By 2050, Alzheimer’s cases in the U.S. are projected to double — from about 7 million people today to nearly 14 million. Globally, dementia cases are expected to triple, topping 150 million. That’s not an abstract number. It means almost every CPA firm will be touched by this issue through clients, colleagues or family members.

Why start a conversation about burnout with Alzheimer’s? Because the link is closer than most realize. Chronic workplace stress — the hallmark of burnout — floods the brain with stress hormones that literally change its structure. The memory center (hippocampus) shrinks, the decision-making center (prefrontal cortex) weakens and the fear center (amygdala) goes into overdrive. These changes don’t just cause brain fog or poor focus in the moment; over time, they increase long-term risks for cognitive decline and dementia.

For CPAs, the cost compounds on two levels: personally and organizationally.

The Personal Cost

• Your brain slows down. Stress rewires memory and decision-making. Errors creep in, and judgment calls take longer.
• Your body pays interest. High blood pressure, diabetes, and cardiovascular disease rise with chronic stress. A “bad busy season” can cascade into lasting health issues.
• Your relationships suffer. Burnout shows up as irritability, withdrawal, or cynicism, eroding patience at home and empathy at work.

The Firm’s Cost

• Efficiency drops. Burned-out CPAs log more hours but produce less. Rework and presenteeism eat into billable capacity.
• Turnover doubles. Fatigue and stress make professionals twice as likely to leave — whether through resignation, early retirement, or medical leave. Replacing even one mid-level CPA can cost 1.5–2x their salary in lost productivity and recruiting.
• Reputation erodes. Clients notice when staff are disengaged, slow to respond, or constantly “under water.” Trust — the core of client relationships — quietly weakens.

Why Doing Nothing Costs More

Burnout isn’t just a personal problem, and it’s not something you can “push through.” Left unaddressed, it compounds like interest: small leaks today turn into career-ending crises tomorrow. The real cost of doing nothing is measured not only in mistakes and turnover, but also in long-term brain health, firm profitability and the pipeline of future leaders.

The good news is, prevention doesn’t require a wholesale culture overhaul overnight. It starts with small, intentional changes:

• Protecting true downtime and recovery like you would a client appointment.
• Training managers to recognize early warning signs.
• Treating rest, boundaries and resilience as business investments, not perks.

The Bottom Line

CPAs know better than anyone that errors left uncorrected only compound over time. Burnout works the same way. The question isn’t “can we afford to address burnout?” It’s “how much longer can we afford not to?”