September 30, 2019
Older men and women who are cognitively “normal” but who are prone to falling for financial scams and other forms of fraud are at heightened risk of developing Alzheimer’s disease years down the road. They are also at heightened risk of developing mild cognitive impairment (MCI), a brain disorder that about half the time leads to full-blown Alzheimer’s disease.
The findings are not surprising: People with failing memory and thinking skills would be expected to have less judgment when it comes to assessing the reliability of sales pitches and other scams. But they underscore that the brain impairment that occurs in Alzheimer’s disease may arise years before memory loss and thinking problems become evident, many years before it is diagnosed.
Changes in judgment, and not just memory impairment, may be among the earliest signs that Alzheimer’s may be affecting the brain, said study author Patricia Boyle, a neuropsychologist with the Rush Alzheimer’s Disease Center in Chicago. “We need to think more broadly about Alzheimer’s disease. It’s not just a syndrome of memory impairment. There are these other behavioral symptoms that occur.”
Older adults frequently are targeted by con artists and tend to be highly vulnerable to scams and fraud, particularly those that are financial in nature. Older people are also less likely to report fraud, either because they don’t know who to report it to, are embarrassed, or remain unaware they have been scammed. However, there has been little research studying whether susceptibility to such scams is a predictor of later Alzheimer’s onset.
So for the new study, researchers from Rush Alzheimer’s Disease Center in Chicago asked 935 older men and women, many in their late 60s and 70s, to complete a “scam awareness questionnaire.” All were free from Alzheimer’s disease or other forms of dementia at the start of the study.
The researchers did not look for actual instances of victimization. Instead, the questionnaire consisted of five questions about behaviors related to openness to sales pitches, interest in potentially risky investments, and awareness of higher scam vulnerability due to older age. Is someone relatively likely to answer a phone call, for instance, even if they don’t know the number of the person who is calling? Are they willing to talk to “anyone”? Or quick to give a stranger personal information?
Over the following six years or so, participants underwent yearly psychological and memory tests to look for signs of dementia or memory impairment. During this time, 264 of the study participants died, and researchers did an autopsy of their brains to look for signs of Alzheimer’s disease.
Over the course of the study, 151 participants developed Alzheimer’s disease, and 255 developed mild cognitive impairment. Participants who had low scam awareness at the start of the study had higher risk for Alzheimer’s disease or mild cognitive impairment than participants with higher scam awareness. Low scam awareness was also associated, at the time of death, with more general brain changes typically observed in Alzheimer disease.
The findings were published in Annals of Internal Medicine.
The researchers say that these results suggest that low scam awareness may be an early sign of impending mild cognitive impairment and dementia. Evaluation of behaviors such as scam awareness may help to identify individuals at risk for dementia before memory and thinking problems become evident, they say. In any case, it is useful for the family and relatives to be aware that their loved one might be at increased risk of scammers.
In an editorial accompanying the study, Dr. Jason Karlawish of the University of Pennsylvania Perelman School of Medicine describes an elderly patient who was scammed out of most of his life savings by a slick fraudster who tricked him into thinking he had won the lottery. The fraudster called numerous times, acting friendly and getting the man to pay “taxes” and “fees” on his supposed lottery “winnings.”
The AARP warns that criminals have many ways to prey on the elderly. They may pose as agents of the IRS or of Medicare, or as debt collectors. They may even pose as a victim’s grandchild, calling late at night or emailing to get the elderly person to wire emergency funds for a grandchild in distress.
An older adult who is defrauded may end up unable to pay for medications, food and long-term care. As such, the findings from this study should be a call to action for health care systems, the financial services industry and their regulators to protect the health and wealth of our aging population, Dr. Karlawish notes.
The study authors stress that their findings do not indicate that being scammed means a person will develop Alzheimer’s disease. But the findings do suggest that susceptibility to scams could be a red flag for families that something may be wrong with a loved one.
By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Patricia A. Boyle, PhD; Lei Yu, PhD; Julie A. Schneider, MD, MS, et al: “Scam Awareness Related to Incident Alzheimer Dementia and Mild Cognitive Impairment: A Prospective Cohort Study.” Annals of Internal Medicine, April 16, 2019