Financial Problems May Precede Alzheimer’s Diagnosis

Deteriorating financial capabilities appear to be among the earliest signs of cognitive decline.

This finding is based on analysis of Medicare beneficiaries living in single households. Single-beneficiary households were specifically chosen so that the presence of a spouse without cognitive decline—or less severe impairment—would not impact the data. Married couples may not show signs of financial problems if the less impaired spouse steps in and takes over responsibilities.

The study looked at a period of seven years prior to diagnosis and four years after. More than 81,000 Medicare beneficiaries were included. Approximately 27,000 of them received a diagnosis of Alzheimer’s disease or related dementia for at least one quarter of observation. The average age of those with a diagnosis was 79.4.

“After adjusting for demographic and health characteristics, we found important differences in adverse financial events among Medicare beneficiaries who did versus did not develop ADRD that emerged prior to clinical diagnosis,” observed the study’s authors. Beneficiaries who developed ADRD were at significantly higher risk of payment delinquency compared with similar beneficiaries who never developed ADRD beginning six years prior to diagnosis.”

As you can see in the chart, there is a noticeable increase in the portion of beneficiaries with missed credit payments before and soon after being diagnosed. In an email to us, corresponding author Lauren Hersch Nicholas explained, “While the majority of households with and without dementia never experience these adverse financial events, the heightened risk of these and related financial problems among those with early-stage and undiagnosed dementia is important to watch out for.”

Cognitive impairment not only impacts one’s ability to manage finances, but puts one at greater risk of being scammed. Fraudsters commonly target retirees, hoping to take advantage of those who are less willing to ask questions or otherwise are easily conned due to impairment.

Sources: “Financial Presentation of Alzheimer Disease and Related Dementias,” by Lauren Hersch Nicholas, Ph.D., MPP et al., JAMA Internal Medicine, January 11, 2021; and “Financial Problems Can Foreshadow Alzheimer’s Disease,” AAII Investor Update, May 6, 2021.