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Years Before Diagnosis, People With Alzheimer's Lose Financial Acumen
  • Posted December 3, 2020

Years Before Diagnosis, People With Alzheimer's Lose Financial Acumen

Even before signs of Alzheimer's disease or dementia appear, people are prone to make poor financial decisions, a new study finds.

Older people diagnosed with dementia or Alzheimer's were more likely to miss credit card payments as early as six years before their diagnosis, compared with similar people without dementia (about 8% versus 7%), the researchers found.

Patients with dementia were also likely to have lower credit scores in the three years before diagnosis than those without dementia (about 9% versus 8%). These financial problems were more common among patients with less education, the findings showed.

"Missed bill payments can have catastrophic consequences, like losing a home, car or business. By the time dementia is detected, it may be too late," said lead researcher Lauren Hersch Nicholas, an associate professor and health economist at Johns Hopkins University Bloomberg School of Public Health in Baltimore.

Faltering financial acumen can also leave older people vulnerable to scammers.

"We don't have access to data on phone scams, but worry a lot about those," Nicholas said. "Given the patterns that we're seeing, along with other research suggesting that people who are more susceptible to fraud in hypothetical survey questions are more likely to develop dementia in the future, I would definitely view falling for a phone scam as a potential early sign/symptom that I would monitor."

However, "earlier detection of dementia can help protect patients from these financial errors," she added. "When dementia is diagnosed, it is important to make sure that patients are also receiving assistance in managing their money."

For the study, Nicholas and her colleagues collected data on more than 81,000 Americans receiving Medicare, a federal health insurance program for people who are 65 or older, or disabled.

"Although we currently lack treatments to delay or reverse dementia, our work points to an important role for strategies like emergency financial contacts that can help to protect financial security of people with dementia," she said.

Nicholas also believes that community financial institutions have a part to play in protecting their older clients.

"Businesses like banks and credit card companies may be on the front lines on dementia detection and prevention," she said.

Heather Snyder, vice president for medical and scientific operations at the Alzheimer's Association, said these findings are not surprising, and "add to other work in this area aiming to identify what may be the first noticeable changes a person may experience."

Past work highlights that changes in judgment, financial ability or decision-making may be the first memory and thinking changes that people and family members notice, Snyder said.

This new research suggests an association between early Alzheimer's-related brain changes and poor financial decision making, she said. "It does not, however, prove cause, and it does not mean that older individuals who miss a payment have dementia," Snyder stressed.

Many other personal, social and economic reasons can account for why someone may make poor financial decisions, such as making late payments or overspending.

"If you are concerned about an individual's changes in memory or judgment, schedule an appointment with the doctor to discuss the symptoms and get an evaluation," Snyder said.

And if a decline in mental acuity is spotted, there are ways to help shield individuals against fraud and scammers.

According to the Alzheimer's Association, "because of their vulnerability, people with Alzheimer's disease hold a higher risk of being victims of scams, fraud, and crime." The association recommends:

  • Putting up a "no solicitation" sign on the outside entrance to the home.
  • Calling the national "Do Not Call" Registry (1-888-382-1222) to cut down on phone solicitations.
  • Removing a person's name from the credit bureau's mailing list. To do so, call the Consumer Credit Reporting Industry at (1-888-567-8688).
  • Registering with the DMA (Direct Marketing Association), www.dmachoice.org to help reduce solicitations by mail.

The new study was published online Nov. 30 in JAMA Internal Medicine.

More information

For more on helping a loved one avoid scams, including the common "grandparent scam," head to the Alzheimer's Association.

SOURCES: Lauren Hersch Nicholas, PhD, associate professor, health economist, Johns Hopkins University Bloomberg School of Public Health, Baltimore; Heather Snyder, PhD, vice president, medical and scientific operations, Alzheimer's Association; JAMA Internal Medicine, Nov. 30, 2020, online

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