable logistic regression model was used to estimate the association between the financial access barriers to health care and patients’ reported quality of life.

Results: A total of 9,640 patients with cognitive impairment were identified out of 705,669 respondents for estimating the association between the financial access barriers to health care and reported quality of life. On the multivariate logistic regression, patients who reported financial access barriers to health care were less likely to rate their quality of life as “excellent,” “very good,” or “good” (OR: 0.70, 95% CI: 0.63 to 0.77, P-value: <0.001).

Conclusion: Patients with cognitive impairment who reported financial access barriers to health care are more vulnerable to have a lower quality of life, suggesting better care should be taken to these patients.